In urbanising areas, siloed planning for water supply, sanitation, and solid waste management impedes sustainable development. This study examines barriers to integrating services in urban Uganda, focusing on Wobulenzi and Kakooge with different service models. A mixed-method approach using qualitative and quantitative data was applied. Document reviews and interviews with 48 stakeholders were conducted. The Problem-Driven Political Economy Analysis framework was used with thematic analysis and quantitative assessment of political economy attributes. Findings showed fragmented institutions, insufficient resources, and poor coordination hinder integration. Small towns face financial constraints, technological gaps, and political interference. Key attributes influencing integration include implementation dynamics (19/20), accountability (12/20), and collaboration (10/20). An enabling political economy is crucial for integrated services in urban Uganda. Addressing fragmented governance through policies, coordination, decentralisation, capacity building, and financing is essential. Realigning resource planning can enable strategic solutions, promote service integration, and ensure sustainable WASH and SWM services.

This study reviews the status of access to water supply, sanitation, and solid waste management (SWM) services in Uganda, examining the influence of national government policies, institutional frameworks, and financing mechanisms. It employs a mixed-methods approach, combining qualitative analysis of primary data from key informant interviews with secondary data from systematically reviewed literature, including performance reports, project data from ministries, development partner websites, and peer-reviewed journal articles. The findings reveal persistent challenges related to intersectoral coordination, overlapping roles, policy inconsistencies, stakeholder conflicts, and funding inefficiencies. Water services receive a disproportionately high percentage of funding (over 80%), whereas sanitation and SWM receive significantly less (approximately 5% and 10%, respectively). Regulations advocate for sustainability, but their implementation in small towns remains weak. Policy analysis at the local level suggests a misalignment that prioritizes SWM over individual water and sanitation services. Decentralization empowers local authorities, but successful service delivery depends on robust enforcement of available policies. The analysis of funding and service delivery gaps underscores the need for equitable resource allocation and integrated approaches. The study concludes by emphasizing the need for active engagement by governments, development partners, local communities, and the private sector to achieve equitable access to basic services.

The top priorities for urban water sustainability include the provision of safe drinking water, wastewater handling for public health, and protection against flooding. However, rapidly aging infrastructure, population growth, and increasing urbanization call into question current urban water management strategies, especially in the fast-growing urban areas in Asia and Africa. We review innovative approaches in urban water management with the potential to provide locally adapted, resource-efficient alternative solutions. Promising examples include new concepts for stormwater drainage, increased water productivity, distributed or on-site treatment of wastewater, source separation of human waste, and institutional and organizational reforms. We conclude that there is an urgent need for major transdisciplinary efforts in research, policy, and practice to develop alternatives with implications for cities and aquatic ecosystems alike.