Health impacts of faecal sludge management based on citywide inclusive sanitation in Bangkok city, Thailand

Abstract Poor faecal sludge management (FSM) in developing countries are causing public health concerns. This study assesses the main factors of diarrheal infection in Bangkok city, focusing on CWIS factors and socio-economic aspects of the affected people from sanitation officials and households by using valid questionnaires. Collected data was analyzed by using Peason’ correlation, t -test, Chi -squared test, and univariable logistic regression analysis. The findings indicated a positive relationship between diarrheal cases and uncollected faecal sludge rates from HHs ( r = 0.47, p < 0.01) in Bangkok city was found in this research. Households (HH) experiencing leakage and overflow/high loading of contaminants from faecal sludge containments exhibited a prevalence of diarrhea 4.27 times (confidential interval (CI) 1.92–9.49) and 2.50 times (CI 1.33–4.69), respectively, higher than households whose containments had no leakage or overflow of containments. Additionally, households without faecal sludge emptying showed 2.25 times (CI 1.52–3.31) increased risk of diarrheal prevalences higher than households with faecal sludge emptying. The socio-economic data indicated households in high density areas had more diarrheal infections than those in low density areas. However, the difference in family incomes did not have significant effects on diarrheal infections, suggesting households in Bangkok city have adequate access to health education. The aforementioned data indicate the uncollected faecal sludge, and leakage or overflow of faecal sludge containments, and without faecal sludge emptying to be the main factors causing diarrheal infections in households in Bangkok city. Therefore, the Bangkok Metropolitan Administration (BMA) should increase the % faecal sludge collection from households by regular emptying services, using small faecal sludge collection trucks in high household density areas and periodic checking the performance of FS containments to prevent leakage and overflow of containments. In addition, Bangkok Metropolitan Administration should improve its accountability (AC) in faecal sludge management services, possibly by developing robust data/information management systems which should be accessible by stakeholders. Graphical abstract