Table 1.

Water supply, sanitation and hygiene interventions—main features of reviewed economic evaluation studies.

Studies (intervention options)	Country	Study type and year of cost data	Benefits included	Costs included	Key results	Reference and source
Water supply only
Household disinfection and storage for HIV people	Uganda (rural)	CEA; RCT; 2004	Health (diarrhea)	Capital, O&M	US$5.2 DCA US$1,252 DALY	[27]PM
Source-based protection Household chlorination Household filtration Household solar disinfection Household flocculation	Global (AFR-E and SEAR-D presented; AFR-E shown here)	CEA; Model; 2002	Health (diarrhea)	Construction, O&M, programmer	US$123 DALY US$53 DALY US$142 DALY US$61 DALY US$472 DALY	[26]PM
Sanitation only
Constructed wetland Wastewater treatment plant	Italy (Venice)	CMA; programmer; 2005	Treatment efficacy	Capital, O&M (excluding land)	Wetland half to one eighth cost	[28]PM
Constructed wetlands Waste stabilization ponds	U.K. (urban)	CEA; CMA; programmer; 2005	Treatment efficacy	Capital, O&M (including land)	Stabilization pond one third to one seventh cost of wetland	[31]PM
Latrine improvement (construction or rehabilitation)	Afghanistan (Kabul)	CEA; case-control study; 1999	Child mortality (diarrhea only)	Provider and household	US$3,436 per death averted	[29]PM
DEWATS + EcoSan DEWATS + biogas STP	Indonesia (Surabaya)	CBA; model; 2001	User fees; health costs; productivity	Construction, O&M	BCR 1.1 BCR 0.92 BCR 0.66	[30]BC
Health and hygiene education only
Health education for mothers	Burkina Faso (Bobo-Dioulasso)	CEA; programmer evaluation and model; 1999	Health (diarrhea children under 5)	Start-up/running costs to provider and household	US$51 DCA US$8 DCA including cost offsets	[32]PM
Chemotherapy months 0,18 Chemo. Months 0,6,12,18 Health education Option 2 and 3 combined	Bangladesh (rural)	CER; randomized intervention; 1995	Health (intestinal parasites)	Programmer costs	3% PR per US$1 2.5% PR per US$1 0.3% PR per US$1 1.1% PR per US$1	[33,113]PM
Combined WSH interventions
Latrines and safe water ORS (moderate diarrhea) Treat severe diarrhea	Guinea	CEA; model; 1994	Health (diarrhea children under 5)	Programmer costs	US$343 death US$7 death US$74 death	[35]PM
Water improvement alone Water and sanitation Household water treatment	Global, regional (AFR-E presented here)	CBA; model; 2000	Health; VOSL; productivity, time savings	Capital, O&M costs	BCR 4.9 BCR 6.0 BCR 6.3	[25,114] PM, DR
Water and sanitation Household water treatment	Global, regional (AFR-E presented here)	CBA; model; 2000	Health, VOSL, productivity, time savings	Capital, O&M costs	US£534 DALY US$24 DALY	[34]PM
Integrated biogas, latrine and hygiene programmer	Africa-wide, Uganda, Rwanda, Ethiopia	CBA; model with field data; 2006	Fuel, health, productivity, VOSL, forest, greenhouse gases, time, lighting	Construction, O&M, programmer costs	BCR > 4.5 EIRR > 78%	[36]DR
SW added to existing HW HW and SW combined HW only SW only ORS	Global (generic)	CEA; model; 1996	Health (diarrhea children under 5)	Construction, O&M for HW; programmer costs for SW	US$20 DALY US$413 DALY US$1152 DALY US$44 DALY US$24 DALY	[37]PM

Abbrevations: ORS, oral rehydration salts; SW, software (hygiene and education); HW, hardware; CBA, cost-benefit analysis; CEA, cost-effectiveness analysis; CMA, cost-minimization analysis; RCT, randomized controlled trial; AFR-E, Africa WHO epidemiological strata E; SEAR-D, Southeast Asia WHO epidemiological strata D; WHO, World Health Organization; BCR, benefit-cost ratio; CER, cost-effectiveness ratio; CM, EIRR, economic internal rate of return; DEWATS, decentralized wastewater treatment; EcoSan, ecological sanitation; STP, off-site sewage treatment plant; DCA, diarrhea case averted; DALY, disability-adjusted life year (averted); PR, prevalence reduction.

Notes: Source: PM, PubMed (U.S. National Library of Medicine and National Institutes of Health); BC, book chapter; PR, other peer reviewed sources; DR, United Nations, donor, university or NGO report.