Increasingly, partnership arrangements are including health and hygiene promotion activities. Through the development of greater health awareness and understanding of the origins and risks of water- and faecal-borne disease, the BoTT in South Africa hopes to promote understanding of the importance of paying for water. Other initiatives, such as those established through the work of the operator in El Alto, have not promoted this link, but have focused on health and hygiene as a central part of their efforts to empower individuals, strengthen communities and raise awareness of some of the key dimensions of poverty. In order for benefits to be realised, the timing of health and hygiene promotion activities needs to match the programme for service improvements. Such activities may need to be linked into other important activities (such as mother and child care or financial services), and they should be delivered by agents that the communities trust.