Like most cities in developing countries, Uganda's capital city, Kampala, is experiencing urbanisation leading to an increase in population, and rapid development of peri-urban (informal) settlements. More than 60% of the city's population resides in these settlements which have the lowest basic service levels (sanitation, water supply, solid waste collection, stormwater and greywater disposal). A review of earlier studies on infrastructure development and sustainability within Kampala's peri-urban settlements, field surveys in a typical peri-urban settlement in the city (Bwaise III Parish), and structured interviews with key personnel from the National Water and Sewerage Corporation (NWSC), Kampala City Council (KCC), and the National Environment Management Authority (NEMA) were undertaken. Findings on current environmental health practices as well as perspectives of local communities and interviewed institutions on problems, constraints and possible solutions to basic service provision are presented. The implications of these viewpoints for possible environmental health interventions are presented.