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Book Details
Abstract
The aim of Valuing Water, Valuing Livelihoods is to give decision-makers, health professionals and analysts a comprehensive view of the arguments and challenges associated with establishing the value of drinking-water interventions.
The experts who have contributed to this publication provide guidance on assessing the benefits from improving access to safe drinking-water and from reducing the burden of water-related diseases. They show how to compare the value of these benefits to the costs of interventions, with special reference to small-scale drinking-water systems. Valuing Water, Valuing Livelihoods provides decision-makers, health professionals and analysts with the tools to promote improved access to safe drinking-water, especially for small and vulnerable communities in developing countries, by presenting comprehensive coverage of principles and practice, technology and economics, health, livelihoods and ethics.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Cover\r | Cover | ||
| Contents | v | ||
| Foreword | vii | ||
| Acknowledgements | ix | ||
| Introduction | xi | ||
| 1:\rBackground | 1 | ||
| SAFE DRINKING-WATER AS A HUMAN RIGHT | 4 | ||
| HOW LACK OF ACCESS TO SAFE DRINKING-WATER AFFECTS WELL-BEING | 6 | ||
| WHAT ARE COST–EFFECTIVENESS ANALYSIS AND SOCIAL COST–BENEFIT ANALYSIS? | 8 | ||
| REFERENCES | 12 | ||
| 2:\rThe practice of economic assessment of small-scale drinking-water interventions | 15 | ||
| ASSESSING THE EFFECT OF DRINKING-WATER INTERVENTIONS ON PEOPLE’S LIVELIHOODS | 16 | ||
| Livelihoods | 17 | ||
| COSTING FEASIBLE INTERVENTIONS AND ASSESSING COST–EFFICIENCY | 18 | ||
| Discounted cost-efficiency | 21 | ||
| ASSESSING COST–EFFECTIVENESS | 21 | ||
| Benefits of reducing morbidity and mortality | 22 | ||
| Time saved in collecting and processing water | 23 | ||
| Savings on health-care expenditure | 24 | ||
| The complete cost–effectiveness analysis | 24 | ||
| UNDERTAKING A SOCIAL COST–BENEFIT ANALYSIS | 26 | ||
| Estimating costs and benefits for a full social cost–benefit analysis | 27 | ||
| Bringing costs and benefits together for analysis | 30 | ||
| SENSITIVITY TESTING TO DETERMINE THE ROBUSTNESS OF THE SOCIAL COST–BENEFIT ANALYSIS RESULTS | 33 | ||
| Deciding which variables to include in a sensitivity test | 33 | ||
| A LAST WORD | 37 | ||
| REFERENCES | 37 | ||
| 3: Economic assessments of improvements in drinking-water supply– the global evidence\r | 39 | ||
| THE NEED FOR PUBLIC SECTOR INTERVENTIONS | 40 | ||
| THE NEED FOR AN ECONOMIC ASSESSMENT | 47 | ||
| COST-EFFECTIVENESS ANALYSIS AND THE CASES FOR AND AGAINST PRIORITIZING DRINKING-WATER IMPROVEMENTS | 48 | ||
| SOCIAL COST–BENEFIT ANALYSIS AND THE UNDP 2006 HUMAN DEVELOPMENT REPORT\r | 50 | ||
| THE WAY FORWARD | 52 | ||
| REFERENCES | 53 | ||
| 4:\rCurrent situation in access to drinking-water | 55 | ||
| GLOBAL LEVELS OF ACCESS TO SAFE DRINKING-WATER | 59 | ||
| LIVELIHOODS ANALYSIS | 61 | ||
| WATER FOR DRINKING AND LIVELIHOODS IN RURAL AREAS | 63 | ||
| LIVELIHOOD ASPECTS OF ACCESS TO WATER | 66 | ||
| CONCLUSIONS | 71 | ||
| REFERENCES | 71 | ||
| 5: Defining the current situation\r– epidemiology | 75 | ||
| MEASURES OF DISEASE OCCURRENCE | 76 | ||
| ESTIMATING DISEASE OCCURRENCE | 77 | ||
| Case definition | 77 | ||
| Primary surveys | 78 | ||
| Sampling | 81 | ||
| Using existing local health data | 81 | ||
| Extrapolating from previous studies | 83 | ||
| Using existing global estimates | 84 | ||
| ESTIMATING DISEASE ATTRIBUTABLE TO A SPECIFIC ENVIRONMENTAL RISK | 84 | ||
| Risk assessment | 85 | ||
| Epidemiological approaches | 86 | ||
| Existing global and regional estimates | 88 | ||
| NONCOMMUNICABLE DISEASE | 88 | ||
| CONCLUSION | 91 | ||
| REFERENCES | 91 | ||
| 6:\rDefining the current situation | 101 | ||
| USING THE LIVELIHOODS FRAMEWORK | 102 | ||
| REDUCING INFORMATION ERROR IN A COMPLEX LIVELIHOODS CONTEXT | 104 | ||
| RISKS IN FORMULATING THE DEEP ISSUES AND ESTABLISHING THE BASELINE | 107 | ||
| IDENTIFYING OBJECTIVELY MEASURABLE VARIABLES | 108 | ||
| DESIGNING THE MEASURING INSTRUMENT -\rTHE RISK OF MEASUREMENT INACCURACY | 108 | ||
| RISKS IN IDENTIFYING THE RELEVANT POPULATION | 111 | ||
| DECIDING WHICH CASES TO INVESTIGATE - THE RISK OF BIAS AND SAMPLING ERROR\r | 111 | ||
| NEGOTIATING CONTRACTS - THE RISK OF UNDER-RESOURCING AND INFLUENCE OF VESTED INTERESTS\r | 112 | ||
| RISKS IN FIELD MANAGEMENT | 113 | ||
| RISKS IN EMPLOYING, TRAINING AND SUPERVISING INTERVIEWERS OR ENUMERATORS | 114 | ||
| PROCESSING DATA | 116 | ||
| ANALYSING DATA TO PRODUCE INFORMATION | 117 | ||
| COMMUNICATING INFORMATION | 118 | ||
| CONCLUSION | 119 | ||
| REFERENCES | 119 | ||
| 7:\rInterventions for water provision | 121 | ||
| WATER INTERVENTIONS | 122 | ||
| SOURCES OF WATER | 122 | ||
| Rainwater harvesting | 123 | ||
| Groundwater sources | 124 | ||
| Surface water sources | 125 | ||
| Regional supply | 126 | ||
| SOURCE PROTECTION AND SUPPLY INTERVENTIONS | 127 | ||
| Resource and source protection | 128 | ||
| Supply interventions | 129 | ||
| Water treatment | 135 | ||
| SMALL-SCALE WATER DISTRIBUTION SYSTEMS | 136 | ||
| Water haulage | 138 | ||
| Household interventions | 139 | ||
| EDUCATION AND COMMUNITY TRAINING | 141 | ||
| POLICY INTERVENTIONS | 142 | ||
| REFERENCES | 146 | ||
| 8:\rEstimating the costs of small-scale water-supply interventions | 149 | ||
| CHALLENGES OF COSTING A SMALL-SCALE WATER SYSTEM INTERVENTION | 151 | ||
| ELEMENTS OF COSTING | 152 | ||
| Capital costs | 153 | ||
| Recurrent costs | 154 | ||
| ESTIMATING COSTS FOR A SMALL-SCALE WATER SYSTEM | 156 | ||
| Preliminary requirements | 157 | ||
| Activity cost estimation | 158 | ||
| Developing the source | 158 | ||
| Storage | 159 | ||
| Treatment | 159 | ||
| Distribution | 160 | ||
| Pumping | 160 | ||
| Public source points | 161 | ||
| General remarks on estimating maintenance cost | 161 | ||
| General remarks on estimating operational costs | 162 | ||
| Estimating unit costs | 163 | ||
| POLICY, EDUCATION AND COMMUNITY TRAINING FOR COST ESTIMATION AND RECOVERY | 163 | ||
| REFERENCES | 165 | ||
| 9:\rEstimating health impacts of interventions with a focus on small-scale drinking-water interventions | 167 | ||
| INTERVENTION STUDIES | 168 | ||
| USING PREVIOUS STUDIES AND SYSTEMATIC REVIEWS | 170 | ||
| RISK ASSESSMENT | 174 | ||
| GLOBAL SCENARIOS | 176 | ||
| PHASED INTERVENTIONS | 176 | ||
| CHRONIC DISEASE | 178 | ||
| VULNERABLE GROUPS | 178 | ||
| CONCLUSION | 179 | ||
| REFERENCES | 179 | ||
| 10:\rCost-effectiveness analysis in practice | 181 | ||
| ECONOMIC ASSESSMENT -\rTHE STEPS TO BE TAKEN | 182 | ||
| Step one: describe the present position | 182 | ||
| Step two: identify the feasible improvements | 182 | ||
| Step three: estimate the costs of improvements to water supply | 182 | ||
| Step four: estimate the health benefits | 183 | ||
| HOW COST-EFFECTIVENESS ANALYSIS IS CARRIED OUT | 185 | ||
| THE DISEASE CONTROL PRIORITIES PROJECT AND DISABILITY-ADJUSTED LIFE YEARS | 188 | ||
| WHO PROJECT FOR CHOOSING INTERVENTIONS THAT ARE COST–EFFECTIVE | 192 | ||
| GENERALIZED COST–EFFECTIVENESS ANALYSIS AS APPLIED TO WATER INTERVENTIONS | 193 | ||
| REFERENCES | 196 | ||
| 11: Social cost–benefit analysis – principles\r | 199 | ||
| SOCIAL COST-BENEFIT ANALYSIS - BACKGROUND\r | 200 | ||
| Conditions for a perfectly competitive market | 205 | ||
| Structure | 206 | ||
| Conduct | 206 | ||
| Performance | 206 | ||
| WILLINGNESS TO PAY | 208 | ||
| THE SPECIFICS OF SOCIAL COST-BENEFIT ANALYSIS FOR DRINKING-WATER INTERVENTIONS | 208 | ||
| REVIEW OF THE COMPLETE PROCESS FOR SOCIAL COST–BENEFIT ANALYSIS | 213 | ||
| REFERENCES | 216 | ||
| 12: Social cost–benefit analysis - summarizing the available global evidence on drinking-water interventions\r | 217 | ||
| THE MONETARY VALUE OF A DALY | 221 | ||
| WHAT ARE INVESTMENTS IN WATER IMPROVEMENTS WORTH? | 222 | ||
| THE WAY FORWARD: POLICY, PACKAGES AND SEQUENCING | 225 | ||
| REFERENCES | 226 | ||
| ANNEX 1. EXAMPLE OF THE COSTS AND BENEFITS OF A DUG WELL | 228 | ||
| BENEFIT/COST RATIO | 228 | ||
| THE NET PRESENT VALUE | 229 | ||
| THE INTERNAL RATE OF RETURN | 229 | ||
| THE THREE MEASURES BROUGHT TOGETHER | 233 | ||
| SENSITIVITY ANALYSIS | 233 | ||
| REFERENCE | 233 | ||
| ANNEX 2:\rTHE VALUATION PROBLEM | 234 | ||
| REFERENCES FOR THIS ANNEX | 236 | ||
| Index | 239 |