This ‘GSF in focus’ case study presents eight lessons learned from the GSF-supported Uganda Sanitation Fund (USF) programme in coordinating, planning, and implementing CLTS at scale through a decentralized government system. The USF is the largest programme of its kind in Uganda. The programme, which began in 2011, is currently implemented by 30 District Local Governments 2 under the overall management of the Ministry of Health. By September 2016, the USF reported helping over three million people live in open defecation free (ODF) environments.