This review article attempts to analyse the social issues that impact the performance of natural treatment systems (NTSs). An NTS is a decentralised wastewater treatment system found to be appropriate in developing countries due to its affordability and lower technicity. However, if socio-economic and institutional issues of community are ignored then NTSs may turn out to be unsuitable for developing countries. The article also takes a critical view on the extant literature which ignores the social cost of NTSs. The social cost of NTSs may be high as a decentralised system requires the engagement of various governmental agencies, research institutes and the community. The cost of engagement may make NTSs a socio-economically unattractive proposition. The article discusses the variables to be considered for the social cost-benefit analysis. It also discusses the implications of social cost-benefit analysis for appreciating the incentives and net benefits for collective actions at the community level. Social cost-benefit analysis can help overcome the initial difficulty of high financial cost and usher sustainability.
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