Hygiene and health in developing countries: defining priorities through cost - benefit assessments.

Presented here are the four preliminary conclusions in the assessment of health and hygiene in developing countries: (a) child mortality, and disease burden associated with hygiene, water and sanitation in the developing and the developed regions of the world, has declined substantially in the past two decades, but substantial inter-regional and cross-country differences persist; (b) while child mortality and disease burdens decline with higher income levels, a substantial number of countries have been performing far better in reducing child mortality and disease burdens than their income levels would indicate, suggesting that active policy and investment interventions can yield significant health improvements without necessarily jeopardising economic growth; (c) despite the evidence of the role of water and sanitation services in reducing mortality and morbidity, service coverage at the country level has not increased as much as one may have expected in the past decade, in part because of the substantial resource requirements; (d) the paper will provide some new perspectives and evidence on the cost-effectiveness of interventions to reduce the disease burden of poor water and sanitation services and inadequate hygiene practices, in particular with regard to economic evaluation and in reference to hygiene programmes.