A mix of secondary and primary research was conducted to examine the hypothesis that access to an at-house water supply will deliver significantly greater health, social and economic benefits than those derived from a shared public water supply. The research was carried out by a team from the University of Leeds, University of North Carolina, University of East Anglia, the London School of Hygiene and Tropical Medicine and University College London, and was based on a mix of literature review and field-base case studies. Fieldwork was carried out in three countries; Ghana, South Africa and Vietnam and used a mix of data collection methods, specifically a three-part household questionnaire, which included anthropometric measures and the measurement of water collection journeys, natural group discussions, and contextual checklists. The headline conclusion from the research is that at-home water supply has significant, measurable benefits when compared with shared water supply outside the home provided that the service provided is reliable enough to ensure access to adequate quantities of water when required. Reliable at-home water supply results in higher volumes of water consumed, greater practice of key hygiene behaviours, a reduction in musculo-skeletal impacts associated with carrying water from outside the home, and improved water quality. This suggests a logical policy shift towards the promotion of reliable household access as the international benchmark for water supply