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Hygiene Cost Effectiveness study in Ghana

Prepared by Dr. Kwabena Nyarko/ KNUST and others for the Monitoring Sustainable WASH Service Delivery Symposium, 9 - 11 April 2013, Addis Ababa, Ethiopia

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Hygiene Cost Effectiveness study in Ghana

  1. 1. Hygiene Cost Effectivenessstudy in GhanaDr. Kwabena Nyarko/ KNUSTPaa kwesi Woode, Kwabena B Nyarko and Bismark Dwumfour-AsareKwame Nkrumah University of Science and technology, Kumasi, Ghana
  2. 2. Title, speakerOutline • Introduction • Methodology • Results – Change in Hygiene Service levels – Cost of hygiene intervention – Cost effectiveness of the hygiene intervention • Conclusion Monitoring Sustainable WASH Service Delivery Symposium
  3. 3. Title, speaker Hygiene Promotion Interventions (HPIs) • Hygiene promotion interventions are project cycle-based activities aimed at changing hygiene behaviours in targeted populations within a particular time frame (Potter et al, 2011). • Cost-effectiveness, the cost of a unit effect of an intervention, is largely unknown for HPIs etc. Monitoring Sustainable WASH Service Delivery Symposium
  4. 4. Title, speaker Objectives • To assess the cost-effectiveness of Hygiene Promotion Interventions (HPIs) – Determine Hygiene Service levels before and after the intervention – Find the total costs of the intervention (Households, Intervention Implementers and Government) – Compare costs to change in Hygiene Service levels. • This presentation is focused on the short terms effects, conducted immediately after the completion of the hygiene intervention Monitoring Sustainable WASH Service Delivery Symposium
  5. 5. Title, speaker Method • Hygiene Service levels determined by pre- and post intervention household surveys (May 2012 and January 2013). • Cost Data collected at all stages of intervention for all actors: – Household – Implementer – Government • Hygiene Service levels assessed by the use of WASHCost Hygiene Service Levels. Monitoring Sustainable WASH Service Delivery Symposium
  6. 6. Title, speaker Hygiene Service levelEffective- Faecal Hand washing with Drinking water source andness containment soap/ Managementlevels and latrine use SubstituteHighlyimprovedImprovedBasicLimited Extra textNoneExtra text Monitoring Sustainable WASH Service Delivery Symposium
  7. 7. Title, speaker Description of Intervention • Modified Community Led Total Sanitation (modified CLTS). • Community triggering, education and construction of hand pump boreholes. • Four (4) Selected rural communities in the Brong Ahafo Region, with total population of 1,870. Monitoring Sustainable WASH Service Delivery Symposium
  8. 8. Fecal Containment and Latrine UseTitle, speaker Service LevelsService Levels Pre-Intervention Post-InterventionHighly Improved 0% 1%Improved 0% 0%Basic 0% 0%Limited 99% 98% Extra text Extra textNo service 1% 1% Monitoring Sustainable WASH Service Delivery Symposium
  9. 9. Title, speaker Hand washing with Soap Service LevelsService Levels Pre-Intervention Post-InterventionImproved 3% 7%Basic 0% 0%Limited 23% 57%No service 74% 36% Monitoring Sustainable WASH Service Delivery Symposium
  10. 10. Title, speaker Drinking Water Management Service Levels Service Level Pre-Intervention Post Intervention Highly Improved 1% 6% Improved 33% 52% Basic 16% 10% Limited 22% 17% Not Effective 28% 15% Monitoring Sustainable WASH Service Delivery Symposium
  11. 11. Title, speakerTotal Intervention costs prior to surveyDescription (cost Total Cost for 4 Cost per Cost perclassification) communities Household Person (USD; 2012) (USD; 2012) (USD; 2012)Household participation 3,961 11 2cost (CapEx Software)Household Output 1,397 4 1(CapEx Hardware)Household Expenditure 17,481 47 10on Soap (OpEx)Implementer Cost 2,133 6 1(CapEx Software)Government (ExpDS) 267 1 0.2Water Supply Costs 81,600 218 44(CapEx)Total 106,819 286 57HH expenditure on soap was for 6 months Monitoring Sustainable WASH Service Delivery Symposium
  12. 12. Title, speaker Cost effectiveness • Fecal Indicator Cost – HH participation + HH output (facilities) + implementer + government • HWWS Cost – HH participation + HH OpEx + implementer + government + water supply costs • Drinking Water Cost – HH participation + implementer + government + water supply costs Monitoring Sustainable WASH Service Delivery Symposium
  13. 13. Title, speaker Cost effectivenessIndicator % Total Cost for Total Cost Cost per % Cost per % Movement 4 per % Change Per Change Per above Basic communities movement Household Person Service (USD; 2012) for 4 (USD; 2012) (USD; 2012) Level communities (USD; 2012)Fecal 1 7,758 7,758 21 4Containmentand LatrineUseHand washing 4 73,976 18,494 49 10with soapDrinking 18 87,961 4,887 13 3WaterManagement Monitoring Sustainable WASH Service Delivery Symposium
  14. 14. Title, speaker Conclusions • Drinking Water Management has highest cost- effectiveness, followed by Fecal Containment and Latrine Use and then Hand washing with soap. • Drinking Water Management - Cost effectiveness value of USD 3 per Percentage change per Person. • The cost effectiveness with regards to Faecal Containment and Latrine Use and Hand Washing With Soap were USD 4 and 10 per Percentage change per Person respectively. • Cost-effectiveness of hygiene service level indicators varies widely. Monitoring Sustainable WASH Service Delivery Symposium

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