Potable water and sanitation facilities access constitutes one of the major problems faced by developing countries. In Senegal, more than 70% of urban centres lack drinking water distribution networks and satisfactory sewage systems. For this reason, public authorities have initiated series of institutional plans to strengthen the implementation of water and sanitation policies in various urban contexts as in the town of Rufisque. Geographical and epidemiological investigations were carried out from 2003 to 2005 to evaluate these policies impact in Rufisque. The goal was to assess health impact of various water supply and sewage management systems. Results show that operating different water supply and sewage management systems induces considerable variations on community's sanitary, environmental, social, economic and political development. Despite of some progress made, many areas in the town still have difficulties to access to safe drinking water and to satisfactory sanitation services. The behaviours of the communities are still lacking the right changes. Spontaneous and growing urbanisation has increased the financial and other capacity shortfalls mainly at municipal levels. This paper makes an inventory of areas where these policies were implemented, and emphasizes the important role that scientific research would better have to play to reinforce their achievements.