This session will share the experience of the Asutifi North District, and the Ahafo Region, in collective action to improve water and sanitation systems and the services they provide. It will look back on 5 years implementation and how key challenges were addressed and overcome at district level, and the current priorities of the district. The session will also share emerging experience from the regional level on how a systems approach for water and sanitation services is being scaled, and how national engagement is critical in this process. In Asutifi, with support from the Conrad N. Hilton Foundation and Later Day Saints Charities, IRC, World Vision International Ghana, Safe Network, Netcentric Campaigns, Centers for Disease Control and Prevention, and Aquaya Institute are working with government to test a local authority-led partnership with NGOs to drive district-wide access to water and sanitation services to achieve universal coverage and SDG6 in Asutifi North District by 2030. In 2017, the Asutifi North District Assembly of Ghana and community leaders worked to develop a long-term plan to deliver water, sanitation, and hygiene to 100% of the people in Asutifi North by 2030. The plan identifies the needs, provides an overview of the current situation, presents the challenges, and identifies an ambitious goal and vision. Activities have recently been extended to the Ahafo region.