Cost effectiveness of hygiene promotion in Mozambique

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Prepared by Arjen Naafs, country coordinator WASHcost Mozambique, for the Monitoring Sustainable WASH Service Delivery Symposium, 9 - 11 April 2013, Addis Ababa, Ethiopia

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  • Within the range of costs obtained in previous study in Mozambique for hygiene education programmes- results from van de Reep gave 4 USD/person/year (2008)- large variation in costs due to the use of a different Hp approach, requiring hardware improvements thus more costly
  • Cost effectiveness of hygiene promotion in Mozambique

    1. 1. Cost effectiveness of hygiene promotion inMozambiqueArjen Naafs,WASHCost Country Coordinator
    2. 2. Specificities in Mozambique studyCost and effectiveness of hygiene promotion components, WASHCost Mozambique, Alana PotterMonitoring Sustainable WASH Service Delivery Symposium3 – Methodology of the study• Study conducted within the following programmes:– Bilateral programme (2007-2011) with water supplycomponent and improvement of sanitation throughmodel latrines and hygiene education– Baseline and endline data collected by two differentagencies:• Baseline in 30 communities, incl. 15 in target area,• Endline in 20 communities, incl. 10 in targeted areaStatistically representative at project level
    3. 3. Specificities in Mozambique studyCost and effectiveness of hygiene promotion components, WASHCost Mozambique, Alana PotterMonitoring Sustainable WASH Service Delivery Symposium3 – Methodology of the study• Flowcharts were adaptedto match the HHquestionnaire conductedwithin the bilateralprogramme• Proxies were used formissing data• Costs data obtained from project reports andcontracts of bilateral programme
    4. 4. Specificities in studyCost and effectiveness of hygiene promotion components, WASHCost Mozambique, Alana PotterMonitoring Sustainable WASH Service Delivery Symposium3 – Methodology of the study• Cost data allocated by the WASHCost team on hygiene,sanitation and water activities on project basedassumptions• Part of the programme was conducted in schools: sincethe study is at HH level only, the WASHCost teamallocated part of the costs for HH based on assumptions• No control group, all changes assigned to theintervention
    5. 5. Hygiene promotion costsCost and effectiveness of hygiene promotion components, WASHCost Mozambique, Alana PotterMonitoring Sustainable WASH Service Delivery Symposium4 – Results of the study• Household and district costs were not collected• Implementer costs:- Within the range of costs obtained in previous study inMozambique for hygiene education programmes- Results from van de Reep gave 4 USD/person/year (2008)
    6. 6. 6Figure 3: Household expenditure on soap per month1%1%4%6%24%64%020040060080010001200number of respondents 1023 383 100 65 17 141 - 5 USD$ permonth6 - 10 USD$ permonth11 - 15 USD$per month16 - 20 USD$per month21 - 25 USD$per month>25 USD$ permonthAverage per capita per year: 12.62 US$Data does not permit allocation to hygiene promotionComparison with household expenditure
    7. 7. Cost and effectiveness of hygiene promotion components, WASHCost Mozambique, Alana PotterHygiene behaviours effectiveness4 – Results of the study
    8. 8. Cost-effectiveness of the interventionCost and effectiveness of hygiene promotion components, WASHCost Mozambique, Alana PotterMonitoring Sustainable WASH Service Delivery Symposium• An investment of 5 USD/ person/ year resulted in:– 5% increase in basic latrine use (indicator 1):• All or some household members use a latrine some or most of the time• When there is no access to a latrine, faeces are generally buried• Latrine separates users from faecal waste– 28% increase in basic hand washing (indicator 2):• Accessible designated handwashing facility• sufficient water is available for handwashing• water for handwashing is poured/ not re-contaminated by handwashing• soap or substitute available and used• All household members wash their hands with soap/ substitute at critical times– 57% increase in safe water management (Indicator 3)• protected water sources are always used• Collection vessel (if necessary) is regularly cleaned with soap or substitute• Water storage vessel (if necessary) is uncovered and/or water is not drawn in a safemanner
    9. 9. Cost-effectiveness of the interventionCost and effectiveness of hygiene promotion components, WASHCost Mozambique, Alana PotterMonitoring Sustainable WASH Service Delivery Symposium4 – Results of the study• Challenges:– Only one cost of intervention calculated(5USD/person/year) but there are 3 indicators,– How to divide costs among the 3 indicators?• Analysis is made by setting out % of change acrosseach key hygiene behaviours, to get a nuancedunderstanding of where the change happened
    10. 10. LimitationsCost and effectiveness of hygiene promotion components, WASHCost Mozambique, Alana PotterMonitoring Sustainable WASH Service Delivery Symposium• Limitations of the study:– Secondary data used to test the methodology– Difficult to distinguish costs between water, sanitationand hygiene interventions– Use of many proxy since the HH questionnaire wasdeveloped and used independently from the WASHCoststudy– No household data collected– Presence of school activities within the programme, notcovered by the WASHCost study– Not known if additional interventions occurred

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