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This paper discusses the common constraints to the provision of improved sanitation services to people living in low-income urban communities in Africa and makes suggestions on improved practice. The paper also highlights the current research gaps that SHARE could potentially examine over the next five years. Over the years, both African and Asian countries have faced enormous backlogs in the provision of sanitation services, especially in urban poor communities, resulting partly from the use of inappropriate service approaches. This is coupled with limited financial resources and rapid urbanization and population growth. This paper also shows that for the Millennium Development Goal target on sanitation to be achieved, there is need to develop effective links between communities and sanitation agencies and to use cheaper alternative sanitation technologies. Areas where sanitation improvements have been made there is normally a good relationship between the communities and the authorities. This paper is based on literature, work experience, interviews and SHARE country visits.