Evaluations - Water and Sanitation

October 6, 2016





Improved water supply and sanitation are critical for health and development, especially of young children, by reducing the transmission of disease. Toilets and easily accessible water supply systems provide women and children with security and dignity. They also can help raise school attendance, reduce healthcare costs and ultimately, strengthen productivity. For too many, this is still out of reach: More than 2.5 billion people don’t have access to basic sanitation, 1.1 billion people still defecate in the open, and more than 780 million people do not have regular access to clean drinking water. Improving water and sanitation makes good business sense as well, because poor sanitation and its effects depresses a country’s economic potential. SIEF-supported researchers are evaluating what mix of informational campaigns, financial instruments and incentives, and provision of sanitation infrastructure can successfully boost sustained access and usage. The evidence collected will give governments powerful evidence for making policy decisions that will ultimately bring tangible improvements in people’s well-being. Read more about water and sanitation and impact evaluation in our Cluster Note.





Bangladesh: Impact of Low-Cost In-Line Chlorination Systems in Urban Dhaka on Water Quality and Child Health

  • Principal investigators: Stephen Luby, Stanford University
  • Timeline: 2013 - 2017
  • Evaluation: In Bangladesh, limited water supply and poor sanitation infrastructure in dense slums is associated with high rates of child diarrhea and stunting. Central treatment and delivery of water supply is prohibitively expensive for municipal governments to implement in low-income areas. A new in-line chlorination system has been developed to deliver the right dose to dispensed water at existing handpumps in Dhaka. Researchers seek to determine the effectiveness of using automated chlorination at public water dispensing stations to improve water quality and child health outcomes.


Ethiopia: The impact of enhanced, demand-side sanitation and hygiene promotion on sustained behavior change and health in Ethiopia

  • Principal investigator: Matthew Freeman, Emory University
  • Timeline: 2014 - 2018
  • Evaluation: Neglected tropical diseases (NTDs) are a diverse group of parasitic, bacterial, and viral diseases affecting more than one billion people around the world, primarily those in poor regions without adequate sanitation. Some of the diseases, namely soil-transmitted helminthiasis, schistosomiasis, and trachoma, can be controlled with preventive chemotherapy, but reinfection can rapidly occur. Long-term drug provision is not a sustainable solution, and eliminating these conditions as public health concerns will not occur without adequate provision of water, sanitation and hygiene infrastructure and changing related behaviors. Millions of people in Ethiopia are at risk of neglected tropical diseases, and the Government of Ethiopia has made control and elimination a priority. Researchers will study the impact of an intervention that integrates specific sanitation and hygiene behavior change components into current government supported programming to encourage improved personal hygiene and sanitation practices and reduce the spread of neglected tropical diseases. Resulting evidence will help the Government of Ethiopia decide on next steps for the prevention and control of neglected tropical diseases and promotion of better sanitation and hygiene.  


India: Incentivizing Sanitation Uptake and Sustainable Usage through Micro Health Insurance

  • Principal investigators: Orazio Attanasio, University College London
  • Timeline: 2012 - 2017
  • Evaluation: India accounts for 33 percent of the global population without access to safe water and adequate sanitation. At the same time, the number of Indians with health insurance coverage is low, and out-of-pocket expenditures pay for most health care costs. Researchers will examine the links between a sanitation intervention, health insurance claims and health status in poor areas of rural India. The sanitation intervention creates awareness and provides access to credit to construct safe sanitation systems. The research team will also explore and test whether a health care program can be provided as an incentive for communities to sustain their safe sanitation over time. 


India: Technical Proposal for the Impact Evaluation of Second Kerala Rural Water Supply and Sanitation Project (Jalanidhi-II)

  • Principal investigator: Luis Alberto Andres, World Bank
  • Timeline: 2015 - 2018
  • Evaluation:  In the Indian state of Kerala, the World Bank is working closely with the government to implement and expand the Second Rural Water Supply and Sanitation Project (Jalanidhi-II), which provides piped water connections to individual households. Researchers will evaluate the effects of improved water and sanitation access on the health and education of these rural communities, as well as on social and economic empowerment, particularly women, who are no longer tasked with collecting water for their household. 


Kenya: Turning Pipe Dreams into Reality: Improving access to water and sanitation services in a Nairobi Slum

  • Principal investigators: Sebastian Galiani, University of Maryland; Paul Gertler, University of California, Berkeley
  • Timeline: 2013 - 2017
  • Evaluation: In Kenya, researchers will study the effects of hygiene promotion campaigns and providing subsidies on people's decision to connect to piped water and sewage services. The results will help development experts in Kenya and elsewhere determine how to encourage behavioral changes that can lead to improved hygiene, health and living standards for poor residents.


Nicaragua Sustainable Water and Sanitation Sector Project

  • Principal Investigator: Josh Gruber, University of Maryland
  • Timeline: 2014 - 2019
  • Evaluation: Poverty in Nicaragua is concentrated in rural areas, where more than 40 percent of the population lives. Just over a third of people in rural areas don’t have piped in water and lack access to adequate sanitation. The World Bank has developed a new rural water supply sanitation project, known as PROSASR, to help the Government of Nicaragua improve water and sanitation for the rural poor. An impact evaluation, conducted with the government, will measure how well the program does at strengthening water and sanitation services to ensure everyone has good access. The results will inform the government’s future policymaking in this area.


The Philippines Pantawid Pamilya CCT Sanitation Impact Evaluation

  • Principal Investigators: Paul J. Gertler, University of California, Berkeley; Joshua Gruber, University of California, Berkeley
  • Timeline: 2014 - 2017
  • Evaluation: Access to basic sanitation is still one of the largest development challenges in the Philippines. About a quarter of the population don’t have access to latrines and other improved sanitation facilities, putting especially children at risk of diarrheal illnesses that can stunt growth, harm health and make it hard for them to reach their potential. The Government of the Philippines, working with the World Bank, is implementing and evaluating a new program that will twin subsidies or loans with promotional campaigns to convince households to acquire and use toilets. The results of the evaluation will help the government decide what is the best approach for ending open defecation.