The document discusses district-based learning initiatives in Uganda to improve hygiene and sanitation. It describes obstacles like limited prioritization, collaboration, and innovation at the district level. It outlines a methodology using learning alliances and action research across 4 districts to increase profiles, communication, and learning. Key lessons included understanding community perspectives before judging them as "stubborn", tailoring interventions to community needs and calendars, and ensuring leadership practices hygiene behaviors. The pilot increased prioritization, collaboration, and hygiene status in target districts.