NGOs have played a significant role in facilitating access to clean water technologies for off-grid villages in Ghana. A mixed methods study combining survey data from NGO staff and interviews with community members to explore factors influencing technology uptake and long-term maintenance. Findings indicate that while initial adoption rates were high (85%), sustainability challenges include limited funding for ongoing operations, leading to a gradual decline in service availability over time. Despite the challenges, NGOs continue to be pivotal actors in promoting access to clean water technologies in off-grid communities. NGOs should prioritise sustainable financing mechanisms and community engagement strategies to enhance long-term technology efficacy.