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Access to water supply and sanitation in Ethiopia is amongst the lowest in Sub-Saharan Africa and the entire world. While access has increased substantially with funding from external aid, much still remains to be done to achieve the Millennium Development Goal of halving the share of people without access to water and sanitation by 2015, to improve sustainability and to improve service quality.

Some factors inhibiting the achievement of these goals are the limited capacity of water bureaus in the country's nine regions and water desks in the 550 woredas; insufficient cost recovery for proper operation and maintenance; and different policies and procedures used by various donors, notwithstanding the Paris declaration on aid effectiveness.