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Gravity-fed water systems are widely used in the rural hills of Nepal. This study identifies the systematic factors that contribute to rural households not obtaining water due to system breakdowns. The study makes use of data from a 2017 to 2018 study of 202 households served by 10 community-based water systems from three localities within the western middle hills of Nepal. A hierarchical regression model is used to capture both household- and system-level variables. The analysis identifies three household-level and three system-level predictors of the duration of water system breakdowns. The significant household-level predictors include (1) a sense of ownership toward the water system, (2) user involvement in decision making during the planning and implementation of the water system, and (3) income earned from water-based productive activities. The significant system-level predictors include (1) distance from the village to the water source, (2) the performance of the water user committee, and (3) the water system operator's level of activity. In addition, the interactions between household- and system-level variables are captured. The empirical relationship between household productive income and the duration of breakdowns is a novel finding. These findings will be valuable to the Nepalese government and other actors working to implement sustainable water systems. ; Published version