Equitable access to safe drinking water remains a key challenge in many urban areas of low- and middle-income countries. This study aimed to characterize the enabling environment for inclusive urban water service delivery, and specifically to elucidate the institutional arrangements, policies, regulations, service delivery approaches, financing models, and surrounding contextual factors that influence progress. We identified six cities across Africa, Asia, and South America that offered historical examples of success in inclusive piped water provision, resulting in high levels of access and service quality, including within low-income areas. Using a modified form of the social-ecological systems framework to structure our investigation, we conducted a comparative case study analysis to learn from these cities. Our analysis focused on a review of existing case-specific literature, supplemented by interviews with 1–3 key informants per case to update or fill gaps in the literature. A variety of characteristics supported safe and inclusive services, with contextually appropriate strategies depending on existing institutional arrangements, infrastructure, and the surrounding social, economic, political, and environmental context. Our study cities illustrated three types of progress–utility-driven, regulator-supported, and municipality-driven–each characterized by specific features and drivers of success. We also identified 12 characteristics making up the enabling environment across all three types. These characteristics highlighted two broad themes. First, a well-functioning water service provider was often a prerequisite for inclusive, pro-poor service provision. Elements such as clear performance indicators, customer feedback mechanisms, and strategies to sustainably finance operating costs contributed to cities’ success. Second, inclusive water services often required explicit pro-poor policies and strategies, such as the removal of land tenure requirements for piped connections and community mobilization for participatory decision-making. Although the importance of specific characteristics will vary depending on context, our analysis offers a common foundation to guide progress toward universal access to safe water.
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