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Solving the problem of inadequate access to sanitation in unplanned settlements in East Africa needs to combine social and technical dimensions in such a manner that they fit the local context. The modernized mixtures approach offers an analytical framework for identifying such solutions, but this approach requires effective methods for participatory decision making. This article intends to contribute to filling this gap by identifying and further elaborating an appropriate multicriteria decisionmaking tool. The multicriteria decision analysis methodology, Proact 2.0, offers an adequate solution as it creates the possibility to connect knowledge, experiences, and preferences from scientists, experts, and policy makers with those of the end users. We show in particular that users not always prefer the most optimal sanitation system, defined from an "expert" point of view. This article concludes that using Proact 2.0 can lead to substantial improvements in decision making in the field of sanitation in unplanned settlements in East Africa.

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Urban slums in East Africa exhibit deplorable sanitary conditions. Despite (inter)national efforts, slum sanitation provision remains inadequate and the projected population growth forecasts a worsening of this crisis. The core of the problem is that available knowledge about the local feasibility of the currently applied sanitary methods is limited. This paper analyses the interface of sanitation policy and technology domains by reviewing the distribution and local characteristics of current centralized and decentralized sanitation options. The findings confirm that conventional, centralized sanitation is an unrealistic solution for application in slums. Simplified sewerage may prove appropriate, but the reported initiatives are in the planning phase only. At present, only decentralized sanitation options are found to be viable in the assessed slums, but their servicing is increasingly neglected by the municipal authorities. The quasi-monopoly of pit latrines implies that improved sanitation technologies are not sufficiently rooted yet. Public toilets are crucial to these slums, especially where land tenure issues prevail. Although the potential of ecological sanitation is currently negligible, novel biocenter initiatives are promising. Municipal authorities are advised to prioritize the implementation of elsewhere successful slum sanitation technologies and to integrate appropriate decentral solutions into their predominantly centralized sanitation schemes.