The objective of this study is toanalyze how integrated policy, institutional, and regulatoryinterventions (institutional interventions in brief) canhelp align incentives for more sustainable water supply andsanitation (WSS) service delivery. The context for the studyis the enhanced global concern about the sustainability ofattempts to increase access to, and improve the quality of,WSS services, as exemplified in the sustainable developmentgoals. Aligning institutional interventions refers toharmonization among the objectives for the sector, agreedprinciples established through political and socialprocesses, and the organizations and mechanisms thatimplement actions based on such objectives and principles.This report focuses on the formal policy, institutional, andregulatory interventions available to and or prevalent inthe water sector, recognizing the critical importance of theinformal conventions that will be key factors in the successof any incentive regime. Previous global initiatives offereda range of promising technical solutions that often provedto be unsustainable. New thinking that draws not onlyinfrastructure economics but also on the understanding ofpolitical, behavioral, and institutional economics isneeded. This new thinking must be grounded within thediffering contextual realities of countries globally and inlessons learned from what has or has not worked with regardsto achieving specific objectives.