The method can be used at different levels in the planning process – from early on and at an overarching level, to decision-making before implementation, to post-implementation – to understand the sustainability of different existing systems.

With this report we have the following objectives.
1. To present a sustainability assessment method that will identify strengths and weaknesses of different sanitation alternatives along the service chain from different co-defined sustainability perspectives.
2. To act as an inspiration to improve and optimize existing sanitation systems.
3. To act as an inspiration to introduce sanitation innovations to improve environment and health sustainability.

The authors examine sustainability of different sanitation systems considering all stages of the sanitation chain, and they provide a broader picture of sanitation approaches in Bolivia, which tend to prioritize large infrastructure improvements at the collection or treatment stages that require higher investments.

Nonetheless, with current national sanitation policies including better practices that improve sustainability of existing systems, the content of this report is timely. The illustrative case study in the city of Montero, with different sanitation systems simultaneously in place, and further comparison with an innovation scenario proposed by the authors, serve as examples worth exploring when planning, implementing and improving systems to achieve safe and equitable sanitation for all inhabitants of growing cities in Bolivia, but also in other countries in Latin America.