This study is based on a visual inspection and a questionnaire survey about sanitation in central Nepal. A total of 201 people from different groups were asked about their knowledge about eco-toilets, the fertilizer value of human urine and wood ash. Farmers were the least educated and least aware of most of the topics asked. Although the majority of educated people were aware about urine fertilizer, 68% of them were not interested in its use in their home, and 39% of them said that it might be not accepted. The visual inspection revealed that environmental hygiene depends on education. It is concluded that farmers need to receive practical demonstrations about the use of eco-toilets and wood ash to appreciate the direct benefits. It can be assumed that since urine fertilizer is a bonus obtained from eco-toilets, this could encourage even poor people to construct these kinds of facilities.