Due to inadequate sanitation facilities and a lack of hygiene education, by the late 1990s, the urban poor within the City of Tiruchirapalli were subject to frequent outbreaks of water borne diseases. A lack of maintenance, rather than existence of toilet facilities, was identified as the main barrier to improved sanitation within the city. A local non-government organisation (NGO), Gramalaya, in partnership with WaterAid initiated a scheme which sought to involve women self-help groups from the local community in the maintenance of existing toilets in Tiruchirapalli. The initiative has not only helped improve the condition of the community toilets but also generated awareness among the local population regarding sanitation and hygiene. As a result of the action, the women’s groups within the community were mobilized and empowered to operate and maintain their toilets whilst simultaneously improving their sanitation behaviour.