Over the past decades, in developing countries, several urban sanitation management models have been promoted, showing various results, often poor, as regards reducing negative environmental, public health impacts and in reaching access to sanitation for all. Many studies and reports highlight that solutions should be found by promotion of on-site and decentralized sanitation approaches including fecal sludge management (FSM). However, few papers have either offered a comprehensive analysis of FSM services, regarding both demand from households and services provision from public and/or private operators. Based on field research in Cambodia, this paper aims to fill this gap. It is built on a large survey conducted in three cities in 2011. Results showed that the Cambodian FSM sector is dominated by private mechanical extraction and transportation operators (ETO). The FSM market looks economically efficient with reasonable fees. It also offers a reasonably high level of service quality including profitability of businesses, although the FSM market is also characterized by strong negative environmental externalities that are not considered. Consequently, this paper advocates an integrated urban sanitation approach that aims at exploring in more detail how to integrate gradually and complementarily private mechanical ETOs and households practices into a more complex sanitation urban model raising the key issue of financing the externalities’ costs.
