Catholic Relief Services led the implementation of Madagascar’s Rural Access to New Opportunities for Health and Prosperity (RANO Ham Pivoatra or RANO HP) and Rural Access to New Opportunities for Health and Water Management (RANOn’ala) projects between October 2009 and September 2013. Funded by the U.S. Agency for International Development, both projects improved access to reliable and safe water and sanitation services in targeted areas, in part through the establishment of public-private partnerships. Using private funds, CRS has continued to monitor these partnerships. While not without challenges, about 90 percent of the systems are still functioning at the time of writing — two years after the end of project funding.