Since the late 20th century, water and sanitation management has been deeply influenced by ideas from economics, specifically by the doctrine of neoliberalism. The resulting set of policy trends are usually referred to as market environmentalism, which in broad terms encourages specific types of water reforms aiming to employ markets as allocation mechanisms, establish private-property rights and full-cost pricing, reduce (or remove) subsidies, and promote private sector management to reduce government interference and avoid the politicization of water and sanitation management. Market environmentalism sees water as a resource that should be efficiently managed through economic reforms.
Instead of seeing water as an external resource to be managed, alternative approaches like political ecology see water as a socio-nature. This means that water is studied as a historical-geographical process in which society and nature are inseparable, mutually produced, and transformable. Political ecological analyses understand processes of environmental change as deeply interrelated to socioeconomic dynamics. They also emphasize the impact of environmental dynamics on social relations and take seriously the question of how the physical properties of water may be sources of unpredictability, unruliness, and resistance from human intentions. As an alternative to the hydrologic cycle, political ecology proposes the concept of hydrosocial cycle, which emphasizes that water is deeply political and social. An analysis of the politics of water flows, drawing from political ecology explores the different relationships and histories reflected in access to (and exclusion from) water supply, sanitation, and drainage. It portrays how power inequalities are at the heart of differentiated levels of access to infrastructure.