Over the past 10 years the government of Uganda has endeavored to increase latrine coverage and promote hygiene with a view to improving health outcomes. In 1997, in the Kampala declaration for sanitation, leaders from all of Uganda's districts pledged to improve sanitation. Then in 2001, three ministries, the Ministry of Water, Lands, and Environment; the Ministry of Education and Sports; and the Ministry of Health, signed a memorandum of understanding to clarify institutional responsibilities with respect to sanitation and hygiene and to improve implementation at the district and local levels. The three ministries agreed to put in place institutional arrangements to prioritize resources for excreta-related sanitation and hygiene programs. Although the main focus of this report is on excreta-related sanitation and hygiene, the 2006 joint sector review for water and sanitation also requested clarification of existing mandates for two specific aspects of environmental sanitation, namely solid waste management and drainage and asked whether these two issues should be included in the memorandum. Accordingly, this report also explores the institutional issues linked with municipal solid waste management and urban drainage. Because of limitations of time and scope, it examines these particular issues only in Kampala.