Chumo, IvyMberu, BlessingWainaina, CynthiaMurigi, WanjiruSumba, LeunitaKabaria, Caroline2024-01-152024-01-152023-12https://doi.org/10.1371/journal.pwat.0000086https://ir-library.ku.ac.ke/handle/123456789/27267ArticlePoorly managed sanitation is degrading, unhealthy and far too dominant among the urban poor. The conventional solution to poorly managed onsite sanitation and/or open defecation is for governments to provide adequate sanitation at subsidized prices. Few governments in low and middle income countries can subsidize access to sanitation facilities for people living and working in informal settlements. This leaves the urban poor in informal settlements to face challenges in accessing safely managed sanitation, with some residents and manual pit emptiers adopting social capital approaches. We sought to identify sanitation challenges along the value chain and social capital approaches to addressing the challenges. We used qualitative approaches. Our target population were manual pit emptiers and community members. We analysed data using conventional content analysis methodology. We grouped sanitation challenges into those that are outside individual households and those that are at the individual household. Challenges outside the household could not be controlled at the individual level, and included legislative, physical, and social challenges, while challenges at the individual household could be controlled at individual level, and included health, financial and technical challenges. As a result of these challenges, both the manual emptiers and community members adopted social capital approaches, which included the use of reciprocity and trust, networks and information channels and norms to counter the challenges. Sanitation challenges along the sanitation value chain should persuade policymakers and practitioners that sanitation extends beyond the four walls of a sanitation containment facility, to include emptying, transportation, treatment and disposal. Many of the challenges could be attributed to governance outside the sanitation sector. Hence long-term improvement of sanitation conditions in informal settlements ought to be supported by broader policies and strategies like social capital that begins by thinking outside “the sanitation box”.enArticle