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In this chapter, we argue that monitoring progress towards global goals of universal water and sanitation coverage is valuable, but that the priority given to using similarly constructed indicators internationally has undermined their local relevance, and has supported misleading rural–urban comparisons, diverting attention from severe urban deficiencies. The first section examines how the understandable desire to develop internationally applicable water and sanitation’ladders’, and common technical criteria for defining coverage, have contributed to the underestimation of urban deficiencies and a monitoring system insufficiently supportive of local improvement efforts. The second section uses the case of Dar es Salaam to illustrate these claims, and includes an example of water and sanitation ‘climbing frames’ developed with the help of focus groups of residents from informal settlements. The chapter concludes that …