Drawing on implementation experiences from Tamil Nadu, this module explores different approaches to strengthening sanitation access. It examines community and public toilet management models, including community-led initiatives and public-private partnerships, as well as efforts to improve individual household toilet provision and last-mile sewer connectivity.

This module introduces on-site sanitation systems (OSS), focusing on their design, siting, construction, operation and maintenance. Drawing on lessons from TNUSSP, it highlights why getting OSS right during initial construction is critical for public health, environmental protection and long-term efficiency.

Drawing on Tamil Nadu's experience, the module examines approaches to strengthening and scaling E&T services, particularly by building on an existing private-sector-led service system. It explores choices around service delivery models, regulation, access to treatment facilities, and worker safety and inclusion. Through these experiences, learners will gain insights into the opportunities, challenges and trade-offs involved in strengthening E&T services.

This module explores fecal sludge treatment as a critical link in the urban sanitation chain, drawing on lessons from TNUSSP. It covers planning, technology selection, design, operation and maintenance of treatment systems, including dedicated fecal sludge treatment plants (FSTPs) and co-treatment at sewage treatment plants (STPs).

This module examines two important dimensions of inclusive sanitation: integrating gender into sanitation programmes and improving the well-being of sanitation workers. Drawing on experiences from Tamil Nadu, it explores how these priorities can be translated into action, from initial assessments and programme design to implementation and institutional strengthening. Note: This module focusses on TNUSSP's work on gender and sanitation workers. Initiatives on access with a focus on urban poor is covered in Module 2 of this MOOC.

This concluding module provides an opportunity to reflect on the programme's journey, including the choices made, challenges encountered and lessons learnt. The module also brings together key lessons from across the sanitation chain and examines what it takes to sustain safe sanitation services at scale. It explores how policies, regulations, institutional arrangements and capacities can support the institutionalisation of sanitation initiatives, alongside the costing and financing considerations required for their long-term sustainability.