Investigations were conducted on the total and faecal coliform status of streams, hand-dug wells and boreholes highly patronised by communities in the West Akim and Kwaebibirem Districts, Eastern Ghana. Total coliform values obtained range from 60–2,672 cfu, 0–680 cfu and 0–128 cfu for streams, hand-dug wells and boreholes, respectively. Faecal coliform values similarly range from 31–1,988 cfu, 0–136 cfu and 0–36 cfu for streams, handdugs and boreholes, respectively. The data indicates that samples from streams and hand-dug wells returned high coliform counts beyond the Maximum Permissible Levels (MPL) recommended by the World Health Organization (WHO). Some borehole water contained coliform counts above MPL. Because many rural people in the areas studied, and indeed in most areas in Ghana, depend heavily on these principal sources of water for drinking and other domestic purposes, a policy response that incorporates periodic assessment of water quality in rural communities may be appropriate. In addition, it would seem that current government and development partner programmes in the water resources sector that emphasise provision of borehole water must be integrated with land use considerations, water quality monitoring and education on environmental awareness in local communities.