Rural drinking water quality is an emergent issue in the State of Punjab. In response to health concerns related to children being exposed to metals in some regions, and reports of higher incidence of cancers in the state, the department of drinking water supply and sanitation conducted blanket testing of all its water supply sources. The objective of this study was to systematically examine the drinking water quality issue and provide practical guidance to the state on possible responses. The state's commitment to addressing this issue is highlighted by its allocation of 59 million dollars for a component to improve water quality through the Punjab Rural Water and Sanitation Sector Improvement Project, financed by the World Bank. While the study seeks to provide an analytical basis for understanding the occurrence and impact of the contamination, practical actions have been explored and demonstrated to allow the state to begin actively managing the water quality issue. The study is designed around three key areas: understanding the problem
taking appropriate action
and institutional sensitization and action. This report is a first step toward understanding and managing water quality issues in the state. It provides an analytical basis for moving forward and has demonstrated approaches that have yielded valuable lessons for scale-up. The next steps are for the state to identify key actions and develop detailed action plans for implementation.