This synthesis report details theprocess, outputs and intermediate outcomes of the WorldBank’s Water and Sanitation Program (WSP) TechnicalAssistance (TA) to pilot and operationalize city sanitationplans (CSPs) towards outcome oriented sector investments(P131967). This TA addresses issues of ad hoc planningthough CSPs that are holistic, intended for city-wideimplementation and address the full cycle of sanitation.However, prior to preparation and operationalization ofCSPs, it was recognized that this needed to be anchored in astatewide sanitation program. The statewide sanitationprogram needed to: estimate and provide for the capitalrequirements to address the gaps in sanitationinfrastructure across the sanitation service delivery chain(collection, treatment and disposal), estimate the operationand maintenance (OM) requirements, and set out the frameworkfor prioritization of cities, and attendant institutionalframeworks. This TA aimed at piloting and operationalizationof CSPs towards outcome oriented sector investments, bysupporting (i) select state and local governments withtechnical assistance to operationalize city sanitation plansby targeting outcome oriented investments, and (ii)improving the institutional and regulatory framework andstrengthening state and local government capacity forefficient and sustainable delivery of Government of India orWorld Bank or other development partner funded programs.