Cost Effectiveness and Benefit Cost Analysis of Some Water Interventions in Bauchi State in Nigeria

This study presents a Cost-Effectiveness Analysis of two water interventions in Bauchi state, Nigeria aimed at reducing the incidence of and death from diarrhea disease namely: the Pipeline and Hand pump water supply schemes.

Author: Eberechukwu Uneze, Ibrahim Tajudeen & Ola Iweala

Publication Date: September, 2011

Document Size: 42 pages

This report presents a Cost-Effectiveness analysis of water interventions in Bauchi state, Nigeria, with particular emphasis on pipeline and borehole (Hand pump) water supply schemes. Using the measures adapted from Whittington et al (2008), this study estimates the cost and effectiveness measures such as time savings and health benefit aimed at reducing the incidence of and death from, diarrhea disease. First, it conducts a BASIC CEA which compares the cost per household per year of PWS with BWS program. Second, it performs a PROGRAM CEA to determine the relative effectiveness of the programs. The cost analysis shows that BWS is less expensive than PWS. Combining cost and effectiveness, the cost-effectiveness ratio shows the BWS is more cost-effective than the PWS program.

Nevertheless, CEA is not sufficient to determine the most attractive intervention, since it cannot quantify cost and effectiveness in the same unit. Hence, a benefit-cost analysis, which estimates the monetary value of benefits, is applied. The results of the BCA seem to support the evidence that emerged from the cost-effectiveness analysis.

A sensitivity analysis is then performed to determine the robustness of these findings. A oneway and multi-way sensitivity analyses (with worse and best case scenarios) performed on the results show that BWS is more cost-effective and attractive. The study then concludes with a recommendation that in areas where there are high cases of morbidity/mortality from diarrheal, access to portable water and improved health outcomes in densely populated areas can be achieved by diverting resources from BWS to PWS, that is by increasing pipeline water supply. The converse is true for sparsely populated areas with low cases of morbidity/mortality from diarrheal. However, in mildly populated areas with moderate cases of morbidity/mortality, PWS and BWS can be implemented as complements.