In 2019, Babati had neither proper wastewater management system nor sanitary solid waste disposal. The main challenge to address this was the reluctance of authorities to invest and work with other actors on sanitation and hygiene. This was partly due to the common misconception that sanitation has to be done with a sewerage system, with very large capital costs, even though the town relied on on-site sanitation. An action research programme took stock of the situation through a formative research, data collection with city authorities and communities, a political economy analysis and a Shit-Flow-Diagram. The results were used for a scenario planning workshop which brought together many town actors to identify which options for sanitation and for hygiene were possible and preferable.