Public toilets are vital to the design of sustainable, inclusive cities. In Nepal, public toilets suffer from inadequate maintenance, unhygienic conditions, and poor waste treatment. Women and children are disproportionately affected resulting in urine and pathogen retention, bladder distension, and continence. Pay-per-use public toilets is a social franchise business opportunity that drastically improves access to sanitation facilities in urban areas. Aerosan’s business model demonstrates that public toilets can be profitable, hygienic, gender-inclusive and environmentally sustainable. This innovation will upscale their business model, with five new public toilets in high traffic areas, to facilitate three million toilet usages per year. Women will operate newly built toilets and also earn income from biogas sales, sanitary and menstrual health management products and contracts with other businesses. Hardware and software will enable operators to regulate all five toilets from a central control centre.