Many non-governmental and intergovernmental organizations, as well as bilateral and multilateral donors, recognize the importance of closely working with governments in sanitation and hygiene programmes. Collective behaviour change approaches, such as Community-Led Total Sanitation (CLTS), are also increasingly being embraced by governments as an alternative to traditional subsidy and enforcement-based approaches. This ‘GSF in focus’ case study presents eight lessons learned from the GSF-supported Uganda Sanitation Fund (USF) 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 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.