This chapter focuses on West and Central Africa, a sub-region of the African continent as delineated by United Nations Children's Fund (UNICEF) and World Health Organization (WHO). Hygiene and sanitation, by default, fell under the auspices of public health departments. This is because no specific unit of government was established to directly take care of sanitation and hygiene matters. In Ghana, a formal government entity in charge of water supply was created as far back as 1928. This entity, the Hydraulics Unit of the Public Works Department (PWD), was responsible for water supply. As already observed, water and sanitation conditions in the West and Central Africa sub-region tend to leave much to be desired. However, the situation in Kinshasa in particular and the Congo Democratic Republic in general needs to be evaluated in the context of recent events in that country. The country is emerging from a series of internal strives and violent conflicts.