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This dissertation presents the design and case study application of a participatory decision-making support tool for appropriate safe water systems development in marginalized low-income communities of the global South. The tool focuses on the resolution of two key design decisions: 1) selecting the appropriate level of application (i.e. household or community level) for a safe water system; and 2) selecting an appropriate water treatment technology (or technologies). The tool breaks the process down into four stages. First are pre-implementation steps which develop a contextualized, baseline understanding of the local community. Second is community-based field research, including focus groups and key informant/informal interviews, to investigate the two key design questions by exploring local preferences, capacities, and circumstances with community-members, government officers, NGO workers, and other stakeholders. Third are analytical steps to integrate information from baseline, informal, and primary research to generate recommendations on the two key design questions. This includes a comparative analysis of household and community level systems; a technology feasibility flowchart; performance assessments of technological alternatives with respect to appropriate technology criteria; and a multi-factor analysis to integrate information from the preceding analytical steps. Fourth are community forums in which further participatory action and research is planned on the basis of the recommendations emerging from the tool. Through these steps, the decision-making support tool guides implementing organizations through the stages of safe water systems design and planning in a manner that centres local people in the process. The tool weaves together several theoretical and methodological strands including humanitarian engineering, post-normal science, appropriate technology, participatory development, grounded theory, engineering decision-making, and water treatment engineering. The case study application of the decision-making support tool was conducted in a marginalized peri-urban community called Mylai Balaji Nagar in Chennai, India. This indicated that a household level approach is more appropriate for the case study community and that the TATA Swach filter, alum coagulation with chlorination, or boiling, in order of decreasing suitability, may be appropriate technologies for household application in the case study community. / Degree: Doctor of Philosophy Department: School of Engineering Advisor: Hall, Kevin / International Development Research Centre (IDRC)