Background: Continued management of sanitation and hygiene services, post-intervention, is a global challenge,
particularly in the school-setting. This situation threatens anticipated impacts of school sanitation and hygiene
investments. To improve programming and policies, and increase the effectiveness of limited development
resources, we seek to understand how and why some schools have well-managed sanitation post-intervention,
while others do not.
Conclusions: Findings corroborate those from a similar study in Belize, and comparison suggests the need for
financial community support and the possibly tenuous reliance on local champions in the absence of adequate
government support for operations and maintenance. Sub-determinants to the necessary conditions are also
discussed which have implications for school sanitation in Bangladesh and may have broader relevance for other
low-income countries though further research is needed.