Town Sanitation Planning in Northern Uganda

Contributed by Irene Alinga, Fred Nuwagaba (GIZ Sanitation for Millions), Trinah Kyomugisha Elizabeth Babita, Martin Mukasa, and Felix Twinomucunguzi (Ministry of Water and Environment, Uganda)

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High urbanization in Sub-Saharan Africa (SSA) has led to the proliferation of small towns, with significant challenges in achieving safely managed sanitation. The predominant toilet system is the pit latrines, which are abandoned when full and the burden of the recurring cost of re-building toilets must be catered for by the owners of the facility. There are no standards for toilet design, the supply chain for sanitation products is fragmented, and thus making the cost of toilet construction high. Additionally, there are limited options for safe emptying and disposal. This lack of access to safely managed sanitation exposes a significant population to sanitation-related diseases, which further limits the socio-economic development of the small towns. An integrated and inclusive approach in planning interventions to address sanitation related challenges in small towns is generally lacking.

This case study highlights the successes, challenges and lessons learned in piloting Town Sanitation Planning (TSP) approach, towards enhancing sustainable sanitation solutions along the service chain in small towns in Northern Uganda. The approach was implemented by Uganda’s Ministry of Water and Environment (MWE) in partnership with the Deutsche Gesellschaft für International Zusammenarbeit (GIZ) under the Sanitation for Millions project, commissioned by the German Federal Ministry for Economic Cooperation and Development (BMZ). The TSP approach includes mechanisms that facilitate mindset change to improve sanitation and hygiene behaviors and practices, inclusive sanitation and hygiene facilities that take care of the needs of girls and people with physical disabilities, putting in place legal and institutional frameworks, sanitation financing mechanisms for households and institutional private sector capacity strengthening on operation and maintenance of sanitary facilities. The case study is relevant to policymakers and development partners trying to look for ways of solving sanitation issues in small towns in developing countries.

Date of publication: March 2023

Geographic information



Town cluster and population:

Apac: 45,000
Oyam: 40,000


  • High urbanization levels have resulted in many small towns predominantly relying on on-site sanitation facilities for safe disposal of faecal matter.
  • Despite the over reliance on on-site sanitation in small towns, there is inadequate socio-institutional capacity to plan and manage the sanitation service chain to ensure safe disposal of faecal matter. In Uganda, only less than 40% of the faecal matter is safely managed.
  • There is a lack of coherent plans to analyse the extent of the sanitation challenge in small towns, nor strategic plans towards addressing the challenges.


  • In response to the sanitation challenges in small towns, the MWE in partnership with GIZ piloted the Town Sanitation Planning approach, focusing on strengthening institutional capacity of urban councils. The capacity to identify sanitation gaps and develop action points bridge the identified gaps in an integrated and participatory manner.
  • Town Sanitation Plans (TSPs) provide a strategic framework to deliver on the set short-term, medium to long-term goals of sanitation in small towns. It is being promoted to properly integrate and coordinate various sanitation-related measures on the local level, including co-ordination with town planning, sanitation marketing and behaviour change, involvement of local businesses, fully-fledged stakeholder participation and law enforcement, among others.

1. The Problem

Achieving inclusive safely managed sanitation in urban centres remains a daunting challenge in low-income countries of the world. High urbanization levels in SSA have resulted in many small towns, which depict urban characteristics, but are not gazetted cities. Such urban centres are usually faced with inadequate financing and planning capacities to implement sustainable inclusive sanitation approaches. Access to safely managed sanitation services in SSA is still low at 46%, compared to a global average of 88%. In Uganda, over half of the urban population (with the total urban population of approximately 20 million) reside in small towns, with low access to safely managed sanitation, estimated at less than 40%. The small towns mainly rely on on-site sanitation (OSS) facilities, especially pit latrines. However, when the pit latrines are full, there is a significant gap in safe emptying and ultimate safe disposal of the faecal matter, leading to environmental contamination. This unsafe disposal results into proliferation of sanitation-related diseases leading to loss of life, loss of productive time, all which lead to reduced socio-economic development.

Despite the over-reliance on on-site sanitation in the small towns in Uganda, there was lack of standards in existence to guide the construction of sanitary facilities, limited compliance to the existing laws (Public Health Act, Physical Planning Act, Building regulation etc.), limited awareness on safely managed sanitation and poor hygiene and sanitation practices. These, and many other sanitation-related issues, affect social and environmental safety and sustainability throughout the country. Safely managed sanitation does not necessarily consider only provision of sanitary facilities but also includes the operations of sanitation as a system, i.e., from containment, emptying, transportation, treatment, to disposal and/or reuse of end-products. However, there are significant socio-institutional challenges, including inadequate financing of sanitation services in the small to medium sized towns, limited institutional capacity, especially of the urban councils, to identify their sanitation gaps and develop action points to bridge the identified gaps in an integrated and participatory manner. As such, there are no coherent plans or sufficient strategies on how to overcome the challenge of attaining sustainable development goal 6.2 in the small towns in Uganda.

2. The solution

The MWE in partnership with GIZ has been supporting the use of TSP approach in the past 10 years. The TSP approach seeks to coordinate, integrate, and improve various sanitation-related measures at the local level, including aspects of solid waste management. It takes into consideration coordination of town planning, sanitation marketing and behaviour change communication, involvement of the local private sector, fully-fledged stakeholder participation and law enforcement. The TSP process is undertaken in each of the towns and starts with the formation of a Sanitation Taskforce (STF), a multi-disciplinary team of technical staff within the urban councils. Technical capacity development of the STF members follows, and it is ensured that the baseline sanitation situation is assessed properly. The baseline report is validated through a stakeholder forum. Based on the findings, the STF then develops the TSP in a cooperative manner and ensures its approval by the town council and its integration into the 5-year Town Development Plan. During preparation for implementation of the TSP, a monitoring framework is elaborated, including timelines and targets to be monitored. The TSP usually is evaluated on an annual basis and adaptations can be agreed on and integrated in the amended 5-year Town Development Plan.

The approach was piloted in six small towns of Apac, Aduku and Ibuje in Apac Cluster, and Loro, Oyam and Kamdini in Oyam Cluster in Northern Uganda. To date, scaling has been achieved in 29 other urban centres across the country. So far, the towns are implementing and reviewing the plans annually and several achievements have been registered, including but not limited to the following:

  • Enabling environment has been transformed through budget allocation for sanitation activities. For example, Apac Municipal Council used to allocate 20% of its health budget towards sanitation activities which most times remained unfunded. However, after the TSP process, the allocation towards sanitation activities increased to 35% and became a funded priority. Enactment of by-laws that have been gazetted in the towns and targeted financing of the urban poor through sub-structure subsidies. Political leaders were also trained in governance and regulation enforcement.
  • Sanitation service delivery has improved through better capacity of the local technical teams to have data on sanitation services, behavioural change campaigns (Figure 2) and knowledge exchanges with other major towns in Uganda.
  • A backbone for sanitation services has been imprinted through local masons gaining skills to construct appropriate sanitation technologies, linking households to financial services to access sanitation loans, motivating and equipping the private sector participants, among others.
  • Dedicated budget allocation for sanitation activities and subsequent implementation of the activities for sanitation improvement.

Unresolved challenges in the TSP process include:

  • Lack of a national sanitation policy has greatly hampered the growth of a stronger enabling environment for sanitation improvement in Uganda.
  • Insufficient funding and, as such, all major infrastructure projects are highly dependent on external funding.
  • Limited staffing, staff transfers especially of Town Clerks, and high staff turn-over within the local governments, which negates sustained implementation of TSPs.

3. Lessons Learned

  • Development of an inclusive plan towards addressing town sanitation challenges is a precursor to the formulation of a realistic strategy towards addressing the sanitation needs of the town. TSP enhances a holistic approach to sanitation – that is it involves sanitation improvements along the entire value chain. For example, in Apac municipal council, there has been an increase in the number of improved/emptiable toilets at household level (71.4% of households were using unlined/traditional pits at baseline – 2015, 48.5% use unlined pits by September 2019).
  • Capacity development of both the technical and political authorities has created awareness of the leaders (technical and political) on existing sanitation gaps and triggered action to provide solutions. This has guaranteed buy in and proper coordination between the technical and political leaders.
  • Formation of a multidisciplinary and inclusive STF is crucial in the planning process. The broad composition of the STF members provides a wider base for discussions, ideation and informed decision making. This includes the integration of the TSP into the 5 years’ development plan, which puts sanitation activities such as awareness creation, community mobilization, enforcement activities among others on the priority list for adequate funding, especially using locally raised revenue, without necessarily requiring external support.
  • Formation of a stakeholder forum that involves several stakeholders plays a key role in Water, Sanitation and Hygiene (WASH) improvement in the towns, as their ideas lead to increased participation and ownership.
  • The existence of holistic sanitation by-laws is critical for creating awareness, improving enforcement and up-scaling of standards. The by-laws therefore cover all aspects of the sanitation service chain, including solid waste management at all levels.
  • The TSP approach enables the sanitation needs of the towns to be put at the centre of activities within the Town Development Plan, rather than the development partner imposing the project on the town authority. This improves ownership of the planned activities.
  • Inclusive capacity development is key for sustainability and ownership. Exposure visits and knowledge sharing are important aspects that help to build confidence and motivation to improve the prevailing sanitation situation.
  • Engagement of local service providers is crucial, especially during provision of low-cost toilets, emptying and transport services, treatment, and reuse/disposal of wastes. It is critical to sustainability e.g., local masons were trained, and they construct toilets according to the approved minimum standard for OSS, manual pit emptiers were trained on safe emptying using the gulping technology and can offer emptying services within the cluster at a much lower cost.

About us

About the Author(s)

Felix Twinomucunguzi holds a PhD (Civil and Environmental Engineering), MSc Resources Engineering, MMS Project Planning and Management and BSc Civil Engineering. He serves as an Assistant Commissioner in charge of urban sanitation in the Ministry of Water and Environment, Uganda.

Irene F. Alinga has over 8 years of experience in institutional WASH and faecal sludge management, with an interest in stakeholder management to enhance meaningful participation. She is the Sanitation and Hygiene Technical Advisor at the GIZ Sanitation for Millions Programme, overseeing the support to increase access to adequate and improved sanitation in small towns, in Northern Uganda.

Fred Nuwagaba is a civil engineering professional with over 20 years of practice. He possesses extensive experience in planning, development, and strategic coordination of implementation of social services, physical infrastructure projects, including urban water and sanitation provision. Currently he is the Country Manager for the global GIZ Sanitation for Millions programme in Uganda, managing the promotion of access to improved, safe sanitation and hygiene in small towns and cities in Uganda.

Trinah Kyomugisha is a Senior Environmental Health Officer under the Urban Water Supply and Sewerage Services Division, Ministry of Water and Environment. She is responsible for the implementation of urban sanitation and sewerage services under the Ministry. She holds an MSc in Water and Sanitation Engineering (KYU), Master of Public Health (MUK), Postgraduate Diploma in Project Planning and Management (UMI) and a bachelor’s degree in environmental health science (MUK).

Elizabeth Babita is the Senior Environment and Sanitation Officer under Water and Sanitation Development Facility North (WSDF-N), Ministry of Water and Environment. She has 15 years of experience in WASH, with special interest and focus on faecal sludge management and institutional sanitation in small towns. Elizabeth Holds a Master of Integrated Water Resources Management (University of Dare Salaam) and Bachelor of Environmental Health Science (MUK).

Martin Mukasa is the Senior Environmental Health Officer at the Ministry of Water and Environment, under the Urban Water Supply and Sewerage Division. He supports system strengthening and sanitation governance and has keen interest in health promotion, specifically on improving sanitation service delivery for the urban poor. Martin holds a Master and Bachelor of Public Health (Clerk International University).

About the institution / organisation

Deutsche Gesellschaft für International Zusammenarbeit – GIZ Sanitation for Millions

Sanitation for Millions Sanitation for Millions is a GIZ programme commissioned in 2016 by the German Federal Ministry for Economic Cooperation and Development (BMZ) as a multi-donor programme to contribute to safe and adequate access to sanitation. It considers the entire sanitation chain and applies sustainability criteria to ensure long-lasting results in line with the Sustainable Development Goals, in particular SDGs 6, 4 and 3. The programme operates worldwide, focusing notably on the needs of disadvantaged and vulnerable groups such as children, women and girls, indigenous communities, refugees and internally displaced people, as well as persons with disabilities.;

Ministry of Water and Environment

The Ministry of Water and Environment is the lead government agency with the overall responsibility of the development, managing, and regulating water and environment resources in Uganda.