The aim of this chapter is to explain the challenges of decentralisation and management of water as economic good principles of integrated water resources management (IWRM) in Malawi in the rural areas of Ntcheu, Balaka, and Mangochi. Semi-structured interviews, focus group discussions, community meetings, and observation of water points were conducted. It was established that households and other state institutions prefer to receive services from Mpira-Balaka Water Users Association, which subsidizes households, rather than Southern Regional Water Board, which operates along commercial lines. The chapter questions the focus in the implementation of IWRM, which remain the establishment and fixing of decentralised institutions whilst recognising water as an economic good.