ABSTRACT: Access to safe water and improved sanitation continue to represent considerable challenges for Ethiopia‟s development. Diarrhoea caused by unsafe water and sanitation is responsible for almost a quarter of the deaths of children under five. The Government estimates that the proportion of the population with access to a water supply is 68.5% (81.5% in urban areas and 65.8% in rural areas); however, international estimates are much lower for rural areas – around 26%. The situation for sanitation is even worse, with access to improved sanitation at around 8%. The fourth Health Sector Development Programme (HSDP IV) reported that 44%, or 32.5 million Ethiopians, have no access to even basic sanitation facilities. Again, international estimates are lower – WHO/UNICEF report that about 88% of Ethiopia‟s population, a shocking 65 million people, have no access to improved sanitation.