Many rural communities in sub-Saharan Africa still lack clean water for basic needs such as drinking and washing. Even where water points have been constructed, many break down prematurely or provide inadequate, seasonal or poor quality water supplies. While techno-managerial factors are relevant in explaining these problems, attention is needed to the institutional and political-economic dynamics shaping policy outcomes on the ground. This report presents the findings from a political economy study of Malawi’s rural water supply sector. Combining a review of the literature with in-country interviews at a national and district level, the analysis identifies the underlying causes of bottlenecks in the service delivery chain, which undermine sustainability and functionality of water points. These relate to structural factors (i.e. the political, economic and institutional context) and actors’ practices, influence and incentives.