This book explores two frameworks for progressing structural change that supports safe, universal and equitable water, sanitation and hygiene (WASH): systems strengthening and the human rights to water and sanitation. As such, it elaborates and defines the intersection between these two areas. Whilst inherently interconnected, the two also represent different entry points for change, with opportunity for increased intentional integration to improve progress towards Sustainable Development Goal 6: Clean water and sanitation.Systems strengthening is widely recognised as foundational for ensuring access to sustainable, equitable WASH services in low- and middle-income countries, leaving no-one behind. Such systems comprise clear sector policy and strategy, effective institutional arrangements, sufficient sector financing, regular cycles of planning, monitoring and review and capacity development across the sector; as well as the people, interactions, power relations and behaviours that shape these elements.Equally, the human rights to water and sanitation provide numerous entry points for change, both in supporting people to claim and realise their rights and in supporting and advocating for governments at all levels to respond.Effective approaches to strengthen systems and realise the rights depend on inclusive processes that meaningfully involve people and advance equality, including gender equality. They facilitate mutual learning, capacity building and increased accountability, promote informed choice and place development in the hands of those it concerns.In Focus a book series that showcases the latest accomplishments in water research. Each book focuses on a specialist area with papers from top experts in the field. It aims to be a vehicle for in-depth understanding and inspire further conversations in the sector.