Despite global efforts
on meeting sustainable development goals
by 2030, persistent and widespread sanitation deficits in rural, underserved
communities in high-income countriesincluding the United States
(US)challenge achieving this target. The recent US federal
infrastructure funding, coupled with research efforts to explore innovative,
alternative decentralized wastewater systems, are unprecedented opportunities
for addressing basic sanitation gaps in these communities. Yet, understanding
how to best manage these systems for sustainable operations and maintenance
(O&M) is still a national need. Here, we develop an integrated
management approach for achieving such sustainable systems, taking
into account the utility structure, operational aspects, and possible
barriers impeding effective management of decentralized wastewater
infrastructure. We demonstrate this approach through a binomial logistic
regression of survey responses from 114 public and private management
entities (e.g., water and sewer utilities) operating in 27 states
in the US, targeting the rural Alabama Black Belt wastewater issues.
Our assessment introduces policy areas that support sustainable decentralized
wastewater systems management and operations, including privatizing
water-wastewater infrastructure systems, incentivizing/mandating the
consolidation of utility management of these systems, federally funding
the O&M, and developing and retaining water-wastewater workforce
in rural, underserved communities. Our discussions give rise to a
holistic empirical understanding of effective management of decentralized
wastewater infrastructure for rural, underserved communities in the
US, thereby contributing to global conversations on sustainable development.