Currently, one-third of hand pumps in sub-Saharan Africa are estimated to be non-functional within the first few years after construction. Professionalized maintenance arrangements demonstrate the potential to solve this issue, but only if local governments support them and if communities demand and are willing to pay for improvements. This research, produced by USAID’s Sustainable WASH Systems Learning Partnership (SWS), identified the combined influence of operational, political, social, natural, and physical conditions on contract retention among consumers over a period of 3 years, indicating sustained consumer demand and willingness to pay for professionalized maintenance services over time. Evidence suggests that operational, social, and political conditions may be sufficient to enable high-contract retention, irrespective of the natural and physical conditions of an implementation context. Given the importance of local government participation for sustainability, this research further examined the constraints on and determinants of local government follow-through on key supportive actions, finding that policy changes alone are unlikely to motivate support.