In 2022, FINISH Mondial and the Sanitation Learning Hub conducted a participatory and immersive research study to understand ground realities and lived experiences of sanitation and hygiene access in Nandurbar district, Maharashtra and Darbhanga district, Bihar in India. The main objectives for the immersion were to identify challenges and barriers towards access to and use of sanitation and hygiene services within challenging contexts, capture community voices and find contextually rooted ways to identify enablers towards safe and equitable access to and use of sanitation and hygiene services in these areas; and inform FINISH programme design and support the development of human-centric strategies for improving access to sanitation hygiene services for marginalised and left-out communities, while strengthening gender equality and social inclusion (GESI). Key lessons learnt from the study included universal access to and use of toilets has not yet been achieved, and people affected by poverty and marginalisation remain excluded; existing toilets need retrofitting and maintenance to become usable; we need to consider context specific adaptations for programming for tough physical conditions such as flooding and drought; and caste-based inequality is prevalent with major implications for access to sanitation and hygiene services; and behaviour change programming remains relevant for these contexts.\