Government leadership at both the national and sub-national levels is an essential step towards ensuring safely managed sanitation services for all. Though the importance of sub-national government leadership for water, sanitation and hygiene is widely acknowledged, to date much of the focus has been on the delivery of water services. This article sets out to start to address this imbalance by focusing on practical ways to galvanise and foster sub-national government leadership for sanitation programming. By focusing on the experiences across three sub-national areas in East Africa where positive changes in the prioritisation of sanitation by local governments have been witnessed, we (a group of researchers, local government representatives and development partner staff) cross-examine and identify lessons learnt. The results presented in this paper and subsequent discussion provide practical recommendations for those wishing to trigger a change in political will at the local level and create the foundation to strengthen sanitation governance and the wider system needed to ensure service delivery for all.

Climate change is a growing concern that exposes and deepens existing inequities and vulnerabilities with sanitation and hygiene access, use and safe management of facilities. It will continue to challenge the expansion of rural sanitation and hygiene coverage, with climate impacts disproportionately affecting already disadvantaged and marginalised groups. This publication unpacks the reasons behind the limited progress towards addressing climate change in the sanitation and hygiene sector, explores its impacts on rural sanitation and hygiene practices and provides actionable ideas to integrate climate thinking into rural sanitation and hygiene programming.