This document provides an annual review and summary of activities for Integrated Regional Support Program (IRSP) in 2012. It discusses several projects implemented by IRSP including promoting civil society participation in water and sanitation governance in Pakistan. For this project, IRSP established a network of 15 civil society organizations in Mardan district and built their capacity in areas such as participatory planning and budget tracking. Through this project, over 23,000 people gained access to safe water supplies and 25 communities engaged in activities to improve sanitation.