SNV’s comprehensive and area-wide Sustainable Sanitation & Hygiene for All (SSH4A) approach, first developed in 2008 in Asia, is now working towards sustainable sanitation services across 18 countries in Asia and Africa. For SSH4A RP Programme countries, lasting change is visible, with more than 3.9 million people having gained access to improved sanitation, and an additional 1.2 million people now practising handwashing with soap.