This report summarizes the findings of a Water and Sanitation for Health (WASH) Project team in providing technical assistance to the government of Slovakia. The purpose of the activity was to identify and analyze options for restructuring the institutions which deliver drinking water and wastewater services at the local level. This activity, conducted from August to November 1993, is the latest in a series of WASH activities supported by the U.S. Agency for International Development (USAID) in the water/sanitation sector in Slovakia. It is part of USAID's overall program of environmental assistance to East and Central Europe.