This report provides a case study of how to design a sanitation program within the unique conditions of a peri-urban settlement. Specifically, the report considers the experience of USAID's Environmental Health Project in designing an initiative to install and maintain appropriate excreta and graywater disposal solutions in the peri-urban settlement communities of Rosemont and Norwood in the Montego Bay area, Jamaica. the project has been in the implementation phase since late 1994 and is scheduled to end in the fall of 1997; results will be documented in a subsequent report. Chapter 2 discusses the common deficiencies of most sanitation programs and then the principles behind a successful sanitation program design. Chapter 3 discusses the community in which the project is working and then the process the project went through during is design phase. the resulting project design, including activities to be implemented and performance indicators to measure its success, is included in Chapter 4. Chapter 5 summarizes the key principles behind, the data needs of, and the strategies to be used in the design of a community excreta sanitation project in a peri-urban area. Includes a sample sanitation inventory survey to be used for data collection.