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Effectiveness and sustainability of water, sanitation, and hygiene interventions in combating diarrhoea

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  • Hugh Waddington
  • Birte Snilstveit

Abstract

This paper presents a synthetic review of impact evaluations examining effectiveness of water, sanitation, and hygiene interventions in reducing diarrhoea among children. The evaluations were conducted in 35 low- and middle-income countries during the past three decades. The paper challenges the existing consensus that water treatment at point-of-use and hygiene interventions are necessarily the most effective and sustainable interventions for promoting reduction of diarrhoea. The analysis suggests that sanitation 'hardware' interventions are highly effective in reducing diarrhoea morbidity. Moreover, while there is a wealth of trials documenting the effectiveness of water treatment interventions, studies conducted over longer periods tend to show smaller effectiveness and evidence suggests compliance rates and therefore impact may fall markedly over time.

Suggested Citation

  • Hugh Waddington & Birte Snilstveit, 2009. "Effectiveness and sustainability of water, sanitation, and hygiene interventions in combating diarrhoea," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 1(3), pages 295-335.
    • Handle: RePEc:taf:jdevef:v:1:y:2009:i:3:p:295-335
    DOI: 10.1080/19439340903141175
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    Cited by:

    1. Dionissi Aliprantis, 2011. "Community-Based Well Maintenance in Rural Haiti," OVE Working Papers 0611, Inter-American Development Bank, Office of Evaluation and Oversight (OVE).
    2. Dionissi Aliprantis, 2018. "What Is the Equity-Efficiency Tradeoff When Maintaining Wells in Rural Haiti?," The World Bank Economic Review, World Bank, vol. 32(2), pages 482-504.
    3. Arnold,Benjamin Ford & Briceno,Bertha & Colford Jr.,John M. & Gertler,Paul J. & Patil, Sumeet R. & Salvatore,Alicia Link, 2013. "A randomized, controlled study of a rural sanitation behavior change program in Madhya Pradesh, India," Policy Research Working Paper Series 6702, The World Bank.
    4. Henrik Hansen & Ole Winckler Andersen & Howard White, 2011. "Impact evaluation of infrastructure interventions," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 3(1), pages 1-8.
    5. Isabel Günther & Youdi Schipper, 2013. "Pumps, Germs And Storage: The Impact Of Improved Water Containers On Water Quality And Health," Health Economics, John Wiley & Sons, Ltd., vol. 22(7), pages 757-774, July.
    6. Xuhang Shen & Ziqi Wang & Shi Li, 2023. "Access to Piped Water and Off-Farm Work Participation: Evidence from Rural China," Sustainability, MDPI, vol. 15(4), pages 1-20, February.
    7. Chris Elbers & Samuel Godfrey & Jan Willem Gunning & Matteus van der Velden & Melinda Vigh, 2012. "Effectiveness of Large Scale Water and Sanitation Interventions: the One Million Initiative in Mozambique," Tinbergen Institute Discussion Papers 12-069/2, Tinbergen Institute.
    8. Rieckmann, Johannes, 2015. "Determinants of drinking water treatment and hygiene habits in provincial towns in Yemen," VfS Annual Conference 2015 (Muenster): Economic Development - Theory and Policy 113183, Verein für Socialpolitik / German Economic Association.
    9. Peters, Jörg, 2016. "Infrastructure and poverty in Sub-Saharan Africa: A review," Ruhr Economic Papers 628, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    10. Whittington, Dale & Jeuland, Marc & Barker, Kate & Yuen, Yvonne, 2012. "Setting Priorities, Targeting Subsidies among Water, Sanitation, and Preventive Health Interventions in Developing Countries," World Development, Elsevier, vol. 40(8), pages 1546-1568.
    11. Youngmee Tiffany Jung & Ryan James Hum & Wendy Lou & Yu-Ling Cheng, 2017. "Effects of neighbourhood and household sanitation conditions on diarrhea morbidity: Systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-17, March.
    12. Biljana Macura & Laura Del Duca & Adriana Soto & Naomi Carrard & Louisa Gosling & Karin Hannes & James Thomas & Lewnida Sara & Marni Sommer & Hugh S. Waddington & Sarah Dickin, 2021. "PROTOCOL: What is the impact of complex WASH interventions on gender and social equality outcomes in low‐ and middle‐income countries? A mixed‐method systematic review protocol," Campbell Systematic Reviews, John Wiley & Sons, vol. 17(2), June.
    13. Nicholas Valcourt & Amy Javernick-Will & Jeffrey Walters & Karl Linden, 2020. "System Approaches to Water, Sanitation, and Hygiene: A Systematic Literature Review," IJERPH, MDPI, vol. 17(3), pages 1-18, January.
    14. Michael A. L. Hayashi & Marisa C. Eisenberg & Joseph N. S. Eisenberg, 2019. "Linking Decision Theory and Quantitative Microbial Risk Assessment: Tradeoffs Between Compliance and Efficacy for Waterborne Disease Interventions," Risk Analysis, John Wiley & Sons, vol. 39(10), pages 2214-2226, October.
    15. Acheampong, Alex O. & Opoku, Eric Evans Osei & Tetteh, Godsway Korku, 2024. "Unveiling the effect of income inequality on safe drinking water, sanitation and hygiene (WASH): Does financial inclusion matter?," World Development, Elsevier, vol. 178(C).
    16. Senanayake, Nari & Mukherji, Aditi & Giordano, Mark, 2015. "Re-visiting what we know about Irrigation Management Transfer: A review of the evidence," Agricultural Water Management, Elsevier, vol. 149(C), pages 175-186.
    17. Santosh Kumar & Sebastian Vollmer, 2013. "Does Access To Improved Sanitation Reduce Childhood Diarrhea In Rural India?," Health Economics, John Wiley & Sons, Ltd., vol. 22(4), pages 410-427, April.
    18. Voth-Gaeddert, Lee E. & Fikru, Mahelet G. & Oerther, Daniel B., 2022. "Limited benefits and high costs are associated with low monetary returns for Guatemalan household investment in water, sanitation, and hygiene technologies," World Development, Elsevier, vol. 154(C).
    19. Orgill-Meyer, Jennifer & Jeuland, Marc & Albert, Jeff & Cutler, Nathan, 2018. "Comparing Contingent Valuation and Averting Expenditure Estimates of the Costs of Irregular Water Supply," Ecological Economics, Elsevier, vol. 146(C), pages 250-264.

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