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An international symposium was held in April 2010 to discuss the current issues and initiatives of rural water services. The aims of the symposium were to: provide a platform for learning about, and sharing possible ways of improving, initiatives on sustainable rural water services at scale; debate and analyze these emerging initiatives; and identify common principles to facilitate improved policy and practice in water service delivery. This report presents the main findings of the symposium, based on the work of the different streams during the symposium, as well as the discussion of the experts in the panel and the inputs of all those who presented papers. A number of priorities emerged from the symposium and can best be summed up as the next steps in community managed rural water services are about strengthened governance and improved management.