The implementation timeframe of this institutional development effort was almost six a half years of continuing consultant input. Many lessons were l earned in this this period and many of these lessons are highly relevant, not just to the specific case of the National Water Supply and Drainage board, but also to institutional development of utility agencies everywhere. This report concentrates on the institutional development elements of the Water Supply and Sanitation Sector Project, other project activities which were not directly related to institutional upgrading are dealt with in separate reports.