Providing safely managed sanitation/hygiene requires key competencies for education, training, service delivery, enterprise development and management, product and infrastructure design and development, construction and installation, governance, financing, research, etc. These strategic sanitation capacities will have to be built from higher education’s academic and professional programmes structured and designed to produce skilled and knowledgeable professionals and practitioners. This study aims to investigate the quality of the sanitation/hygiene management content of Environmental Health programmes; the adequacy of the existing central curricula; and the perception of environmental health sanitation/hygiene-trained professionals to determine the next phase for building knowledge and capacity of sanitation professionals in Nigeria through higher education institutions. A multi-level mixed method concurrent study was used for sampling and data collection with a multi-level perception analysis to examine the perceptions of students, lecturers and graduate alumni, as well as employers/supervisors and clients/service users of sanitation/hygiene-related graduates. The main findings of this paper show a limited understanding of the concepts of contemporary issues of sanitation/hygiene management like sustainable sanitation, citywide inclusive sanitation, regenerative sanitation, circular bioeconomy, etc.; the central/national teaching and curricula were found to be seriously out of date; and clients/service users were dissatisfied with the skills and knowledge levels of the graduates. The study concludes by recommending a national sanitation management higher education pathway to guide the provision of integrated sanitation/hygiene management education at higher education institutions (HEIs), to build an effective, efficient, competent and sufficient workforce for the country.