A description of the relation between sanitation and infant mortality prefaces this wide-ranging discussion of programs to improve water supply and sanitation (WS&S) in developing countries. The discussion explores incentives and constraints to the use of new WS&S facilities, the significance of cultural behavior patterns in this regard, and the need to find technologies to relieve women of the onerous task of drawing and carrying water. Stressing the primary roles women play as mothers, managers, motivators, communicators, and agents of change, the discussion concludes that improving WS&S systems requires not only increasing physical access to water, but in also providing the household equipment needed to make hygienic use of water and training women to use and to teach their children to use the new equipment.