About 50% of total world's population is rural population (WB,2011), and water services delivery projects in these settlements are not sustained. Inadequate operation and maintenance has exacerbated non sustenance of the services and hence lowering water supply coverage. This book offers a rich reflection on Constraints in Technical, Financial, Institutional and Social/Environment dimensions. It reaches new heights by analyzing sustainability index using Multi-Criteria Analysis Framework (MCA) and identifies potential opportunities to suppress these constraints. The book provides appropriate use and application of available resources and techniques in planning, operating and maintaining water supply services as opposed to most rural beneficiaries perception of " we are poor, we can't manage". Its Context is contented to MDG goal No. 7 targets 7A & 7C and gives analysis of high order and in a well structured manner for Constraints and Opportunities and with stunning observations. This book is recommendable to Engineers, Researchers, Water Service Providers, Water Sector Practitioners & Professionals,Policy Analysts and other parties interested on sustainability of Water Services