Rural sanitation practitioners already consider many types of risk in the design and implementation of programmes. This publication supports rural practitioners in civil society and government to add a climate lens to existing programmes. It provides the sector with a menu of options and ideas from a climate change perspective. It is not a prescriptive list or a ‘one size fits all’ approach. Practitioners can draw on various ideas and parts of this guidance and modify them to suit specific programmatic and regional contexts. The quotes included are from interviews with sanitation and hygiene practitioners. They describe their experience with programming in contexts increasingly challenged by climate related concerns.