Haller Laurence, Hutton Guy, Bartram Jamie
Institute F.-A. Forel, University of Geneva, Switzerland.
J Water Health. 2007 Dec;5(4):467-80. doi: 10.2166/wh.2007.008.
The aim of this study was to estimate the costs and the health benefits of the following interventions: increasing access to improved water supply and sanitation facilities, increasing access to in house piped water and sewerage connection, and providing household water treatment, in ten WHO sub-regions. The cost-effectiveness of each intervention was assessed in terms of US dollars per disability adjusted life year (DALY) averted. This analysis found that almost all interventions were cost-effective, especially in developing countries with high mortality rates. The estimated cost-effectiveness ratio (CER) varied between US$20 per DALY averted for disinfection at point of use to US$13,000 per DALY averted for improved water and sanitation facilities. While increasing access to piped water supply and sewage connections on plot was the intervention that had the largest health impact across all sub-regions, household water treatment was found to be the most cost-effective intervention. A policy shift to include better household water quality management to complement the continuing expansion of coverage and upgrading of services would appear to be a cost-effective health intervention in many developing countries.
增加获得改善的供水和卫生设施的机会、增加获得室内管道供水和污水连接的机会以及提供家庭水处理。根据避免的每残疾调整生命年（DALY）的美元数评估了每种干预措施的成本效益。该分析发现，几乎所有干预措施都具有成本效益，尤其是在死亡率高的发展中国家。估计的成本效益比（CER）从使用点消毒每避免一个DALY的20美元到改善供水和卫生设施每避免一个DALY的13000美元不等。虽然增加地块上的管道供水和污水连接的机会是在所有次区域中对健康影响最大的干预措施，但家庭水处理被发现是最具成本效益的干预措施。在许多发展中国家，转向包括更好的家庭水质管理以补充持续扩大的覆盖范围和服务升级的政策似乎是一种具有成本效益的健康干预措施。
