Strengthening local government capacity to improve sanitation and other basic services is a challenge in many low resource countries. There is growing interest in peer learning as a mechanism to spread successful practices and increase local government performance in the settings. However, few studies have investigated if peer learning leads to changes in practices and improved results. The study aims to identify and evaluate the causal linkages between peer learning activities and any changes to participants capacity, local government practices and increases in sanitation coverage in rural districts. Contribution Analysis, a theory-based evaluation approach, was used to design a longitudinal study investigating outputs, outcomes and impacts of two peer learning workshops between Open Defecation Free (ODF) Districts and non-ODF Districts in Mozambique alongside the enablers and barriers to change. The research draws on a survey of 66 participants directly after the workshops and 29 semi-structured follow-up interviews nine months later. We found that despite broader structural challenges that hinder progress in sanitation service provision, the workshops enabled the spread of knowledge of good practices (outputs) some of which were replicated (outcomes). There is evidence that these replicated practices accelerated progress towards ODF status (impact) in some districts. We demonstrate that under the right conditions peer learning can nurture local learning, improve knowledge, spread frugal practices and lead to incremental improvements in local government performance. We therefore recommend it be integrated into broader programmes to maximise benefits.