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TitleWater supply, sanitation, and hygiene promotion [chapter 41]
Publication TypeBook Chapter
Year of Publication2006
AuthorsCairncross, S, Valdmanis, V
Paginationp. 771 - 792; 3 fig.; 12 tab.
Date Published2006-01-01
PublisherOxford University Press
Place PublishedNew York, NY, USA
Keywordsbusiness risks, cost benefit analysis, excreta disposal systems, faecal-disposal diseases, safe water supply, sanitation, water supply
Abstract

Water supply includes the supply of water for domestic purposes, excluding provision for irrigation or livestock. Sanitationis used here in the narrow sense of excreta disposal, excluding other environmental health interventions such as solid waste management and surface water drainage. The effect of these other measures on disease burden is largely confined to urban areas and is considerably less than that of water supply, sanitation, and hygiene promotion. More fundamentally, expenditure on solid waste disposal and drainage is rarely seen as forming part of a portfolio of investments in public health or competing with public health investments. Rather, it is generally perceived by decision makers as comparable with other investments in municipal infrastructure and services, such as roads or public transportation, which are not considered to be public health interventions. There is a focus on water supply, excreta disposal, and hygiene promotion and attention on the costs and benefits of each in turn. Water supply and sanitation can be provided at various levels of service, and those levels have implications for benefits. Water supply and sanitation offer many benefits in addition to improved health, and those benefits are considered in detail because they have important implications for the share of the cost that is attributable to the health sector. From the point of view of their effect on burden of disease, the main health benefit of water supply, sanitation, and hygiene is a reduction in diarrheal disease, although the effects on other diseases are substantial. In the concluding sections, the percentage reductions arrived at in the discussion throughout the chapter are used together with data on existing levels of coverage to derive estimates of the potential effects of water supply and excreta disposal on the burden of disease, globally and by region, and with cost data to derive cost-effectiveness estimates. [authors abstract]

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