Ghana, like most developing countries, struggles to improve access to water and sanitation to its urban population. Presently, many areas within the country do not have access to clean water from the national grid. And in areas served by the approved utility company, water service is mostly erratic and increasingly unreliable. Available evidence indicates that only 59 percent of urban residents have access to improved drinking water. The main policy tool aimed at improving water supply is private sector participation in the water sector. The inadequacies in urban water supply are felt disproportionally in disadvantaged or peri-urban communities. Often, the needs of the disadvantaged communities are hidden in the aggregate statistics of the larger urban areas. This research theorizes that because of the unique characteristics of the disadvantaged community—a high concentration of low income dwellers, squatter communities, and poor infrastructure developments—private sector participation often has very limited effect on the disadvantaged communities. Using a multiple case study approach, this study analyzes the unique water problems faced by disadvantaged urban communities. The research concludes by espousing a multi-sectoral approach which utilizes all resources and uses multiple avenues for water delivery as the best approach to ensure water security to disadvantaged communities.