Wastewater management in Latin America faces great challenges to reach a sustainable state. Although enough infrastructure has been built to treat around 40% of wastewater, only between 15–20% is effectively treated, and abandoned or defective infrastructure is a common sight. Data about current conditions at specific sites is quite fragmented, when existing. This leads to challenges in management, decision making and planning for sustainable options. We argue that a main obstacle is the lack of a regionally relevant sustainability assessment framework that allows for a holistic understanding of wastewater management as a nexus problem. We therefore developed a comprehensive framework to (1) understand current conditions (2) involve stakeholders and (3) point to pathways to improve wastewater management in the Americas. Building on literature review and stakeholder involvement, we constructed a multi-scalar extended dataset framework that is adaptable to different study sites using specific criteria. Sustainability was assessed through a “distance-to-target” approach. Social and economic variables were the lowest ranking in both cases, with technical variables generally performing better. Although some dimensions of sustainability are performing acceptably, others, such as social and economic, are general low to very low performing. This means, when looked at in an integrated manner, neither of the wastewater management systems analysed can be considered sustainable. Here we present the approach itself, the results of its application in two pilot sites in Latin America, and our recommendation to shift waste water management into sustainability.

Currently installed wastewater treatment systems in many developing countries are unsustainable, failing in either the social, economic or ecological dimension of sustainability. Nexus research looking at resources involved in wastewater treatment could support the transition towards more sustainable systems. Nexus thinking aims to overcome bio-physical systems thinking by including transdisciplinary research methods. Approaches for integrating results from different types of analysis and disciplinary backgrounds are scarce and have not been described extensively in nexus research. Transdisciplinary research suggests creating system, target and transformation knowledge as a common framework to describe meaningful transformations. Our goal is to show how a better understanding of the level of knowledge created by different types of analysis can pave the way towards integrating results for sustainability. In this article, three types of analysis, namely sustainability assessment, stakeholder perspective analysis and wickedness analysis, were applied in two pilot case wastewater treatment systems in Latin America. Through a three-step process, generated knowledge was assessed for each type of analysis individually while also highlighting synergies between them. The results demonstrate that structuring results by generated knowledge type can help combining outcomes in a meaningful manner. The findings show that technical flaws are present and fixable, and that issues relating to behaviours or values are more challenging to address but arguably more meaningful for systemic change.