The document summarizes a study on the cost of rural and small town water service delivery in Ghana's Bosomtwe District. The study used a life cycle cost approach to determine the capital, operation and maintenance, and capital maintenance costs of providing water services through small town piped systems versus rural handpumps. The results showed that the capital expenditure and running costs for small towns were about twice and four times higher respectively than for rural water point systems. However, small towns provided a higher standard of water service. The conclusions recommended that district water plans incorporate full life cycle costs and asset replacement, and that the government increase funding to support post-construction maintenance and operations.