From leadership research to district action: Stakeholder priorities for sustaining operations and maintenance of school sanitation facilities in Kampala City, Uganda

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

Introduction Sustaining sanitation services in schools in low resource settings requires effective operation and maintenance (O&M), yet the relative influence of management on service reliability remains poorly understood. Methods This study employed a participatory multi-criteria decision-analysis (MCDA) design to identify stakeholder-derived priorities for O&M of sanitation facilities in Kampala schools. The Analytic Hierarchy Process (AHP) was used to weigh domains, and the SWING method was used to prioritise indicators. Stakeholders were selected using purposive sampling techniques. Participants included practitioners from civil society organisations involved in school sanitation programmes, and regulators from relevant ministries and Kampala Capital City Authority (KCCA). The sample also included researchers who had published on sanitation in Kampala, as well as Head Teachers and Sanitation Teachers from the study schools. Thirty five stakeholders attended a facilitated workshop and completed structured AHP and SWING weighting exercises. The data collection instruments were adapted from standard MCDA templates and customised for the school sanitation O&M context. Their validity was strengthened through expert review, pre-testing, and structured participant orientation. AHP consistency ratio checks were also conducted, and all responses met the required threshold (CR ≤ 0.1). Bootstrap confidence intervals were generated to assess robustness. Results Service planning (0.234), resource management (0.199), and facility design standards (0.193) were ranked as the most influential domains. Governance (0.166), service delivery (0.137), and monitoring and evaluation (M&E) (0.071) were assigned lower weights. The highest priority indicators were the presence of an O&M plan, a dedicated budget line, clear roles and responsibilities, effective budget implementation, and reliable water supply. Conclusions and recommendations These findings show that sustained sanitation service provision depends more on effective planning, predictable financing, accountability, and reliable inputs than solely on infrastructure. It is therefore recommended that schools sanitation programmes prioritize strengthening O&M planning, budgeting, and M&E systems to improve sanitation service reliability in resource-constrained school settings. Graphical Abstract Supplementary Information The online version contains supplementary material available at 10.1186/s12982-026-02148-x. Highlights The study incorporates perspectives from regulators, practitioners, Head Teachers, Sanitation Teachers, and researchers. Management domains ranked highest: planning, resources, design standards. Monitoring and evaluation (M&E) received the lowest weights across groups. Top indicators: O&M plan, budget line, role and responsibility clarity, budget execution, water supply. No significant differences in domain weights across stakeholder groups. AHP and SWING produced a practical, stakeholder informed priority framework. Supplementary Information The online version contains supplementary material available at 10.1186/s12982-026-02148-x.

Study methods

This study was conducted in Kampala, the capital city of Uganda from July to September 2025. Kampala City has a resident population of about 1.88 million, a daytime population of 2.5 million [66], and a pupil population of about 321,000 KCCA, [34]. The city has approximately 850 primary and secondary schools with the majority privately owned (88%) and the remainder government-managed.

Limitations

The AHP and SWING methods rely on structured stakeholder judgements which, although systematically elicited, remain subjective and may be influenced by participants’ professional backgrounds. Concurrent field observation or facility level data were not collected during the weighting period, which limited the ability to triangulate stakeholder derived priorities with actual O&M performance. The cross sectional design also restricts inference about how priorities may shift over time or in response to changes in school conditions. In addition, the study did not explicitly integrate broader equity dimensions such as gender and disability, and differences in weighting across stakeholder subgroups were not examined. Furthermore, because the stakeholder sample was drawn from urban Kampala, the findings may not be generalizable to rural schools or other regions with different resource constraints or management structures.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Choose one school improvement question with teachers. Protect a short shared planning cycle, agree an instructional change and use a common rubric for examining student work. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Review implementation fidelity, teacher time and independently scored student work against a recorded baseline. Examine access differences and competing explanations before attributing changes to leadership. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Jude Zziwa Byansi; Swaib Semiyaga; Alex Yasoni Katukiza; Najib Lukooya Bateganya; Angella Mercy Nakaye; Frank Kansiime; Robinah Nakawunde Kulabako. Stakeholder priorities for sustaining operations and maintenance of school sanitation facilities in Kampala City, Uganda. Discover Public Health (2026-05-29). https://doi.org/10.1186/s12982-026-02148-x

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.