Specifically, the purpose of this exploratory study was to assess sewage disposal in urban areas not served by ONAS and establish a process for formulating a national sewage disposal strategy for the development and promotion of alternative disposal methods in Tunisia. The objectives of the exploratory study were to: 1) diagnose sewage disposal alternatives currently used in Tunisia, 2) recommend a process to the Ministry of Public Works and Housing (MOPWH) for formulating a national sewage disposal strategy for Tunisia, and 3) refine and develop in detail the scope of work for follow-up interventions by the WASH project.