In Ghana, over 70% of urban dwellers do not have private sanitation facilities in their home and rely instead on an informal network of shared toilets. The predominance of shared toilets in Ghana is the result of unplanned urbanization, specific features of housing, socio-economic characteristics of the population and political orientations. Shared sanitation includes a whole range of models from large toilets blocks owned by the municipality to toilet cubicles shared by tenants of the same house. Shared toilets are not considered as improved sanitation facilities as access for vulnerable groups, maintenance, hygiene, privacy and safety of the users are not always guaranteed. However, for millions of urban dwellers, shared toilets are the only alternative to open defecation and are used daily. Some of these facilities, through better management models and through better standards, provide services appreciated by the users. The aim of this research is to determine which models of shared facilities are acceptable sanitation solutions for urban dwellers, depending on the local circumstances. To do so, the research framework compares the perspectives of dwellers and sanitation providers, acknowledges the characteristics of the specific urban context and considers the relationships between the key stakeholders. In a fast growing city in Ghana, Ashaiman, 432 house units representing over 8000 residents were surveyed, over 40 participatory exercises and 38 interviews with a range of stakeholders were conducted. This research concludes on four main points. Firstly, many apparently similar areas are actually not uniform; the heterogeneity of urban planning and housing influences any past and future sanitation developments. Urban planners need to integrate sanitation in their future decisions but base these on appropriate solutions. The second finding is that some models of shared sanitation can be considered as adequate given the particular context and its likely evolution. The different models have legitimacy at different stages of urban development and their successful selection depends on the quality of the contextual understanding. Thirdly, cleanliness and affordability are key determinants when the dwellers select shared toilets. Given the toilet options available, these determinants are often mutually exclusive and are a dilemma for the users. This dilemmas result in variations in use of shared toilets within a neighbourhood, and at intra household and individual levels. The final point is that choice and then acceptability of a facility depends on the options available. Therefore deciding which facilities are best adapted to the local context should be in the hands of both local providers and dwellers, supported by other local stakeholders who enable relationships through adapted policies and facilitated dialogues.