Water is critical to the lives and livelihoods of rural communities in developing countries; however, access to water can be inequitable within communities. This paper uses a generalized integrated assessment approach to explore the determinants of water access by marginalized farmers in two villages in coastal Bangladesh, before and after the setup of local water institutions. The study was part of a broader project aimed at promoting socially inclusive agricultural intensification. An integrative framework was developed in this study to capture and link the diverse range of factors that influence the distribution of water, including the often-overlooked role of social dynamics and governance arrangements. While interventions around improving water resource infrastructure can be critical for freshwater availability, the case studies show that a breakdown of asymmetric power structures may also be needed for water access to all individuals, especially marginalized groups. Establishing a community-based water institution on its own does not necessarily address power issues in a community. It is imperative that the agency and capacities of the marginalized members are developed and that the institutional arrangements foster an enabling environment for marginalized members to influence decision making. Integrated assessment allowed the case studies to be explored from multiple perspectives so as to gain a greater understanding of the barriers and levers to obtaining equitable outcomes from water interventions.