Uganda has experienced a major policy shift from a supply-driven to a demand-driven approach in rural water provision since 1990. The article sheds light on the rural population’s access to safe water within the changing institutional frameworks. We analysed individual and group interviews with key informants from national to community levels and relevant official documents with the ‘Social-Ecological Systems’ framework. Since the implementation of the demand-driven approach, rural safe water coverage has slightly improved but operation and maintenance of water sources pose a great challenge hampering, long-term access to safe water. The abrupt and top-down imposed policy shift has resulted in competing signals from old and new policies creating uncertainty and ambiguity about responsibilities, rules and incentives. The analysis shows the importance of taking into account the implications of national institutional disturbances on local collective action for long-term access to safe water.