Access to safe drinking water and adequate sanitation are basic necessities of life, yet not everyone in the world is able to access these services, particularly people living in rural areas. Rural areas in Ghana, defined as communities with populations less than 5,000 people, and some rural areas in the United States (US), defined as non-metropolitan communities, experience water and sanitation-related issues to varying degrees. The purpose of the field study was to examine individual and community level issues related to sanitation, and water sources, water quality, treatment and management, water needs and water-related illness in Accra, Ghana, and to determine areas of similarities and differences with the US. Thus, study results are not generalizable to the entire population of Ghana. Given the short duration of the entire field study (three weeks) and the fact that most information on water and sanitation in the US is publicly-available, secondary data from various sources were used for the US comparison. Results from the study showed that 61.4% of study participants in the selected communities in Accra and 80.0% of Americans living in rural areas had access to safe water. Lack of access to toilet facilities was minimal in rural communities in both Ghana and the US. Copyright © 2022 Willis et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.