In Nepal, only 25% of water supply schemes are functioning well. While there are several approaches to setting up schemes, there is only one model of ongoing service management – community-based management through local water user committees. This case study describes how Oxfam, LeFil Consulting and Nepali enterprise SmartPaani have explored alternative models to boost effectiveness and efficiency of water service delivery. The team surveyed water supply schemes in two regions of Nepal and carried out a sensitivity analysis to estimate the impact of various ‘levers’ on the profitability, and therefore sustainability, of rural water supply schemes. These levers will now be tested together with local government, with the aim of demonstrating that on a scale of 220,000 water supply users, better water service delivery is possible.