Health Impacts in Developing Countries: New Evidence and New Prospects

This review of recent studies of the health impact of water supply and sanitation programmes in developing countries shows that they share many findings, and some methodological problems, with older studies of the subject. Considerable health impacts can occur under appropriate conditions, and it is suggested that the greatest impact can be produced by targeting water and sanitation facilities to those whose existing water sources are furthest away, or whose environment is most faecally polluted. Another finding is that health benefits stem from the changes in hygiene behaviour which water and sanitation make possible. The measurement of such behavioural changes is a subject in need of development. Nevertheless, it is likely to be easier, more reliable, and more useful to water and sanitation programme managers as an operational evaluation tool than any attempt to measure the health benefits directly.