https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(12)61766-8.pdf

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

https://biblio.ugent.be/publication/8617256/file/8617262.pdf

Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(07)61693-6.pdf

What works? Interventions for maternal and child undernutrition and survival.

Many studies have reported the results of interventions to reduce illness through improvements in drinking water, sanitation facilities, and hygiene practices in less developed countries. There has, however, been no formal systematic review and meta-analysis comparing the evidence of the relative effectiveness of these interventions. We developed a comprehensive search strategy designed to identify all peer-reviewed articles, in any language, that presented water, sanitation, or hygiene interventions. We examined only those articles with specific measurement of diarrhoea morbidity as a health outcome in non-outbreak conditions. We screened the titles and, where necessary, the abstracts of 2120 publications. 46 studies were judged to contain relevant evidence and were reviewed in detail. Data were extracted from these studies and pooled by meta-analysis to provide summary estimates of the effectiveness of each type of intervention. All of the interventions studied were found to reduce significantly the risks of diarrhoeal illness. Most of the interventions had a similar degree of impact on diarrhoeal illness, with the relative risk estimates from the overall meta-analyses ranging between 0·63 and 0·75. The results generally agree with those from previous reviews, but water quality interventions (point-of-use water treatment) were found to be more effective than previously thought, and multiple interventions (consisting of combined water, sanitation, and hygiene measures) were not more effective than interventions with a single focus. There is some evidence of publication bias in the findings from the hygiene and water treatment interventions.

https://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(04)01253-8.pdf

Water sanitation and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis.

Cost Effectiveness in Health and Medicine.

Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to Publications, at the above address (fax: +41 22 791 4806; email: permissions@who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The World Health Organization does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. The named authors alone are responsible for the views expressed in this publication 3 Summary The aim of this study was to estimate the economic costs and benefits of a range of selected interventions to improve water and sanitation services, with results presented for 17 WHO sub-regions and at the global level. Interventions evaluated include (1) improvements required to meet the millennium development goals (MDG) for water supply (by halving by 2015 the proportion of those without access to safe drinking water), (2) meet the water MDG plus halving by 2015 the proportion of those without access to adequate sanitation, (3)increasing access to improved water and sanitation for everyone, (4) providing disinfection at point-of-use over and above increasing access to improved water supply and sanitation (5) providing regulated piped water supply in house and sewage connection with partial sewerage for everyone. Predicted reductions in the incidence of diarrhoeal disease were calculated for each intervention based on the expected population receiving these interventions. The costs of the interventions included the full investment and annual running costs. The benefits of the interventions included time savings associated with better access to water and sanitation facilities, the gain in productive time due to less time spent ill, health sector and patients costs saved due to less treatment of diarrhoeal diseases, and the value of prevented deaths. The results show that all water and …

/pdf/evaluation-of-the-costs-and-benefits-of-water-and-sanitation-45n7l2yzlf.pdf

Evaluation of the Costs and Benefits of Water and Sanitation Improvements at the Global Level

The aim of this study was to estimate the economic benefits and costs of a range of interventions to improve access to water supply and sanitation facilities in the developing world. Results are presented for eleven developing country WHO sub-regions as well as at the global level, in United States Dollars (US$) for the year 2000. Five different types of water supply and sanitation improvement were modelled: achieving the water millennium development goal of reducing by half in 2015 those without improved water supply in the year 1990; achieving the combined water supply and sanitation MDG; universal basic access to water supply and sanitation; universal basic access plus water purification at the point-of-use; and regulated piped water supply and sewer connection. Predicted reductions in the incidence of diarrhoeal disease were calculated based on the expected population receiving these interventions. The costs of the interventions included estimations of the full investment and annual running costs. The benefits of the interventions included time savings due to easier access, gain in productive time and reduced health care costs saved due to less illness, and prevented deaths. The results show that all water and sanitation improvements are cost-beneficial in all developing world sub-regions. In developing regions, the return on a US$1 investment was in the range US$5 to US$46, depending on the intervention. For the least developed regions, investing every US$1 to meet the combined water supply and sanitation MDG lead to a return of at least US$5 (AFR-D, AFR-E, SEAR-D) or US$12 (AMR-B; EMR-B; WPR-B). The main contributor to economic benefits was time savings associated with better access to water and sanitation services, contributing at least 80% to overall economic benefits. One-way sensitivity analysis showed that even under pessimistic data assumptions the potential economic benefits outweighed the costs in all developing world regions. Further country case-studies are recommended as a follow up to this global analysis.

/pdf/global-cost-benefit-analysis-of-water-supply-and-sanitation-4te2peazai.pdf

Global cost-benefit analysis of water supply and sanitation interventions

https://repository.supsi.ch/6896/1/Haller%202011%20Water%20Res%2045.pdf

Composition of bacterial and archaeal communities in freshwater sediments with different contamination levels (Lake Geneva, Switzerland)

Using effectiveness data from a recent systematic review and cost data from programme implementers and World Health Organization (WHO) databases, we conducted a cost-effectiveness analysis to compare non-piped in source- (dug well, borehole and communal stand post) and four types of household- (chlorination, filtration, solar disinfection, flocculation/disinfection) based interventions to improve the microbial quality of water for preventing diarrhoeal disease. Results are reported for two WHO epidemiological sub-regions, Afr-E (sub-Saharan African countries with very high adult and child mortality) and Sear-D (South East Asian countries with high adult and child mortality) at 50% intervention coverage. Measured against international benchmarks, source- and household-based interventions were generally cost effective or highly cost effective even before the estimated saving in health costs that would offset the cost of implementation. Household-based chlorination was the most cost-effective where resources are limited; household filtration yields additional health gains at higher budget levels. Flocculation/disinfection was strongly dominated by all other interventions; solar disinfection was weakly dominated by chlorination. In addition to cost-effectiveness, choices among water quality interventions must be guided by local conditions, user preferences, potential for cost recovery from beneficiaries and other factors.

/pdf/cost-effectiveness-of-water-quality-interventions-for-1tuyo57vb9.pdf

Laurence Haller

Papers

Water sanitation and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis.

Evaluation of the Costs and Benefits of Water and Sanitation Improvements at the Global Level

Global cost-benefit analysis of water supply and sanitation interventions

Composition of bacterial and archaeal communities in freshwater sediments with different contamination levels (Lake Geneva, Switzerland)

Cost-effectiveness of water quality interventions for preventing diarrhoeal disease in developing countries.