The introduction of multi-stage filtration, a biological water treatment technology that only uses sand and gravel, producing excellent treatment results should be an autonomous process. Two case studies in six developing countries show, however, that this is not the case. Success and failures in the cases show the complexity of the introduction of water treatment, which needs to take into account the technical, socio-economic, organizational and environmental aspects with special attention for the human dimension. The research spans a period of thirty years of fascinating evolution in the water and sanitation sector and concludes that multi-stage filtration is an excellent technology but, similar to any innovation, it can only work if it is embedded in society.
Based on these experiences and extensive literature review it is concluded that the facilitation of projects and programmes needs considerable improvement. Learning projects that have been used in one of the projects provide great possibilities for this. These projects were the forerunners of FLAIR, Facilitating of Learning, Application, Implementation at scale, and Reflection. This form of facilitation is essential for the introduction of innovation in the water and sanitation sector and has important implications for governments, donor agencies, NGOs and, especially, universities in both developed and developing countries, whose task will be to equip their graduates with the necessary FLAIR.