Community organizations working with local NGOs have been responsible for many of the most cost-effective initiatives to improve and extend provision for water and sanitation to low-income urban households. Some have achieved considerable scale, especially where water and sanitation utilities and local governments work with them. Many of the initiatives that improved and extended provision for water and sanitation were not 'water and sanitation' projects but initiatives through which urban poor households developed better quality and more secure housing and housing finance services that helped them do so. This publication describes many such initiatives and discusses their relevance for meeting the Millennium Development Goal (MDG) target for water and sanitation.