Africa: Economics of Sanitation Initiative

Benin | Burkina Faso | Central African Republic | Chad | Democratic Republic of Congo | The Republic of Congo | Ghana | Kenya | Liberia | Madagascar | Malawi | Mauritania | Mozambique | Niger | Nigeria | Tanzania | Uganda | Zambia

Introduction

Traditionally, sanitation has not received the priority it deserves. It has not been widely recognized how good sanitation policies and practices can underpin socio-economic development and environmental protection. This study provides an estimation of economic impacts on populations without access to improved sanitation in order to provide information on the losses to society of the current sanitation situation. While not all these economic impacts can be immediately recovered from improved sanitation practices, it provides a perspective on the short- and longer-term economic gains that are available to countries through a range of policies to mitigate these impacts. Underlying data sets to estimate economic impacts are weak; the study therefore uses objectively verified data sources and conservative numbers to estimate economic impacts. Several impacts have been excluded due to lack of data. Therefore the total costs of poor sanitation reported are likely to significant underestimate the true costs.

Methods

Phase 1

Data used for these estimates was in large part derived from Demographic and Health Surveys (DHS), Multiple Indicator Cluster Surveys (MICS) and the Joint Monitoring Program for Water Supply and Sanitation (JMP).

Health care cost estimates were based on outpatient and inpatient consultation and treatment costs, including patient travel costs, taking into account disease rates and treatment seeking behavior, as well as unit costs of different types of health services provided.

Health-related productivity costs were based on average length of time spent incapacitated (2 days for diarrhea, 5 days for respiratory infection and 4 days for malaria). While infants are not productive, their sickness leads to diversion of carers from other activities (2 hours per day). Time value is the same as access time costs (see below).

Mortality costs are based on the estimated number of deaths per year (using WHO statistics and attributing 88% of diarrheal deaths to the fecal-oral route) and the average value of premature death. The value of a premature death was estimated using the human capital approach, which estimates the discounted future income of a working person, using the GNP per capita to conservatively estimate the average economic contribution of a member of society. Indirect deaths via increased malnutrition rates (respiratory infections, measles and malaria) were also included, based on attributable fractions from WHO research.

Time costs for accessing site of open defecation: extra travel time is based on the expert opinion of over 25 sector specialists. Time lost is valued at 30% of the Gross Domestic Product per capita for adults and for children over 5 years of age, at 15% of the GDP per capita (i.e. half that of adults).

Funeral costs were estimated from funeral insurance policy benefits, using values from 7 African countries. The value of costs was adjusted downwards based on a study showing that with-insurance spending on funerals was 37% more than funerals that were not insured. As all people die eventually, the future funeral costs were discounted to the present period and subtracted from the costs of holding a funeral now.

The costs of preparedness and response to cholera outbreaks are based on a combination of preparedness and response budgets in countries. Costs included are limited to coordination, community WASH response and WASH expenditure in cholera treatment centers. Calculations use an attack rate of 2% and disease duration of 3-months.


Results of Economics of Sanitation Initiative

ESI Africa Factsheet (PDF): English / French
 

Benin 

Phase 1: Key Findings

  • Poor sanitation costs Benin US$ 104 million per year.
  • This amount is equivalent to US$ 12 per person per year in Benin, or 1.5% of GDP.
  • Each person practicing open defecation spends almost 2.5 days a year to find a secluded spot to defecate, leading to significant economic losses of US$21 million

Report (French)

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Burkina Faso 

Phase 1: Key Findings

  • Burkina Faso loses US$ 171 million per year due to poor sanitation.
  • This amount is equivalent to US$ 11 per person in Burkina Faso per year or 2% of GDP.

Report (French)

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Central African Republic

Phase 1: Key Findings

  • The Central African Republic loses US$ 26 million per year due to poor sanitation.
  • This amount is equivalent to US$ 5.5 per person per year in Central African Republic, or 1.2% of GDP.

Report (French)

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Chad

Phase 1: Key Findings

  • Chad loses US$ 156 million per year due to poor sanitation.
  • This amount is equivalent to US$ 15 per person in Chad, or 2.1% of national GDP.

Report (French)

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Democratic Republic of Congo 

Phase 1: Key Findings

  • The Democratic Republic of Congo loses US$ 208 million per year due to poor sanitation.
  • This amount is equivalent to US$ 3 per person per year in the DRC, or 1.6% of GDP.

Report (French)

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The Republic of Congo

Phase 1: Key Findings

  • The Republic of Congo loses US$ 144 million per year due to poor sanitation.
  • This amount is equivalent to US$ 35.8 per person per year in the Republic of Congo, or 1.1% of national GDP.

Report (French)

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Ghana 

Phase 1: Key Findings

  • Poor sanitation costs Ghana US$ 290 million.
  • This sum is the equivalent of US$ 12 per person in Ghana per year or 1.6% of the national GDP.

Report

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Kenya 

Phase 1: Key Findings

  • Poor sanitation costs Kenya US$ 324 million per year.
  • This sum is the equivalent of US$ 8 per person in Kenya per year or 0.9% of the national GDP.

Report

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Liberia

Phase 1: Key Findings

  • Liberia loses US$ 17.5 million per year due to poor sanitation.
  • This amount is equivalent to US$ 4.9 per person per year in Liberia per year or 2.0% of the national GDP.

Report

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Madagascar 

Phase 1: Key Findings

  • Madagascar loses US$ 103 million per year due to poor sanitation.
  • This amount is equivalent to US$ 5 per person per year in Madagascar, or 1% of GDP.

Report (French)

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Malawi

Phase 1: Key Findings

  • Malawi loses MWK8.8 billion annually due to poor sanitation.
  • This amount is equivalent tof US$3.8 per person per year in Malawi, or 1.1% of GDP.

Report

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Mauritania

Phase 1: Key Findings

  • Mauritania loses US$ 41 million per year due to poor sanitation.
  • This amount is equivalent to 13.1 USD per person per year in Mauritania, or 1.2% of GDP.

Report (French)

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Mozambique 

Phase 1: Key Findings

  • Poor sanitation costs Mozambique US$ 124 million per year.
  • This sum is the equivalent of US$ 6 per person in Mozambique per year or 1.2% of the national GDP.

Report

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Niger 

Phase 1: Key Findings

  • The Niger loses US$ 148 million per year due to poor sanitation.
  • This amount is equivalent to US$ 10 per person per year in Niger, or 2.4% of GDP.

Report (French)

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Nigeria 

Phase 1: Key Findings

  • Poor sanitation costs Nigeria US$ 3 billion per year.
  • This sum is the equivalent of US$ 20 per person in Nigeria per year or 1.3% of the national GDP.

Report

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Tanzania 

Phase 1: Key Findings

  • Poor sanitation costs Tanzania US$ 206 million each year.
  • This sum is the equivalent of US$ 5 per person in Tanzania per year or 1% of the national GDP.

Report

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Uganda

Phase 1: Key Findings

  • Uganda loses US$ 177 million per year due to poor sanitation.
  • This amount is the equivalent of US$5.5 per person in Uganda per year or 1.1% of the national GDP.

Report

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Zambia

Phase 1: Key Findings

  • Zambia loses US$ 194 million per year due to poor sanitation.
  • This amount is the equivalent of US$16.4 per person in Zambia per year or 1.3% of the national GDP.

Report

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