The sustainability of community-managed drinking water systems is a major concern in low-and middle-income countries (LMICs). Water system breakdowns occur frequently, and intermittent piped supplies are common. Some water systems continue to function for decades while others fail shortly after implementation. While many water, sanitation and hygiene (WaSH) stakeholders have sought to learn from failures, we examined what processes have fostered sustainability of community-managed water systems. We conducted qualitative and participatory field research in 18 rural communities in Kenya, Ghana, and Zambia through interviews, focus group discussions, community mapping, timeline activities, and structured observations. Additionally, we conducted interviews with World Vision stakeholders and post-construction support providers. In total, 321 recordings totaling 237 hours were collected between June and August 2015. Data were coded and analyzed thematically.
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