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Household Sanitation Services in Sub-Saharan Africa: Coverage Targets, Child Health Outcomes, and a Benefit-cost Analysis
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Household Sanitation Services in Sub-Saharan Africa: Coverage Targets, Child Health Outcomes, and a Benefit-cost Analysis
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Dissertation
Household Sanitation Services in Sub-Saharan Africa: Coverage Targets, Child Health Outcomes, and a Benefit-cost Analysis
2019
Overview
A large global health burden has been attributed to a lack of adequate sanitation access. Approximately 2.3 billion people still lacked access to basic sanitation services, a private flush toilet or improved latrine, as of 2015. There remains limited evidence on the effectiveness of shared sanitation facilities for protecting child health. Furthermore, while much research has focused on child health outcomes associated with sanitation improvements, the valuation of non-health benefits has often been neglected. Within this dissertation, I examine household sanitation service options, notably basic and limited sanitation (improved latrines and flush toilets shared by 2 or more households) with regards to child health outcomes and overall benefit values. I also consider the role of community sanitation coverage in child health and drinking water quality as compared to household sanitation access in rural Mali.In Chapter 1, I found the level of sanitation access of surrounding households was more important than private latrine access for protecting water quality and child health. In Chapter 2, I examine the associations between sharing of sanitation facilities and child health outcomes via a combination of matching techniques. Limited and basic sanitation households were not significantly different in stunting prevalence, although basic sanitation indicated greater potential benefits when compared to open defecation and unimproved sanitation. In Chapter 3, I quantify the costs and benefits of basic and limited sanitation options in urban Uganda. Sanitation benefits were an estimated 24 percent of rental value for basic sanitation and 16 percent for limited sanitation shared between 2 and 4 households. The overall benefits and costs in urban settings indicate a potential role for both limited and basic sanitation in increasing sanitation coverage despite minimal health benefits at the household level.
