Rapidly increasing populations in informal settlements commonly use pit-latrines that require regular emptying. This study compares two emptying businesses from Kampala, Uganda and Kigali, Rwanda and identifies developments in formal services for hard-to-serve customers that are not accessible to large vehicles. Using observational and operational data shared by both businesses, we analyse the resources, methods, and tariffs used. Results indicate that although portable vacuum pumps are able to empty some facilities, full manual methods are still required to empty thick sludge, deep pits, and weak structures in hard-to-serve areas. Manual emptying in Kampala which uses no mechanical equipment has the same overall duration as emptying using a portable vacuum pump in Kigali due to the additional time required to prepare, pack, and clean equipment. Effective municipal solid-management makes pit emptying faster at a lower cost. Some hard-to-serve customers require manual methods but increased costs are not affordable or equitable. This study highlights the opportunity for government and city authorities to support sanitation businesses by managing the tension between affordability, formalising services, and increasing uptake by recognising that manual emptying is required for some customers, and such higher regulatory standards can increase prices and prevent some customers from accessing formal services.
Portable vacuum pumps are able to empty some pit-latrines that are inaccessible to exhauster trucks.
Fully manual methods are required to empty pit-latrines that cannot be pumped in hard-to-serve areas.
Formalising services increases costs that are unaffordable to some hard-to-serve customers.
Governments and city authorities have opportunities to make services more equitable.
Municipal solid-waste management makes pit-latrine emptying faster at a lower cost.
Co-first author—these authors contributed equally to this work.