The unsustainability of the services related to water, sanitation and hygiene in informal settlements in Sub-Saharan Africa services is deeply embedded in current societal and governance structures, cultures and practices; it is context-dependent and involves numerous actors with different interests. The field of sustainability transitions research addresses such persistent and large scale societal challenges, with transition management being one of its widely applied governance approach. By drawing on an analysis of the root causes of unsustainability and unreliability of WASH services in three case studies in Sub-Saharan Africa (Arusha-Tanzania, Dodowa-Ghana, Kampala-Uganda), we explore how a transition management approach can be designed to support a transition towards sustainable Water, Sanitation and Hygiene (WASH) in Sub-Saharan Africa. We distinguish the following contextual dimensions related to the unsustainability of WASH services: a) Multiplicity of WASH practices, structures and arrangements, b) Governance capacities for WASH services and maintenance, c) Landownership for sustainable access to WASH, d) Public participation in decision-making related to WASH, e) socio-economic structures governing access to WASH. These dimensions prompt the identification of conceptual and application challenges for transition management. Based on these challenges, recommendations were formulated for the design of a prescriptive transition management process that is not only functional but also emancipatory of character.