Improved environmental sanitation services provision and the establishment and implementation of environmental and health standards is an important concern for both government and citizens of Ghana. A recent policy commitment to ensure institutional coordination and effective sanitation service provision is expressed in the National Environmental Sanitation Strategy and Plan. However, in spite of the policy and institutional commitment, Ghana’s current environmental sanitation status leaves much to be desired. Effective waste management and access to improved sanitation services remains a challenge in both urban and rural Ghana. And most worrying, Ghana has not achieved its MDGs in reference to water and sanitation. Thus, there remains an urgent need to focus and evaluate the sector’s key policy objectives, improve accountability and investment outcomes.