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Haïti Priorise: WASH, Whittington

The Problem

Haiti has the lowest coverage rates for improved water and sanitation in the Latin America and Caribbean (LAC) region, on par with some of the lowest coverage countries in the world. 

Not only does Haiti have the lowest improved water coverage rates in the region, but the rates in each of Haiti’s Departments are among the lowest for all administrative units in the region.

Improved water and sanitation coverage in rural Haiti is lower than the coverage in Haiti’s urban areas.

These low coverage rates translate into significant health burdens. The Global Burden of Disease 2015 estimates that between 2,000 and 4,500 people in Haiti die from diarrheal disease per year, which is an estimated 2.4% to 4.4% of the GBD estimated annual deaths.

Solutions

  • Borehole and Handpump with Community Management
  • Borehole and Handpump with Community Management, plus Household Biosand Filter
  • Community-Led Total Sanitation (CLTS)

Summary Table of the BCR

Interventions Benefit Cost Benefits for every gourde or dollar spent
Borehole and Handpump Only US$4.79 US$2.17 2.2
Biosand Filter with Borehole and Handpump US$6.65 US$3.21 2.0
Community-Led Total Sanitation US$1.21 US$1.10 1.1

Benefits, Costs, and BCR

Borehole and Handpump with Community Management

The installation process for a borehole with a handpump typically requires that a drilling rig sink a well that reaches the groundwater aquifer. While the borehole and handpump system is easy to operate, previous work has documented that achieving sustained maintenance can be a challenge.

Costs

The upfront financial cost of a borehole and handpump is estimated to be US$6,500 for the component parts and installation; this accounts for the risk that some drilling attempts will be unsuccessful. An associated capacity building program including behavior change education and the establishment of a community management structure – critical for ensuring repairs and community-level management of the infrastructure – costs an additional estimated additional US$3,500. Therefore, the total upfront cost per borehole and handpump is estimated to be US$10,000. 

Each system is assumed to serve 60 households, and the per household upfront cost is thus estimated to be US$167. 

Additionally, there is an expected annual cost of US$100 per borehole and handpump for routine maintenance and repairs. The costs of ongoing community management to monitor the functionality and safeguard the infrastructure is estimated to be US$500/system per year. The total costs over the lifetime of the project (estimated at 15 years) on a per month per household basis is thus about US$2.20

Benefits

  • Time savings resulting from defecating at home rather than spending time walking to a place to defecate in the open
  • Health benefits from using an improved sanitation facility

Hours saved per month: 45

Value of time savings (monthly): $4

Additional consumption per household per month: 768 liters

Monthly health benefits per household: $1

Borehole and Handpump with Community Management, plus Household Biosand Filter

This intervention will provide households with access to a borehole and handpump system as well a household point-of-use technology (specifically a household-level biosand filter). Biosand filters can be constructed from locally available materials and are relatively easy to install. To construct a biosand filter, one needs a plastic or cement container, which is then filled with layers of sand and gravel. In order to use the technology, an individual simply pours water into the top of the filter and then collects clean, purified water from the storage container placed at the outlet of the filter. A typical household biosand filter system is able to purify around 30-60 liters per hour.

Costs 

The upfront financial cost of the program to purchase and distribute a biosand filter (this includes behavior change promotion) is estimated to be US$75 per filter with an additional expected cost of US$25 for transporting the filter. This is in addition to the costs of the borehole and handpump intervention and results in a per household upfront financial cost of US$267. The ongoing financial costs arise from the routine maintenance and repairs and community management for the borehole and handpump. Therefore, the total costs over the lifetime of the project (estimated at 8 years for the biosand filter) on a per month per household basis is US$3.20.

Benefits

The benefits of the borehole and handpump with community management plus biosand filter intervention are greater than the benefits offered by the borehole and handpump with community management intervention because the biosand filter improves drinking water quality and increases the health benefits to the household.

Health benefits per household, per month: $2.80 

Benefits from Borehole and Handpump per household, per month: $4.42

Community-Led Total Sanitation

CLTS is a behavior change strategy for ending open defecation. The approach attempts to raise awareness among community members of the risks associated with open defecation. The aim is to increase villagers’ perceived need to end open defecation and to ensure that every household and individual uses a latrine, thereby achieving “total sanitation.”

Costs

The upfront financial cost per household for constructing a pit latrine in Haiti is estimated to be US$20. This upfront capital cost is accompanied by a monthly US$0.30 program cost per household to cover the expenses of delivering the behavioral intervention as well as any additional follow-up designed to induce sustained use of latrines. The last component of the total financial costs of the latrine is the operation and maintenance costs, which is estimated to be US$0.42 per household per month. This O&M cost includes purchasing items such as soap, a pail, or other necessary items to clean or repair a latrine.  The total monthly cost is $1.10 per household per month.

Benefits

The benefits from CLTS intervention are the sum of the time savings resulting from defecating at home rather than spending time walking to a place to defecate in the open, and the health benefits from using an improved sanitation facility.

Time savings per household per month: $ 0.20

Health benefits per household per month: $0.72