Measuring and valuing broader impacts in public health: Development of a sanitation-related quality of life instrument in Maputo, Mozambique.
Health Econ
; 31(3): 466-480, 2022 03.
Article
en En
| MEDLINE
| ID: mdl-34888994
ABSTRACT
Two billion people globally lack access to a basic toilet. While improving sanitation reduces infectious disease, toilet users often identify privacy, safety and dignity as more important. However, these outcomes have not been incorporated in sanitation-related economic evaluations. This illustrates the general challenge of outcome measurement and valuation in the economic evaluation of public health interventions, and risks misallocating the US$ 20 billion invested in sanitation in low- and middle-income countries every year. In this study in urban Mozambique, we develop an instrument to measure sanitation-related quality of life (SanQoL). Applying methods from health economics and the capability approach, we develop a descriptive system to measure five attributes identified in prior qualitative research disgust, health, shame, safety and privacy. Sampling individuals from the intervention and control groups of a sanitation intervention trial, we elicit attribute ranks to value a SanQoL index and assess its validity and reliability. In combination with a measure of time using a sanitation service, SanQoL can quantify incremental benefits in a sanitation-focused cost-effectiveness analysis. After monetary valuation based on willingness to pay, QoL benefits could be summed with health gains in cost-benefit analysis, the most common method in sanitation economic evaluations.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
Problema de salud:
2_quimicos_contaminacion
Asunto principal:
Calidad de Vida
/
Saneamiento
Tipo de estudio:
Prognostic_studies
/
Qualitative_research
Aspecto:
Determinantes_sociais_saude
/
Patient_preference
Límite:
Humans
País/Región como asunto:
Africa
Idioma:
En
Revista:
Health Econ
Asunto de la revista:
SERVICOS DE SAUDE
Año:
2022
Tipo del documento:
Article
País de afiliación:
Reino Unido