In the coastal cities of West Africa, land use change, rapid population growth, bad sanitation systems and poor environmental governance degrade the quality of groundwater. This study aimed to assess alternative, acceptable, affordable sanitation disposal and practices for groundwater quality rehabilitation in the cities of Cotonou and Lomé. The study was based on the participatory transdisciplinary approach, field surveys, feedback from interactions with stakeholders, experiences of the practitioners and institutional consultations. This multi-stakeholder approach helped to appreciate ecological aspects of sanitation disposal and its implications on water quality improvement. SWOT model was used to analyze the relevance of assessed ecological system. Well water quality is deteriorated by traditional waste management disposal. Ecological sanitation systems are septic tanks on polyethylene, above-ground latrines and phytoremediation technique in the swamp areas. Collected wastes are used for composting and biogas production. Based on the optimist scenario at 2030 horizon, kind success factors of groundwater security are participation of citizens, existence of sanitation market, valorization of the waste by category, low-cost disposal adaptable to the individual, household and neighborhood's scales. The strategic directions rely on funding and public policies for WASH, ecological sanitation disposal, cultural environment and good sanitation practices for emergence of new sanitation system to secure and sustain well water quality. But the social acceptability of ecological disposal is limited by the society's multicultural heritage.