Assessing hygiene cost-effectiveness: a methodology, 2012.
Amélie Dubé, Peter Burr, Alana Potter and Maarten van de Reep. IRC International Water and Sanitation Centre
This Working Paper describes a methodological framework that is being proposed to assess the cost-effectiveness of a number of hygiene interventions. Currently being tested in Ghana, Burkina Faso, Mozambique and Andhra Pradesh, India – the methodology is designed to:
- Capture the financial costs of labour and materials associated with the intervention, using a three-step approach. First, costs are categorised (e.g., investment costs, maintenance costs, etc.); second, data is gathered and basic statistic treatments are applied; finally, other economic costs (e.g., cost of health) are valued as financial costs.
- Examine three key household hygiene behaviours: faecal containment and latrine use, handwashing with soap, and drinking-water management; and assess their levels of effectiveness. The levels – defined in a hygiene effectiveness ladder – allow for the systematic categorisation of hygiene behaviour data; from ‘not effective’ to ‘improved’. Several flowcharts are also introduced as tools to simplify data capture and the identification of failure points (if any), within the chain of events of certain hygienic practices and behaviours.
The cost-effectiveness measure of each intervention is intended to result in a comparison of household costs with measured efficacy, in terms of behaviour change: moving from one set of behaviours (prior to intervention) to the current set of behaviours (post intervention). The proposed methodology aims to provide further evidence for policy decision-making and investment in the WASH and public health sectors. As it in its testing phase, this working paper also articulates its main limitations.