Small and medium-sized towns, here considered as towns with less than 100,000 inhabitants, carry the brunt of urbanisation; most future urban growth is expected to occur in these towns. Sanitation coverage in small towns will thus be key to achieving the Sustainable Development Goals (SDGs).
Although the challenges are similar to big cities, small towns suffer from a weaker institutional base, lack economies of scale, and have fewer funding opportunities available. In many countries, the high level of centralisation of the state hinders access to national budget transfers, or existing decentralisation processes have delegated responsibilities to municipalities, but without the necessary financial transfers.
These limitations are most apparent in the delivery of basic services, such as water, sanitation and solid waste management.