The period between 1990 and 1997 saw a record growth in the number of public-private partnerships (PPPs) for provision of water/sewerage services in developing countries. Nonetheless, PPPs have not fared well in sub-Saharan Africa, which accounted for 80% of the PPP contracts that attracted disputes or were cancelled between 1990 and 2004. Since the 1980s, management contracts between international water operators and utilities in Africa have been promoted by the World Bank and other multi-international agencies as a model that could boost management capacity in utilities of developing countries and lead to improved effectiveness and efficiency. The present study draws upon empirical data from Kampala, Uganda and uses it as a case study to show that, on the whole, these expectations were not fulfilled. It is demonstrated that the performance improvements of the National Water and Sewerage Corporation, the utility in Kampala, were not as high as expected when it was twice managed by different international operators. On the other hand, the corporation has made impressive performance improvements under the current public management model. Conclusions have been drawn from the case study on what are the drivers of performance improvement in the water utilities of developing countries.