To evaluate and reflect thesustainability of services in the region, an overall sectorsustainability assessment was done taking into account fourmain dimensions: access to services, quality of services,efficiency of services, and financing of services. Each ofthese dimensions is measured through three simple andobjective indicators. For each indicator, best practicevalues are established by looking at the best performers inthe region. Countries closest to those best performers aredeemed to have a more mature sector. A more completedescription of the methodology to assess the sectorsustainability is included in the Annex of the state of thesector regional report from the Danube Water Program. Theoutcomes of this assessment for Romania’s water sector aredisplayed, which also shows average and best practices inthe Danube region. The Romanian sector sustainability scoreis 56, which is below the Danube average sustainability of64, and which is among the lowest scores in the region. Thisis partly due to the fact that a large percentage ofRomania’s population lives in rural areas, where only 29percent are connected to pipe water and 10 percent haveaccess to flush toilets (UNECE/WHO 2010). Aside from that,the main deficiencies identified regarding the Romanianwater sector through the sector sustainability assessmentare affordability, wastewater compliance, and operating costratio. Romania is, however, performing well in terms ofcollection ratio and customer satisfaction. The main sectorchallenges are: improving access to water and sanitationservices in rural areas; strengthening the capacity ofoperators to ensure implementation of investment projects;addressing affordability issues regarding water andsanitation prices; and improving efficiency of water utilities.