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Urban sanitation and solid waste sectors are under significant pressure in East Africa due to the lack of competent institutional capacity and the growth of the region's urban population. This book presents and applies an original analytical approach to assess the existing socio-technical mixtures of waste and sanitation systems and to ensure wider access, increase flexibility and ecological sustainability. It shows how the problem is not the current diversity in waste and sanitation infrastructures and services and variety of types and scales of technology, of formal and informal sector involvement, and of management and ownership modes. The book focuses instead on the lack of an integrative approach to managing and upgrading of the various waste and sanitation configurations and services so as to ensure wider access, flexibility and sustainability for the low income populations who happen to be the main stakeholders. This approach, coined "Modernized Mixtures", serves as a nexus throughout the book. The empirical core addresses the waste and sanitation challenges and debates at each scale - from the micro-level (households) to the macro-level (international support) - and is based on the results of a five-year-long interdisciplinary, empirical research program. It assesses the socio-technical diversity in waste and sanitation and provides viable solutions to sanitation and waste management in East Africa. This book provides students, researchers and professional in environmental technology, sociology, management and urban planning with an integrated analytical perspective on centralized and decentralized waste and sanitation configurations and tools for improvement in the technology, policy and management of sanitation and solid waste sectors.