This paper presents the preliminary stages of a research program centered on the development of a systems approach to water and sanitation service management and operation. Given high failure rates of rural water and sanitation infrastructure in developing countries, the sector now points to “systems approaches” as ways for practitioners and service stakeholders to understand the economic, institutional, political, environmental, and technical externalities that drive sustained service provision. Unfortunately, systems approaches and techniques often rely on expensive or inaccessible forms of quantitative data and are inaccessible to local stakeholders. Moreover, limited evidence exists for the true benefits of a systems approach in supporting sustained service provision. This research aims to fill these gaps by developing and refining an accessible participatory systems mapping approach to modeling factor interaction as a means to improve identification and characterization of leverage points for improved policy and practice for water and sanitation services. Coupled with this, application of computer models of the water and sanitation systems will help to identify areas of technical vulnerability that, alongside stakeholder interviews, will help prioritize which technical interventions, if any, would be most effective.