Economic Assessment of Sanitation Interventions in Vietnam - WSP

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Economic Assessment of Sanitation Interventions in Vietnam | Local Benefits of Improved Sanitation and HygieneTrachoma is endemic in Vietnam. For decades, trachomacontrol has been an important part of Vietnam’s health agenda.Globally, it is estimated that there are 3.8 million casesof blindness and 5.3 million cases of low vision in countriesknown or suspected to have trachoma, resulting in $2.9 billionin lost productivity. In Vietnam, through trichiasis surgery,antibiotic treatment and health and hygiene education,the national prevalence of active disease decreased considerablyfrom 17.5% in 1975 to 7% in 1999. A 2006 – 2007study by the International Trachoma Institute (ITI) and itsmain partners the MOH and the Institute for Ophthalmology,estimated a trachoma prevalence of 1.76% in 2006. Thisstudy indicates that there are still districts where trachoma remainsa public health problem. In the Central and Northernareas, trachoma prevalence is still high, especially in children.Disease rates and premature mortality were sourced fromavailable surveys in the field sites, which indicate total diseaseburden, and not just reported disease burden, whichseverely underreports cases and deaths. Many sick peopleprefer not to seek medical care at their inadequate localclinic, and go instead to district, provincial, or even centralhospitals in large cities. Therefore data were collected notonly from local medical centers but also from the centers ofpreventive medicine at provincial level.Table 16 presents the disease burden attributable to poorsanitation and hygiene. In rural sites annually, it is estimatedthere are 2.64 cases of disease per person, 0.074 DALYs,and an annual risk of death of 2.12 per 1,000 people dueto poor sanitation and hygiene (see Annex B). In urbanareas the rates are lower, at 0.96 cases of disease per person,0.03 DALYs, and an annual risk of death of 1.02 per 1,000people. Site-specific rates used are tabulated in Annex B.Quality of life impacts associated with morbidity are, to someextent, reflected in the DALY calculations above, and in theestimates of health care and productivity costs (see later sections).There is no significant difference in recorded casesbetween urban and rural areas. Although living standardsin urban households seem higher, the population is oftenexposed to numerous health threats including open sewersand canals, and where there is high population density andcrowding infectious diseases spread easily. Moreover, largehospitals in the regional centers like Nghe An, Hanoi andQuang Nam receive a number of visitors from surroundingprovinces, which makes the record of disease cases in thoseprovinces higher. To know the precise origin of patients inurban centers would require separate research studies, andhence the current report uses unadjusted statistics availablefrom government sources. An artificially high helminth eggcontamination figure for Quang Nam (about 31% of thecommune population) is given in Annex Table B.Exposure to household solid waste, agricultural and industrialwaste can also lead to disease and premature death,34TABLE 16: DISEASE RATES ATTRIBUTABLE TO POOR SANITATION AND HYGIENE, 2006Rural SitesUrban SitesDiseaseCases/person/yearDeaths/1000 people/yearDALYs/person/yearCases/person/yearDeaths/1000 people/yearDALYs/person/yearDIRECT DISEASES 2.4859 0.2569 0.0515 0.9120 0.0951 0.0191Diarrheal disease 1.6733 0.2569 0.0128 0.6191 0.0951 0.0047Helminths 0.7402 0 0.0044 0.2739 0 0.0016Scabies 0.0117 0 0.0000 0.0043 0 0.000003Trachoma 0.0603 0 0.0342 0.0145 0 0.0127Hepatitis A,E 0.0004 0 0.0000009 0.0002 0 0.0000003INDIRECT DISEASES 0.1533 1.8645 0.0222 0.0503 0.9253 0.0082Malnutrition 0.1339 0 0.0001 0.0455 0 0.00005Malaria 0.0010 0.0267 0.0003 0.0003 0.0085 0.0001ALRI 0.0179 1.8212 0.0215 0.0043 0.9106 0.0080Measles 0.0005 0.0167 0.0002 0.0002 0.0062 0.0001Total 2.6392 2.1214 0.0737 0.9623 1.0203 0.0273Economic Assessment of Sanitation Interventions
Economic Assessment of Sanitation Interventions in Vietnam | Local Benefits of Improved Sanitation and HygieneFIGURE 9: COMPARISON OF HEALTH STATUS BETWEEN SELECTED STUDY SITES (CASES)Dhong Thap (U1)Hai Phong (U3)Quang Ninh (U4)Daklak (U5)Hanoi (U7)Nghe An (U8)Vinh Long (R2)Quang Nam (R5)0 100 200 300 400 500 600 700 800CasesDiarrhea Malnutrition (
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Economic Assessment ofSanitation In
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Economic Assessment of Sanitation I
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ForewordTarget 10 of the Millennium
Page 22 and 23: Glossary of TermsBenefit-cost ratio
Page 24 and 25: AcknowledgmentsThe Economics of San
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Page 38 and 39: PopulationSelected Development Indi
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Page 46 and 47: III.Study MethodsThe study methodol
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ReferencesAcharya A, Paunio MK and
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ANNEX 1: PROGRAM APPROACH ANALYSIST
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ANNEX TABLESANNEX A. STUDY METHODST
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Economic Assessment of Sanitation Interventions in Vietnam - WSP

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