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37% of Developing world s population lack access to safe and clean water, 2.5 billion people lack improved basic sanitation and hygiene. Over 780 million people still use unsafe drinking water. Trans - Nzoia County, Kenya faces similar challenges hence, limited to achieve health and MDG goals. Traditional approach on appropriate technology and synergistic community participation at household level is no longer in practice, thus projects initiated by Development partners, lack continuity due to limited community participation and ownership, thus no empowerment to provide sustainability. This book therefore provides few social metric evaluations to ascertain community participation in basic health concepts, in order to mitigate and recommend. Evaluation is based on education attained and type of community participation involved, reality of functional community with WASH concepts, example observing foot paths to pit latrines. Accessibility to safe and clean water and how knowledge, attitude and practice influence. Analysis should assist Donors to comprehend that, appropriate technology and synergistic partnership form bench map for project community ownership and sustainability.