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Our research addresses problems associated with water quality and sanitation in the Bagrami District of Kabul Province in Afghanistan. Like many other districts in the Kabul Province, Bagrami has serious problems with waterborne disease morbidity and mortality, which are major public health concerns that pose a threat to social and economic development. Our book includes: (1) an analysis of cases of waterborne diseases in Bagrami District from 2003- 2007; (2) a review and assessment of the effectiveness of three recent water supply and sanitation projects carried out by aid organizations;(3) a description of a Bagrami water sanitation project one of the authors managed in 17 villages in spring 2008; and (4) our recommendations on how to improve the effectiveness of water supply and sanitation projects in Bagrami and other areas of Afghanistan based on insights gained from this study.