The true costs of participatory sanitation: Evidence from community-led total sanitation studies in Ghana and Ethiopia

Autor: Jonny, Crocker, Darren, Saywell, Katherine F, Shields, Pete, Kolsky, Jamie, Bartram
Rok vydání: 2017
Předmět:
Zdroj: The Science of the Total Environment
ISSN: 1879-1026
Popis: Evidence on sanitation and hygiene program costs is used for many purposes. The few studies that report costs use top-down costing methods that are inaccurate and inappropriate. Community-led total sanitation (CLTS) is a participatory behavior-change approach that presents difficulties for cost analysis. We used implementation tracking and bottom-up, activity-based costing to assess the process, program costs, and local investments for four CLTS interventions in Ghana and Ethiopia. Data collection included implementation checklists, surveys, and financial records review. Financial costs and value-of-time spent on CLTS by different actors were assessed. Results are disaggregated by intervention, cost category, actor, geographic area, and project month. The average household size was 4.0 people in Ghana, and 5.8 people in Ethiopia. The program cost of CLTS was $30.34–$81.56 per household targeted in Ghana, and $14.15–$19.21 in Ethiopia. Most program costs were from training for three of four interventions. Local investments ranged from $7.93–$22.36 per household targeted in Ghana, and $2.35–$3.41 in Ethiopia. This is the first study to present comprehensive, disaggregated costs of a sanitation and hygiene behavior-change intervention. The findings can be used to inform policy and finance decisions, plan program scale-up, perform cost-effectiveness and benefit studies, and compare different interventions. The costing method is applicable to other public health behavior-change programs.
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Highlights • Bottom-up cost analysis of community-led total sanitation in Ghana and Ethiopia • The program cost was $30–82 per household targeted in Ghana, and $14–19 in Ethiopia. • Local investments were $8–22 per household targeted in Ghana, and $2–3 in Ethiopia. • The findings are relevant for policy, practice, and further research.
Databáze: OpenAIRE
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