Note on the health impact of water and sanitation services

This literature study examines the role of water and sanitation programs on improving health outcomes, the historical efforts to improve access, the impacts achieved, and the challenges remaining for the future. It reviews the results from an economic point of view, and gives a large role to cost-effectiveness, resulting in some expected and some peculiar findings. As there are : 1) evidence indicates that the quantity of water may be more important than its quality, 2) improving access to sanitation can lead to greater improvements in health outcomes than improving access to water, 3) inadequate access to water and sanitation is unequally distributed between urban and rural areas, and across geographic regions, 4) the vast majority of individuals with poor access to water supply live in Asia and Africa, and 5) two-third of those without water supply and 80 % of those without sanitation live in Asia. But there is also a rural household survey, reporting that the health effects (reduced gastrointestinal disease) only came on the fifth place of top reasons for satisfaction, after lack of flies, cleaner surroundings, privacy and less embarrassment when friends visited.
Given that large portions of the benefits from improved water supply and sanitation accrue outside of health, it is increasingly apparent that they are not solely health sector concerns. While no collaborative strategy has yet been proven to be the most efficient, there is an increasing promotion of collaboration between the public sector, the private sector and community participation to deliver these services.