Integrating environmental concerns into health and sanitation project sustainability: Insights from a qualitative inquiry in Uganda

This study explores how environmental concerns are integrated into the sustainability of health and sanitation projects in Uganda. It examines leadership, community practices, and ecological risk management influencing project performance. The study employed a qualitative design in which 21 purposively selected participants from health and sanitation projects were interviewed using semi-structured interviews, with data analyzed thematically following Braun and Clarke (2021). Findings show that environmental sustainability is shaped by four key domains: (1) ecological risk awareness and mitigation, (2) environmental stewardship and compliance, (3) community eco-behaviour and participation, and (4) leadership orientation towards environmental protection. Participants acknowledged that weak environmental governance structures and limited enforcement undermine long-term project sustainability. Project leaders should embed environmental indicators into planning and monitoring systems. Integrating community eco-literacy, waste-to-resource innovations, and local ecological governance. The study provides an integrated understanding of sustainability and contributes to the application of environmental management theory in public health.