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      Economic Aspects of Sanitation in Developing Countries

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          Abstract

          Background:

          Improved sanitation has been shown to have great impacts on people’s health and economy. However, the progress of achieving the Millennium Development Goals (MDGs) on halving the proportion of people without access to clean water and basic sanitation by 2015 has thus far been delayed. One of the reasons for the slow progress is that policy makers, as well as the general public, have not fully understood the importance of the improved sanitation solutions. This paper, by gathering relevant research findings, aims to report and discuss currently available evidence on the economic aspects of sanitation, including the economic impacts of unimproved sanitation and the costs and economic benefits of some common improved sanitation options in developing countries.

          Methods:

          Data used in this paper were obtained from different information sources: international and national journal articles and reports, web-based statistics, and fact sheets. We used both online search and hand search methods to gather the information.

          Results:

          Scientific evidence has demonstrated that the economic cost associated with poor sanitation is substantial. At the global level, failure to meet the MDG water and sanitation target would have ramifications in the area of US$38 billion, and sanitation accounts for 92% of this amount. In developing countries, the spending required to provide new coverage to meet the MDG sanitation target (not including program costs) is US$142 billion (US$ year 2005). This translates to a per capita spending of US$28 for sanitation. Annually, this translates to roughly US$14 million. The evidence complied in this paper demonstrates that investing in sanitation is socially and economically worthwhile. For every US$1 invested, achieving the sanitation MDG target and universal sanitation access in the non-OECD countries would result in a global return of US$9.1 and US$11.2, respectively.

          Conclusion:

          Given the current state of knowledge, sanitation is undeniably a profitable investment. It is clear that achieving the MDG sanitation target not only saves lives but also provides a foundation for economic growth.

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          Most cited references48

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          Sanitation and Health

          As one article in a four-part PLoS Medicine series on water and sanitation, David Trouba and colleagues discuss the importance of improved sanitation to health and the role that the health sector can play in its advocacy.
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            Global cost-benefit analysis of water supply and sanitation interventions.

            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.
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              Socio-economic aspects of improved sanitation in slums: a review.

              This socio-economic review provides an overview of the sanitation crisis in slum areas, and re-emphasizes the importance of sanitation. It highlights a lack of recognition of actual drivers for sanitation improvements, and the complexities in the provision of sanitation services in the context of urban slums with a mix of tenants and landlords. It elaborates how the drivers of demand for sanitation outlined in contemporary research are not universal but are rather context specific. The authors point out specific knowledge gaps for future research; for example, the need to establish a scientific basis for context-specific drivers of demand for sanitation improvements in slums, and a better understanding of associated complexities in order to set boundary conditions for achieving desired improvements. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Environ Health Insights
                Environmental Health Insights
                Environmental Health Insights
                Libertas Academica
                1178-6302
                2011
                18 October 2011
                : 5
                : 63-70
                Affiliations
                [1 ]Health Economics Department, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
                [2 ]Center for Health System Research, Hanoi Medical University, Hanoi, Vietnam
                [3 ]Swiss Federal Institute of Aquatic Science and Technology (Eawag)
                [4 ]Swiss Tropical and Public Health Institute/University of Basel, Basel, Switzerland
                [5 ]Department of Environmental Health, Hanoi School of Public Health, Hanoi, Vietnam
                Author notes
                Corresponding author email: hvminh71@ 123456yahoo.com
                Article
                ehi-5-2011-063
                10.4137/EHI.S8199
                3212862
                22084575
                54e958d5-e1b4-4ac8-ab6f-ad1bdf910cdf
                © the author(s), publisher and licensee Libertas Academica Ltd.

                This is an open access article. Unrestricted non-commercial use is permitted provided the original work is properly cited.

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                Categories
                Short Review

                Public health
                cost,developing countries,impacts,sanitation,economics
                Public health
                cost, developing countries, impacts, sanitation, economics

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