Pollution from wastewater and solid waste is a significant problem for developing countries, especially in urban and peri-urban areas. Unfortunately, these countries lack the financial and institutional resources to manage waste through the combination of advanced technology and strict regulation used by industrialized nations. This report presents a methodology for improving waste management within these limitations. According to the methodology, there are three possible points of intervention: the individuals and institutions responsible for pollution, those responsible for waste management (e.g., environmental resource and water treatment plant managers), and policies and actions to diminish the adverse effects of pollution. Policy and management are assumed to be the primary influences at each of these control points. The methodology has four steps: (1) determining the health, environmental, social, and economic impacts of poor waste management; (2) identifying key groups and institutions whose decisions and actions affect waste management; (3) examining technologies, policy instruments, and institutions (the three key components of any waste management program); and (4) developing, from the best combination of these three components, a strategy for a national program or a project funded by international donors. Such a strategy should be guided by five principles: health risk reduction, pollution prevention by reducing waste at the source or recycling, provision of efficient services, cost recovery from those who benefit, and selection of appropriate treatment and disposal technologies. Appendixes include an annotated bibliography; a technical discussion of the potential impacts of waste; and information on U.S. water quality standards.