Economic evaluation of an urban sanitation intervention in Maputo, Mozambique

Lead Research Organisation: London Sch of Hygiene and Trop Medicine
Department Name: Public Health and Policy


The research will develop robust estimates of the economic performance of a sanitation intervention in Maputo, Mozambique. The intervention is the construction of community sanitation blocks and shared latrines, implemented by the international NGO Water and Sanitation for the Urban Poor. I will be carrying out costing studies linked to the on-going 'Maputo Sanitation' (MapSan) trial of this intervention, which one of my proposed co-supervisors leads for LSHTM. MapSan has a Controlled, Before-and-After (CBA) study design, and is carrying out three rounds of data collection. Their robust data on health effects of the intervention will be one of my two key data sources. The other will be my own primary data collection focusing on estimating the costs of the intervention. I will combine these data sources to calculate cost-effectiveness indicators. In addition, I will develop an innovative composite measure of sanitation outcome based on the concept of wellbeing, building on work in this area by my supervisor Dr Giulia Greco. Sanitation is a key aspect of housing, and thus fits into one of the ESRC's five priorities for 2016-2020. The research fits into two of the ESRC's strategic areas as follows:

Fostering research and innovation - there are very few (<5) robust economic evaluations of sanitation interventions globally, and none in Sub-Saharan Africa. Furthermore, there is no existing measure of sanitation outcome based on wellbeing. These are two key innovative aspects of the research.
Facilitating partnerships and realising impact - several key partnerships will be developed through this research: (i) between the health economics group and environmental health group within LSHTM (which are in different faculties and rarely collaborate), (ii) between LSHTM and WSUP (the NGO implementing the intervention), and (iii) between LSHTM and MINSAUDE, the Mozambican Ministry of Health. The study has potential for impact both in Mozambique (through better understanding of sanitation costs and therefore better investment planning) and elsewhere (through better comparative information on economic performance of sanitation interventions).

In addition, it is supporting the "capability" aspect of ESRC's strategy by investing in my research skills. I have developed a plan for skills development with my supervisor which includes a programme of training within and outside LSHTM (in addition to the core researcher training provided by the UBEL DTP). The high-priority skill areas I intend to work on through the studentship include:

Economic evaluation - this is the core methodology of my research area. It will be covered through an LSHTM module and an advanced course in economic evaluation at the University of York which I will fund through my ESRC RTSG.
Epidemiology and Statistics - these skills are required to work with the health outcome data. They will be gained through 4 LSHTM modules taken over the course of the first two years, and supplemented by an IFS course in year 2 (funded through my ESRC RTSG).


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Studentship Projects

Project Reference Relationship Related To Start End Student Name
ES/P000592/1 01/10/2017 30/09/2027
1922289 Studentship ES/P000592/1 25/09/2017 20/10/2020 Ian Ross