This paper presents the Household-Centred Environmental Sanitation (HCES) approach, jointly developed by the WSSCC and Eawag/Sandec (Water and Sanitation in Developing Countries). The presentation explores its origins, theoretical foundations and the problems it seeks to address. HCES is a method which proposes to start the holistic planning process with household decisions on service needs, and then move outward from the household to the neighbourhood, town and upper levels of government. Thus, the link between community expression of needs and mobilization of resources to solve them and other inputs from higher up the line is assured. The second part of the paper explores a new approach to widening system and technology options for household-centred approaches by thinking as sanitation as a 'cradle-to-grave' system rather than stand-alone technologies.