To reduce child mortality and improve health in Ghana boreholes and wells are being installed across the country by the private sector, NGO's and the Ghanaian government. Water quality is not generally monitored once a water source has been improved. Water supplies were sampled across Ghana from mostly boreholes, wells and rivers as well as some piped water from the different regions and analysed for the chemical quality. Chemical water quality was found to exceed the WHO guidelines in 38% of samples, while pH varied from 3.7 to 8.9. Excess levels of nitrate (NO3−) were found in 21% of the samples, manganese (Mn) and fluoride (F−) in 11% and 6.7%, respectively. Heavy metals such as lead (Pb), arsenic (As) and uranium (U) were localised to mining areas. Elements without health based guideline values such as aluminium (Al, 95%) and chloride (Cl, 5.7%) were found above the provisional guideline value.\ud \ud Economic information was gathered to identify water costs and ability to pay. Capital costs of wells and boreholes are about £1200 and £3800 respectively. The majority of installation costs are generally paid by the government or NGO's, while the maintenance is expected to be covered by the community. At least 58% of the communities had a water payment system in place, either an annual fee/one-off fee or “pay-as-you-fetch”. The annual fee was between £0.3–21, while the boreholes had a water collection fee of £0.07–0.7/m3, many wells were free. Interestingly, the most expensive water (£2.9–3.5/m3) was brought by truck. Many groundwater sources were not used due to poor chemical water quality. Considering the cost of unsuccessful borehole development, the potential for integrating suitable water treatment into the capital and maintenance costs of water sources is discussed. Additionally, many sources were not in use due to lack of water capacity, equipment malfunction or lack of economic resources to repair and maintain equipment. Those issues need to be addressed in combination with water quality, coordinated water supply provision and possible treatment to ensure sustainability of improved water resources.\ud \u
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