Achieving an operational onsite sanitation chain requires well-managed services in all aspects of excreta management: collection, emptying, transport, treatment and disposal/ reuse. To cover the full chain, however, remains a difficult challenge, and is even harder in informal housing areas. This paper presents an overview of the key limitations to sanitation improvement in low income, high density settlements (LIHDS). In particular, it focuses on the sanitation situation in Kibera LIHDS, Nairobi, Kenya. Results are presented from questionnaires and qualitative semi-structured interviews with stakeholders involved in sanitation provision within the settlement. Currently, there is no policy framework governing planning, implementation and management of onsite sanitation at City level. This leads to uncoordinated actions among the various stakeholders along the sanitation chain. Sanitation providers focus on provision of sanitation facilities, neglecting emptying, transportation, treatment and disposal/reuse of end product. Pit emptiers likewise have unregulated operations with faecal sludge (FS) ending up untreated into the environment (85%). Pay-and-use approaches to sanitation provision enhances the effectiveness of operation and maintenance initiatives: whereas in 73% free-to-use facilities were abandoned on fill-up, 89% and 77% of community-based organisation- (CBOs) and entrepreneur-managed pay-anduse facilities respectively were well managed. Partnership-based sanitation provision improvements provide an entry point for broader initiatives to improve living conditions in informal settlements. By involving government actors, CBOs, community, and pit emptiers, Umande Trust has created an economically viable approach of inclusive sustainable sanitation for underprivileged population. Results from the study are useful to the local government and other partners involved in sanitation improvement within the settlement.