Study site – Maputo, Mozambique

Maputo has a population of approximately 1.2 million people, 70% of whom live in informal slum settlements [26]. Migration to Maputo increased significantly during the war for independence (1964–1974) and subsequent civil war (1974–1992), as people sought refuge from the conflicts but also sought economic opportunities [26]. Currently, Maputo has a mean population density of 4086 people per square kilometer, although this varies significantly across neighbourhoods. Between now and 2050, approximately two-thirds of the country’s population growth is expected to occur in cities, a trend that will put additional stress on already inadequate public health infrastructure and further contribute to the “urbanization of poverty” [26]. An estimated 89% of all Maputo residents use on-site fecal management systems (non-sewered), and only 26% of all fecal waste in the city is safely managed¹ [28].