Abstract
Inadequate water, sanitation and hygiene (WASH) is a significant health burden in Rwanda. Although current approaches for improving water and sanitation provision to enhance health outcomes are often narrowly associated with monetary exchange, analysis of two informal settlements in Kigali (Gitega and Kimisagara) shows that households attempt to meet their water and sanitation needs through four interlinked exchange systems (market-based, command-based, culturally determined and non-market-based exchange systems). By focusing on existing social relations and exchange systems, sanitation practitioners may be able to foster and strengthen these interlinked water and sanitation marketing exchange systems embedding in the local context and local capabilities, and as a consequence improve the lives of the low-income communities of informal settlements.