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Water and sanitation are core for the growth and development of communities. Yet, South African local municipalities are often unable to sustainably deliver safe water and basic sanitation for all. Drawing on perspectives of ecological economics, this study analysed the sustainability of water and sanitation systems in rural communities of the Lepelle Nkumpi Local Municipality. Mixed research approach was used to collect the data from 657 household and institutional respondents. The study found that households used water for multi-purposes including consumptive, productive and domestic, but existing facilities are in deplorable condition. Pollution arising from agrochemicals, waste systems, mining, sewerage, and industrial effluence significantly affected water systems in the communities. Bridging demand-supply gaps require initiatives like bulk water supply and implementation of the free basic water policy in underprivileged areas. Tariffs should either be waived or adjusted for extremely poor households. Waste management initiatives, like capacity building, public education, investments, and facility upgrade, could help avert spread of waterborne infections and improve the resident's health., Competing Interests: Conflict of interestThe authors declare that there is no financial nor competing interest associated with the paper submitted for publication., (© The Author(s), under exclusive licence to Springer Nature B.V. 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)