Small towns lag behind cities in drinking water and sanitation access globally. Closing this gap requires developing service models for areas with both urban and rural characteristics. This study assessed Bushenyi-Ishaka, a municipality in Uganda situated at the rural–urban transition, with a focus on service ladder indictors. Data sources included household interviews (n = 500) and water quality samples from sources and storage containers. Households in more urban (as compared to rural) cells were more likely to use improved water sources (including piped water on-premises), make regular payments for water, rely on shared sanitation facilities, and make use of manual sludge emptying services. Most households (72%) used an unlined pit latrine not intended for emptying and reuse. These findings suggest that small town servicing models should prioritize non-sewered sanitation management, including incentives for safe excreta containment and disposal opportunities. This study also highlights a need for integrated services models to expand rural–urban water and sanitation coverage.

在全球范围内，小城镇在饮用水和卫生设施方面落后于城市。缩小这一差距需要针对具有城乡特色的地区开发服务模型。这项研究评估了位于乌干达城乡过渡的乌干达直辖市Bushenyi-Ishaka，重点关注服务阶梯指标。数据来源包括家庭访问（n = 500）和来自水源和储存容器的水质样本。城市单元（与农村单元相比）的家庭更可能使用改良的水源（包括自来水），定期支付水费，依靠共享的卫生设施，以及使用手动排污服务。大多数家庭（72％）使用了无衬里的坑厕，这些坑厕不打算倒空和重复使用。这些发现表明，小城镇维修模式应优先考虑非下水道的卫生管理，包括鼓励安全排泄物围堵和处置的机会。这项研究还强调了需要采用综合服务模式来扩大城乡水和卫生设施的覆盖面。