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      Water-Borne Diseases, Cost of Illness and Willingness to Pay for Diseases Interventions in Rural Communities of Developing Countries

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          Abstract

          Background

          Almost one third of the global population is living in developing South Asia where disease occurrence is high especially in rural areas and people are unaware of water-borne diseases and cost of illness.

          Methods:

          The quantitative approach involved questionnaire based study (n=50 households). The community awareness, the occurrence of water-borne diseases with related cost of illness and community participation for the introduction of health interventions for water-borne diseases were evaluated through cross-tabulations, correlations, and ANOVA.

          Results:

          Majority (40%) of the community had no knowledge of water-borne diseases except some had little knowledge of diarrhea and typhoid. Diarrhea followed by stomach diseases was widespread in the community. Population below poverty level was bearing the cost of illness around US$ 0.6—1.2 (Rs 50—100) per day followed by low and average income level with direct cost of US$ 2.3 (Rs 200) per day. The indirect cost of illness had showed increasing trend between US$ 2.3—4.7 (Rs 200–400) per day with increase in income levels. Maximum willingness to pay (WTP) for water supply and sewerage system was US$ 3.6 (Rs 300) and US$ 1.2 (Rs 100) per month respectively. Income and water supply demand was strongly correlated with acceptability to pay for the facilities ( r = 0.319, 0.307; P< 0.05). Income had a strong influence on WTP for water and sewerage system ( r = 0.805, 0.797; P< 0.05).

          Conclusion:

          To maintain rural health, water-borne diseases can be reduced by introducing health interventions like proper water and sanitation facilities.

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          Most cited references28

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          Water pollution in Pakistan and its impact on public health--a review.

          Water pollution is one of the major threats to public health in Pakistan. Drinking water quality is poorly managed and monitored. Pakistan ranks at number 80 among 122 nations regarding drinking water quality. Drinking water sources, both surface and groundwater are contaminated with coliforms, toxic metals and pesticides throughout the country. Various drinking water quality parameters set by WHO are frequently violated. Human activities like improper disposal of municipal and industrial effluents and indiscriminate applications of agrochemicals in agriculture are the main factors contributing to the deterioration of water quality. Microbial and chemical pollutants are the main factors responsible exclusively or in combination for various public health problems. This review discusses a detailed layout of drinking water quality in Pakistan with special emphasis on major pollutants, sources of pollution and the consequent health problems. The data presented in this review are extracted from various studies published in national and international journals. Also reports released by the government and non-governmental organizations are included. Copyright © 2010 Elsevier Ltd. All rights reserved.
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            Valuing health care using willingness to pay: a comparison of the payment card and dichotomous choice methods.

            This paper compares willingness to pay (WTP) estimates generated from the dichotomous choice (DC) and payment card (PC) approaches. In a split-sample WTP experiment concerned with allocating scarce health care resources across three health care interventions, the DC approach is shown consistently to generate larger welfare estimates than the PC. Observed difference between PC and DC experiments cannot be explained by the inclusion of non-demanders or methods of statistical analysis but may be partly explained by "yea-saying". No evidence of range bias or mid-point bias was found with PC responses. Data were also collected on respondents' ordinal rankings of the three interventions and person-trade-offs (PTOs). Neither of these approaches converged with WTP. Future work must address the decision heuristics individuals employ when responding to valuation experiments.
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              Microbial contamination of the drinking water distribution system and its impact on human health in Khan Yunis Governorate, Gaza Strip: seven years of monitoring (2000-2006).

              To assess total and faecal coliform contamination in water wells and distribution networks over the past 7 years, and their association with human health in Khan Yunis Governorate, Gaza Strip. Historical data and interview questionnaire. Data were obtained from the Palestinian Ministry of Health on total and faecal coliform contamination in water wells and distribution networks, and on the incidence of water-related diseases in Khan Yunis Governorate. An interview questionnaire was conducted with 210 residents of Khan Yunis Governorate. Total and faecal coliform contamination exceeded the World Health Organization's limit for water wells and networks. However, the contamination percentages were higher in networks than in wells. Diarrhoeal diseases were strongly correlated with faecal coliform contamination in water networks (r=0.98). This is consistent with the finding that diarrhoeal diseases were the most common self-reported diseases among the interviewees. Such diseases were more prevalent among subjects who drank municipal water than subjects who drank desalinated or home-filtered water (odds ratio=2.03). Intermittent water supply, insufficient chlorination and sewage flooding seem to be associated with self-reported diseases. Residents in the Gaza Strip have a good level of knowledge about drinking water contamination, and this is reflected in good practice. Water quality has deteriorated in the Gaza Strip, and this may contribute to the prevalence of water-related diseases. Self-reported diseases among interviewees in Khan Yunis Governorate were associated with source of drinking water, intermittent water supply, insufficient chlorination, sewage flooding and age of water networks.
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                Author and article information

                Journal
                Iran J Public Health
                Iran. J. Public Health
                IJPH
                Iranian Journal of Public Health
                Tehran University of Medical Sciences
                2251-6085
                2251-6093
                30 June 2012
                2012
                : 41
                : 6
                : 39-49
                Affiliations
                Sustainable Development Study Center, GC University, Lahore, Pakistan
                Author notes
                [* ]Corresponding Author: Tel: 923324328933, E-mail address: fmawaisi@ 123456hotmail.com
                Article
                ijph-41-39
                3469006
                23113192
                ab29238a-a046-402c-a06e-2aa9f09fe51a
                Copyright © Iranian Public Health Association & Tehran University of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0), which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                : 19 February 2012
                : 12 April 2012
                Categories
                Original Articles

                Public health
                water-borne diseases,community awareness,diseases interventions,willingness to pay,cost of illness

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