Economic Assessment of Sanitation Interventions in Vietnam - WSP

More documents

Recommendations

Info

Economic Assessment of Sanitation Interventions in Vietnam | Local Benefits of Improved Sanitation and HygieneTABLE 21: UNIT COSTS ASSOCIATED WITH TREATMENT OF DIARRHEA (US$, 2008)PublicHealth providerOutpatient cost (US$)Inpatient cost (US$)Healthcare Incidentals 1 ALOS 2 Healthcare 3 Incidentals 1Urban 3.76 0.83 4.55 8.80 4.74Rural 3.98 1.48 4.55 10.99 4.37PrivateUrban 3.05 1.13 4.55 5.02 1.00Rural 3.49 1.66 4.55 5.16 1.10Self-treatmentUrban 2.68 0.6 - - -Rural 3.00 1.09 - - -Source: ESI-1 study1Incidentals: non-healthcare patient costs such as transport, food, and incidental expenses, per outpatient visit and per inpatient stay.2ALOS: average length of stay.3Inpatient healthcare costs are presented per stay.TABLE 22: AVERAGE HEALTHCARE COST PER PERSON PER YEAR AT FIELD SITES, BY DISEASE AND AGE CATEGORY (US$, 2008)Disease 0-4 Years 5-14 Years 15+ YearsDiarrheal disease 17.95 2.18 1.09Helminths 0.69 0.81 0.69Hepatitis A, E 0.03 0.00 0.00Scabies 0.09 0.01 0.00Trachoma 6.05 0.33 0.04Malnutrition 0.25 0.03 0.00Indirect: malaria 0.01 0.06 0.01Indirect: ALRI 0.50 0.11 0.01Total 25.56 3.53 1.84Source: ESI-1 study.Table 22 shows the annual cost per person (by age group)attributed to poor sanitation and hygiene in Vietnam, bydisease. Diarrheal disease contributes the largest proportionof healthcare costs per person per year for all ages, but itis most significant among children aged 0 to 4 years old.Healthcare expenses are reduced as patients move up fromthe first to the second and the third age groups. After trachoma,the treatment of helminths involves the highesttreatment costs compared to other diseases. Children agedfrom 5 to 14 years incur the most expense for the treatmentof helminths compared to other age groups. Malnutritioncosts are incurred mostly by children aged 0 to 4 years,while those above 15 years old incur no costs.4.1.3 PRODUCTIVITY COSTSTable 23 presents the estimated time lost to disease. Casesof each disease are divided into severe, and non-severe. Assevere cases require more time to treat, more productivetime is lost. Severe Hepatitis A leads to a largest numberof days lost (30) compared to no days lost when peopleare seeking treatment of non-severe helminths, scabies andtrachoma. Amount of time lost serves a basis for calculatingof productivity costs of diseases. GDP per capita was usedas the basis of time value, at US$0.12 per hour.As would be expected, the productivity costs of treatingdiarrhea are the highest (Table 24). The productivity cost38Economic Assessment of Sanitation Interventions
Economic Assessment of Sanitation Interventions in Vietnam | Local Benefits of Improved Sanitation and HygieneTABLE 23: VARIABLES FOR ESTIMATING AMOUNT OF TIME LOST TO DISEASE (2008)Disease% cases Days off daily activitiesTreated Not treatedSevere 1 Non-severe 2 Severe Non-severe Severe Non-severeDiarrhea 29.5% 70.5% 5.0 2.0 2.0 1.0Helminths 29.5% 70.5% 2.0 - 1.0 -Trachoma 29.5% 70.5% 3.0 - 1.0 -Scabies 29.5% 70.5% 1.0 - 1.0 -Hepatitis A 29.5% 70.5% 30.0 5.0 30.0 5.0Malnutrition 29.5% 70.5% 7.0 5.0 7.0 5.0ALRI 29.5% 70.5% 7.0 1.0 10.0 1.0Malaria 29.5% 70.5% 10.0 5.0 5.0 3.0Source: ESI-1 study.1‘Severe’ cases involve treatment at a public or private hospital2‘Non-severe’ cases which can be self-treatedTABLE 24: AVERAGE HEALTH-RELATED PRODUCTIVITY COST PER PERSON PER YEAR IN FIELD SITES, BY DISEASE, AGE(US$, 2008)Disease 0-4 Years 5-14 Years 15+ YearsDiarrheal disease 4.15 0.51 0.51Helminths 0.23 0.27 0.45Hepatitis A, E 0.004 0.0006 0.0002Scabies - - -Trachoma 0.06 0.003 0.001Malnutrition 0.71 0.08 -Indirect: malaria 0.001 0.005 0.001Indirect: ALRI 0.04 0.01 0.002Total 5.19 0.87 0.97Source: ESI-1, 2009.associated with diseases such as hepatitis, trachoma and malariaare smaller, since the number of cases of these diseasesare comparatively infrequent.4.1.4 MORTALITY COSTSTable 25 presents estimated number of annual deaths associatedwith poor sanitation and hygiene for Vietnam. Table26 provides the unit values for the cost of a premature deathusing two calculation approaches: willingness to pay, usingbenefit transfer; and a human capital approach.Table 27 presents estimated premature mortality costper person per year due to diseases associated with poorsanitation and hygiene: diarrhea, malaria and ALRI forthose aged 0 to 4 years old. Calculations have been madeusing methodology presented in the ESI-1 study (WSP,2009).4.1.5 AVOIDED HEALTH COSTSCentral to the arguments for improving sanitation and hygieneis its affect on health. Limited evidence exists for theactual impact of sanitation or hygiene programs on healthoutcomes in Vietnam and this study draws on internationalevidence. Figure 10 shows the relative risk reduction offecal-oral and helminth-related disease following differentsanitation improvement scenarios.www.wsp.org39
Page 3:
Economic Assessment ofSanitation In
Page 9:
Economic Assessment of Sanitation I
Page 12 and 13:
Page 14 and 15:
Page 17:
ForewordTarget 10 of the Millennium
Page 22 and 23:
Glossary of TermsBenefit-cost ratio
Page 24 and 25:
AcknowledgmentsThe Economics of San
Page 27 and 28: V. National Benefits of Improved Sa
Page 29 and 30: Table 32. Sanitation coverage, and
Page 31: Figure 34. What factors were of mos
Page 34 and 35: Annex Table E1. Level of satisfacti
Page 36 and 37: Annex Table J1. Site U1 (Dong Thap,
Page 38 and 39: PopulationSelected Development Indi
Page 40 and 41: Economic Assessment of Sanitation I
Page 46 and 47: III.Study MethodsThe study methodol
Page 60: Economic Assessment of Sanitation I
Page 70 and 71: IV.Local Benefits of Improved Sanit
Page 117 and 118: VI.Costs of Improved Sanitationand
Page 127:
Page 130 and 131:
Page 132 and 133:
Page 134 and 135:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
ReferencesAcharya A, Paunio MK and
Page 152 and 153:
ANNEX 1: PROGRAM APPROACH ANALYSIST
Page 154 and 155:
Page 156 and 157:
Page 158 and 159:
Page 160 and 161:
Page 162 and 163:
Page 164 and 165:
Page 166 and 167:
ANNEX TABLESANNEX A. STUDY METHODST
Page 168 and 169:
Page 170 and 171:
Page 172 and 173:
Page 174 and 175:
Page 176 and 177:
Page 178 and 179:
Page 180 and 181:
Page 182 and 183:
Page 184 and 185:
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 199 and 200:
Page 201 and 202:
Page 203 and 204:
Page 205 and 206:
Page 207 and 208:
Page 209 and 210:
Page 211 and 212:
Page 213 and 214:
Page 215 and 216:
Page 217 and 218:
Page 219:
Page 222 and 223:
Page 224 and 225:
Page 226 and 227:
Page 228 and 229:
Page 230 and 231:
Page 232 and 233:
Page 234 and 235:
Page 236 and 237:
Page 238 and 239:
Page 240 and 241:
Page 242 and 243:
Page 244 and 245:
Page 246 and 247:
Page 248 and 249:
Page 250 and 251:
Page 252 and 253:
Page 254:
Page 257 and 258:
Page 259 and 260:
show all

Economic Assessment of Sanitation Interventions in Vietnam - WSP

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?