<p>This study examined the management of Water, Sanitation, and Hygiene (WASH) facilities in public basic schools within the Mfantseman Municipality of Ghana. Using a convergent mixed-method design, data were collected from 368 students, 16 head teachers, and 4 institutional stakeholders. Results showed that 95.1% of rural and 87.5% of urban schools had toilet facilities, while 50% of rural and 75% of urban schools had access to water. All schools had handwashing facilities, though many were non-functional due to poor water supply. The Ghana Education Service (GES) and District Assemblies were the main providers of WASH infrastructure, while Parent Associations and communities supported with cleaning supplies and minor repairs. However, limited funding and coordination shifted maintenance responsibilities to teachers and pupils, 98% of whom handled cleaning. Only one school had a menstrual hygiene facility, with 89–94% of pupils reporting no sanitary bins. The study recommends that GES and District Assemblies increase financial commitment and supervision, the Ministry of Sanitation enforce hygiene standards, and Parent Associations promote gender-sensitive WASH planning. Clearly defined actor roles, consistent resource allocation, and community participation are essential for sustainable WASH management and equitable learning environments in Ghanaian schools.</p>