Risk-based prioritization of sanitation improvement interventions in Sakhipur Municipality, Bangladesh

Achieving safely managed sanitation in low-resource settings requires substantial investment, but a priority-driven approach is needed to ensure that limited resources are allocated to the most critical risks first. This paper provides a framework of risk-based interventions for improving current sanitation services in low-income communities through the implementation of Sanitation Safety Planning (SSP) methodology in Sakhipur, Bangladesh. Information from published reports and field observations was used to determine the sanitation system boundary and identify hazardous events, exposure groups, and transmission pathways within that boundary. A total of 33 hazardous events were identified, including one Very High Risk, seven High Risk, nineteen Medium Risk, and six Low Risk events. Exposures to raw sewage from overflowing pits and septic tanks, and manual fecal sludge emptying without protective equipment have been identified as the most hazardous events. Fifteen mitigation measures were proposed and prioritized based on their potential, technical effectiveness, acceptability, and cost. Four improvement actions, including preventing illegal containment connections, regular cleaning of stormwater drains, enforcing hygiene practices for sludge emptying, and ensuring adherence to safety protocols at the fecal sludge treatment plant, were identified as immediate interventions. The study findings demonstrated that SSP can be an effective tool to guide municipalities to prioritize safety interventions. It also shows that contextual information can be incorporated into the existing methodology to systematically segregate high-priority interventions, which can be crucial for municipalities operating under limited resources.