This document analyzes and compares the costs and benefits of four solutions to improve drinking water, sanitation, and hygiene in Rajasthan, India: 1) Providing improved drinking water sources like piped water or tubewells, which could reduce diarrheal disease by 11-23% with benefit-cost ratios of 3.2-8.5. 2) Promoting household water filtering, which could reduce disease by 35% with a benefit-cost ratio of 3.0-5.4. 3) Providing household sanitation facilities, which could reduce disease by 47% with urban and rural benefit-cost ratios of 4.0-7.9 and 5.4-

1. Drinking Water and Sanitation Interventions in
Rajasthan
Bjorn Larsen,
Environmental Economist, Independent Consultant
Rajasthan Priorities conference, Jaipur June 8-10
Email: BL@bjorn-Larsen.com
Web: http//Bjorn-Larsen.com

2. Improved drinking water and sanitation– why important?
• Huge global problem
•Nearly 1.7 million people died globally in 2016 from diarrheal disease. Nearly
800 K deaths were in India of which 90% were due to unsafe drinking water,
sanitation and hygiene (WASH)
• Also important in Rajasthan
•47 K deaths from WASH (GBD 2016 estimate)
•85% had an improved source of drinking water in 2015-16, but very few HHs
practiced point-of-use (POU) treatment such as boiling or filtering (6% in 2005-06)
•A quarter of the rural population has more than 30 minutes roundtrip to water
source
• 52% had a sanitary toilet in 2015 (this has increased since then due to government
sanitation program)
•Some HH members with sanitary toilet continue to practice open defecation (OD)
(4.5% in 2016)

3. 1st analyzed solution
Improved drinking water source

4. Description of the solution
• Urban intervention: Piped water to dwelling for urban
households without an improved drinking water source (340 K
households) – diarrheal disease reduction 23%
• Rural intervention: Tubewell/borehole for rural households
without an improved drinking water source or that have more
than 30 minutes round-trip to their drinking water source (3.25
million households) – diarrheal disease reduction 11%

5. Cost of intervention
Note: Annualized cost is calculated using a discount rate of 5%.
Cost per household Rs
Capital cost 15,000
Useful life (years) 20
Annualized capital cost 1,204
O&M (1.5% of capital cost per year) 225
Total annualized intervention cost 1,429

6. Benefits of intervention (Annualized Rs/HH)
Urban Rural
Mortality benefits 6,685 1,571
Morbidity benefits 1,109 261
Time savings 0 4,620
Total benefits 7,795 6,452
Note: Discount rate: 5%.

7. Total costs, total benefits and benefit-cost ratio (BCR)
Urban Discount rate
3% 5% 8%
Benefit (Rs billion/year) 3.57 2.65 1.92
Cost (Rs billion/year) 0.42 0.49 0.60
BCR 8.5 5.5 3.2
Rural Discount rate
3% 5% 8%
Benefit (Rs billion/year) 23.6 21.0 18.5
Cost (Rs billion/year) 4.0 4.6 5.7
BCR 5.9 4.5 3.2

8. 2nd analyzed solution
Household point-of-use treatment of drinking water

9. Description of the solution
• The assessed intervention is: promotion of filtering of
drinking water
• Household response rate is assumed to be 10-20% of
households (1.5-3.0 million HHs)
• Reduction in diarrheal disease: 35%

10. Cost of intervention (Rs/HH)
Note: Annualized cost is calculated using a discount rate of 5%.
* Based on 15% household response rate.
Initial
cost
Effective
cost
Annualized
cost
Cost of water filter 2,000 462
Parts replacement 500
Cost of time spent on filtering of
water (2 minutes/HH/day)
430
Promotion cost 130 867* 200
Total annualized intervention cost 1,592

11. Benefits of intervention
Annualized
Rs/HH
Mortality benefits 5,522
Morbidity benefits 916
Total benefits 6,438
Note: Discount rate: 5%.

12. Total costs, total benefits and benefit-cost ratio (BCR)*
Discount rate
3% 5% 8%
Benefit (Rs billion/year) 19.1 14.7 11.2
Cost (Rs billion/year) 3.56 3.64 3.76
BCR 5.4 4.0 3.0
* Mid-case with 15% HH response rate to promotion program

13. 3rd analyzed solution
Improved sanitation

14. Description of the solution
• Assessed intervention is household sanitation facility (pour/flush
with single- or twin-pit)
• Total beneficiary households are 7.2 million
• Reduction in diarrheal disease is 47%

15. Costs of intervention (Annualized Rs/HH)
Note: Annualized cost is calculated using a discount rate of 5%.
Urban Rural
Capital cost (Rs 20,000) 1,605 1,605
Emptying of pit (Rs 1,500 once per 5 years) 271 271
Cost of cleaning per year (10 minutes/day) 5,258 2,629
O&M cost (5% of initial capital cost) 1,000 1,000
Program cost (Rs 600) 48 48
Total annualized intervention cost 8,182 5,553

16. Benefits of intervention (annualized Rs/HH)
Urban Rural
Mortality benefits 15,407 12,569
Morbidity benefits 2,556 2,085
Productivity benefits (time
savings)
21,115 22,068
Total annual benefit 39,078 36,723
Note: Discount rate is 5%

17. Total costs, total benefits and benefit-cost ratio (BCR)
Urban Discount rate
3% 5% 8%
Benefit (Rs billion/year) 31.3 26.5 22.3
Cost (Rs billion/year) 5.5 5.55 5.6
BCR 5.7 4.8 4.0
Rural Discount rate
3% 5% 8%
Benefit (Rs billion/year) 278.5 239.6 205.1
Cost (Rs billion/year) 35.2 36.2 38.1
BCR 7.9 6.6 5.4

18. 4th analyzed solution
Promotion of the use of existing sanitation facilities

19. Description of the solution
• Assessed intervention is a behavioral change campaign (BCC) that
promotes the consistent use of existing sanitation facilities
• Response rate among current non-users is assumed to be 10-20%
(182-364 K individuals)
• Reduction in diarrheal disease is 28%

20. Cost of intervention (Rs/per son)
Note: Annualized cost is calculated using a discount rate of 5%.
* Based on 15% response rate among current non-users of existing toilet facilities.
Annualized cost
Foregone benefits of ending OD (for individuals
with preference for OD; 36% of non-users)
2,397
Cleaning of toilet (incremental 20 min/week) 754
Promotion cost (every 3 years) 1,429
Total annualized intervention cost 4,580

21. Benefits of intervention (Rs/person)
Annualized
Rs/person
Mortality benefits 1,521
Morbidity benefits 252
Productivity benefits (time savings) 6,701
Total benefits 8,475
Note: Discount rate: 5%. Promotion program response rate 15%

22. Total costs, total benefits and benefit-cost ratio (BCR)*
Discount rate
3% 5% 8%
Benefit (Rs billion/year) 2.56 2.32 2.08
Cost (Rs billion/year) 1.27 1.25 1.22
BCR 2.01 1.85 1.70
* Mid-case with 15% HH response rate to promotion program

23. THANK YOU