Kumasi, Ghana’s second largest city, is located in south-central Ghana and is a commercial, industrial and cultural center with a rapidly increasing population. The city is making progress towards Target 7C of the Millennium Development Goals, which mandates that the number of people without sustainable access to water and sanitation be reduced by half by 2015. However, while access to piped water in Kumasi has increased from 66.2 percent in 2000 to 80 percent in 2008, and solid waste collection is improving, resident endure irregular water supply and about 40 percent of the city’s residents still rely on public and shared toilets. Since public and shared toilets are not considered to be “improved sanitation facilities” by the WHO/UNICEF Joint Monitoring Programme (JMP), the city today, with little more than four years to go, remains far from attaining the sanitation target.