Sanitation improvements are important for saving lives in low-income areas, but progress is slow. A study in East Africa looked at how to increase demand for better sanitation. They found that many people use facilities that don't meet basic sanitation needs. Only a small percentage of people considered installing better sanitation facilities. The level of demand for improvements varied between cities and was influenced by the characteristics of the communities. Tailoring programs to meet local demand and engaging stakeholders can help increase access to better sanitation facilities.