In the 81 countries where most urban dwellers rely on faecal sludge (FS) emptying and transport, services are frequently provided by a heterogeneous private sector. Considering the responses of service providers is essential to ensuring that the regulatory frameworks put into place achieve their intended outcomes and safeguard public and environmental health. Combining a literature review and expert practitioner input, we identify priority challenges for scaling safe FS emptying and transport (E&T) services and use these to adapt a holistic model of business compliance. We confirm well-documented challenges such as cost structures for compliance with regulation, the perception of services as low status, and an inadequate enabling environment. We identify the importance of trust in building voluntary compliance as a novel issue for sanitation but widely discussed in the regulation literature. We also identify a distinct role for the regulator as a catalyst for change. The role of disgust as a policy barrier and the application of behavioural theory to building compliance are areas warranting further research. This is the first paper to explicitly consider the regulation of FS E&T through a compliance lens, linking established areas of the regulation literature to new findings in urban sanitation.

  • For regulation to have an impact compliance with urban faecal sludge emptying and transport must be built.

  • One challenge is the low status of the service and the barrier of disgust.

  • Another challenge is the cost structures for the service provider, which drive non-compliance.

  • There are challenges of trust between the mandated authority and service provider.

  • There is a distinct role for the regulator as a change agent.

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