Faecal sludge management in Accra, Ghana: strengthening links in the chain BootNiall L. ScottRebecca E. 2018 Achieving a fully operational Faecal Sludge Management (FSM) chain requires well managed and sustainable services in all aspects of the collection (emptying), transport (haulage), disposal and treatment of faecal sludge. A fully operational FSM chain offers one type of sustainable sanitation system, particularly for urban populations in low and middle-income countries. Failure to ensure all links in the chain are strong and working effectively results in untreated faecal sludge contaminating the environment, with serious implications for human health and environmental degradation. Research in Accra, Ghana has identified important constraints to achieving an efficient and fully functioning FSM chain, with consequences for both people and the environment. Opportunities to improve the institutional and operating environment are identified, particularly affecting engagement between the public and private sector and civil society. Improved stakeholder engagement, together with better regulation, management and access to facilities, enhances services in a way that bring wider benefits to all.