Background and objective:
Small scale water supply systems (SSWS) in rural areas in Serbia are facing with many challenges in providing safe drinking water to rural population, likewise in in entire pan-European region. This was the first comprehensive situation analysis aimed at assessing the drinking water quality and the sanitary condition conducted in Serbia. Drinking-water quality monitoring in rural areas is less enforced in the Monitoring programme on drinking water quality in Serbia, hindering a comprehensive understanding and systematic assessment of the situation of SSWS, as well as the effective planning and implementation of adequate improvement measures at national and local levels.

Methods:
This national survey was undertaken in rural areas of the Republic of Serbia in 2016 and on the basis of the WHO rapid assessment methodology. The total number 1,136 of small piped systems were inspected, using sanitary inspection forms for each water technologies and in total 1,168 of water samples were taken and analyzed for E. coli and selected physico-chemical parameters against national standards for drinking water quality.

Results:
Only 66.9% of water samples taken from SSWS were in compliance with the National standard regarding E.coli, 55.6% were in compliance regarding physico-chemical characteristics, while overall compliance was 36.9%. The most prevalent identified sanitary risks were: absence of fence in 73%, managing by unqualified personnel in 70%, close vicinity to the source of contamination in 64%, and unsatisfactory technical conditions in 55%,

Conclusion:
This study pointed to the high health risk for rural population in Serbia as a consequence of microbiological contamination of drinking water from rural SSWS and revealed poor sanitary conditions. It is crucial to develop an action plan at national and local level for the improvement of the situation on small-scale water supply systems in rural areas.