This paper outlines the findings of a fecal sludge management (FSM) initial scoping study in 12 cities. This short, desk-based study assesses the institutional context and the outcome in terms of the amount of fecal sludge safely managed in each city. A range of cities was included in the review, all in low- and middle-income countries. None of the cities studied managed fecal sludge effectively, although performance varied. Where cities are seeking to address fecal sludge challenges the solutions are, at best, only partial, with a focus on sewerage which serves a small minority in most cases. FSM requires strong city-level oversight and an enabling environment that drives coordinated actions along the sanitation service chain; this was largely absent in the cities studied. Based on the findings of the review a typology of cities was developed to aid the identification of key interventions to improve FSM service delivery. Additional work is recommended to further improve the tools used in this study in order to enable better understanding of the FSM challenges and identify appropriate operational solutions.

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