Cost-benefit analysis of water source improvements through borehole drilling or rehabilitation: an empirical study based on a cluster randomized controlled trial in the Volta Region, Ghana
Date
2018-10
Journal Title
Journal ISSN
Volume Title
Publisher
Global Health Action
Abstract
Background: Despite remarkable progress in water coverage improvements, diseases associated with poor water remain a considerable public health problem in many developing
countries.
Objective: We aimed to estimate the costs and benefits of drilling or rehabilitating boreholes
with handpumps in resource-poor settings and hard-to-reach areas.
Methods: Diarrheal reduction in the population was predicted on the basis of the empirical
findings from a cluster randomized controlled trial. The full investment and estimated annual
running costs were used to calculate the intervention costs. Direct economic benefits of
avoiding child diarrheal disease, indirect economic benefits related to health improvements,
and non-health benefits related to water improvement were estimated. One-way and multiway sensitivity analyses were performed to determine the robustness of the findings.
Results: Our analysis found that the return on a US$ 1 investment was US$ 9.4 for borehole
drilling and US$ 14.1 for borehole rehabilitation. Time savings were the main contributor,
accounting for 68% of the benefits, followed by the economic benefits of averted child
deaths, which contributed to 15% of the benefits. The sensitivity analyses suggested that
improving water sources yields high returns under all circumstances, and that borehole
rehabilitation is more efficient than borehole drilling.
Conclusion: This study explicitly justifies increased investment in water improvement in rural
areas and demonstrates the high returns of rehabilitating boreholes. We hope that this study
will be used as evidence for informing the policy decisions of governments or international
agencies regarding further investments in improved water coverage in rural areas and the
selection of appropriately designed interventions.
Description
Keywords
Cost-benefit Analysis, Water Source Improvements, Borehole Drilling, Borehole Rehabilitation, Ghana