A detailed analysis of water, sanitation and hygiene facilities in four Nepali schools revealed that they have poor water and sanitation facilities and unhygienic environments both in terms of quantity and quality. Inadequate knowledge of the concept of ‘child-friendly’ sanitation facilities, absence of user involvement in the planning and design process, and lack of training and orientation among members of School Management Committees, Parent Teacher Associations and Child Clubs are the main reasons behind this. To reverse this trend, toilet facilities were constructed at the ‘Sangam’ Primary School not only to demonstrate the process of planning ‘child, gender and differently able friendly’ sanitation facilities but also as a training tool for the concerned stakeholders. Lessons learned from this process have been incorporated into sanitation booklets and training programmes for non-government organizations, District Sanitation Steering Committees, and local masons to raise awareness, make monitoring at the district level more effective, and widen the network of partners working on school sanitation. In this way, a combination of bottom-up and top-down approaches as well as parallel building up of hardware and software components have led towards sustainable sanitation.