The health and environmental impact of unsafe sanitation affects more than half of the world’s population. The lack of access to safe sanitation affects disproportionately rural populations in low- and middle-income countries, where progress is also shown to be slower. The sheer scale of the problem, combined with the variability of climate, geographies, and socioeconomic conditions, requires a variety of adaptable, scalable, centralized, and decentralized solutions working cohesively. This paper presents the case of Mosan, an off-grid, market-based sanitation solution, in order to display how such sanitation approaches can contribute to bridge this gap by addressing the communities most at risk. Mosan is a decentralized, circular sanitation solution encompassing the whole sanitation chain from containment, collection, transport, transformation, and reuse. Focused on community-scale systems, Mosan is applying participatory design principles and co-creation to enable community engagement, raise awareness, trigger creativity, and support local innovation.