Effective management of natural resources is essential for the attainment of the overarching object of sustainable development spelt out in the Millennium Development Goals. The world, however, is increasingly being confronted with problems of excessive resource exploitation and environmental degradation. Water resources, which are the focus of this study, are being over-exploited and contaminated, leading to supply shortages and increased incidence of water related diseases.Water purification strategies were characterized by subjectivity and imprecision which affected their efficacy and potency. Community decision-making processes lacked an inclusive character, and women were sidelined in decision-making, as community leaders who developed meeting agenda and guided the flow of deliberations were predominantly males. Generally, this research made a case for incorporation of the wealth of resource use knowledge and the range of management approaches utilized by the study communities into water resources use and management schemes in Ghana.