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Population growth, urbanization, insecure land rights, and underinvestment impede the development of sanitation infrastructure in African cities. In response, decentralized, affordable, community-driven hybrid sanitation systems have emerged, frequently initiated by local stakeholders. This study examines such systems in Tema, Ghana, an originally planned city undergoing significant unplanned expansion. Employing mixed methods, including surveys of 1,549 households, 3 focus groups, 40 stakeholder interviews, and landscape assessment, the research identifies 5 types of hybrid interventions shaped by distinct power and governance structures. Unplanned areas in Tema exhibit better performance in fecal waste proximity and management compared to wealthier neighborhoods. Despite high community demand, the expansion of these systems is constrained by poor planning and coordination, leading to underutilization of their potential. Realizing the transformative capacity of hybrid infrastructure requires the engagement of intermediary actors who link grassroots practices with policy frameworks. While the influence of hybrid infrastructure is increasing, research on Tema’s sanitation remains limited, relying mainly on media reports and general studies, and lacking detailed local analysis. Further research is necessary to address the underlying causes, inequalities, governance challenges, social practices, service gaps, and strategies for improving sanitation transitions.
Oteng‐Ababio et al. (Mon,) studied this question.