Self-supply, where households invest to develop their own easily-accessible water supplies, is identified as an alternative service delivery model that is potentially complementary to more highly subsidised community-level provision. The approach is widespread in Ethiopia with family wells bringing additional benefits that are in line with wider government objectives, such as supporting small-scale irrigation. However, two recent studies show the current performance of traditional or family wells to be far below potential with most sources providing unsafe water in the absence of adequate protection. Wider formal recognition of Self-supply in policy and the development of the government-led Self-supply Acceleration Programme (SSAP) aim to extend access and improve aspects of performance including water quality. However, a key finding of the paper is that successful uptake of this programme requires a transformation in the attitudes of donor agencies and the roles of government regional- and woreda-level staff, amongst others. Necessary shifts in mindsets and revision of planning mechanisms, as well as the day-to-day operational support requirements, represent a challenge for an under-resourced sector. Other household-focused development interventions such as Community-led Total Sanitation (CLTS) and Household Water Treatment and Storage (HWTS) face some similar challenges, so the processes for the development of one approach could help in the scaling up of all.