This thesis explores the defecation practices and preferences of the people of Ayikuma, a peri-urban community in the Shai-Osudoku District of the Greater Accra Region. The community has few social amenities: There is only one public-private toilet facility serving residents but this facility is hardly patronised. The majority of the people practice open defecation. The study was undertaken against the backdrop that understanding local conditions and specific needs of people is necessary to facilitate improvement in their sanitation behaviour. To study the defecatory behaviour of the people, the study was guided by the following objectives: a) To outline the history of faecal matter disposal in the community and how this informs present methods of excreta disposal; b) To investigate the factors that influence point of defecation preference of community members; and c) To find out preferred options for defecation of community members. The study was undertaken using triangulated quantitative and qualitative research techniques. Thus, a household survey, focus group discussions, in-depth interviews and observations were employed to elicit varied views on defecation practices and preferences in the community. Major Findings It was found that Ayikuma was introduced to public toilet system as early as 1916 by the British colonial authority. Toilet use was free until the 1990s when franchising was introduced and fees were charged. Presently, there is a 12-cubicle public-private flush toilet facility but it is hardly patronised by community members. This is so because there is a perception held by many residents that the fee charged for use of the facility is too high and also that the location of the toilet is not appropriate. The majority of households do not have a toilet facility. People, therefore, make use of group-financed toilets, „solidarity toilets? and the bush. However, these toilets are not child-friendly. Therefore, children defecate in chamber pots or in the bush. In choosing a place to defecate, the residents consider the following: their financial status, age, privacy and safety, the cleanliness and hygienic nature of a defecation point, cultural prescriptions and beliefs pertaining to faecal matter as well as family ties and relationships. Generally, the people prefer to have toilets in their homes for convenience and easy access. Although public water supply is not regular in the community, the majority of people prefer flush toilets. Recommendations On the basis of these findings, it is recommended that: The Shai-Osudoku District Assembly like all district assemblies in Ghana should provide toilet facilities that are owned and patronised by the local population, while ensuring that the community context reflects in the type of facility provided. The district authorities should see the provision of proper sanitary facilities as a responsibility so that people can enjoy access to decent toilets at affordable rates. The worldview and cultural subscriptions of people should never be underestimated if gains are to be made in good sanitation. Sanitation education should incorporate the perspective of the community members who are the target of this education. Future Research Agenda This study has focused specifically on Ayikuma, a peri-urban community. Further studies may be undertaken in future to ascertain the extent to which the findings and recommendations are applicable to other peri-urban communities in the country. In particular, the issues of smell and gender should also be examined to ascertain how they influence excreta disposal among males and females.