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The rural community of Ngohé (Senegal) faces serious hygiene and sanitation problems as a result of the poor water quality and in particular the lack of latrines in homes. As of 2003, a three-year project for the construction of latrines was initiated as part of a donor agency program to support healthcare in the Diourbel area. After three years of activity, the poor results recorded provide ample justification for the analysis of community participation in the project. A cross-sectional descriptive and analytical survey was conducted December 14–17, 2005. Two trained investigators collected data through individual and group interviews. They found that there was close community participation in the decision-making process to determine which activities would be undertaken. However, this was more limited in the areas of need, resource mobilization, resource management, monitoring, and evaluation. Community participation in the implementation of activities was considered average. The low rate of latrines (1.7%), correlated with the high proportion of diarrhea as one of the main reason for consultations in 2004 (33.4%) and 2005 (29.4%), expressing the non-achievement of the project’s objectives, which was planned to end in 2006. Many projects have shortcomings and pitfalls in their participatory strategy at all phases, especially during that of implementation. Participation efforts are often limited to the recruitment of community participants. The organization and coordination that should accompany and support strategies for community participation must be adapted to the context of poor and disadvantaged populations, a majority of whom are illiterate, as they are less aware of the benefits of hygiene and the promotion of health. It is the responsibility of health professionals to organize community representatives and to strengthen their capabilities in the field of hygiene and health in order to ensure the community ownership and sustainability of such projects.