WASH Related Mortality Trends in Sub-Saharan Africa. By Dale Whittington.

August 28, 2014

WASH-related

Mortality Trends in

Sub-Saharan Africa

2

Contextual Factors

& Initial Conditions

{IWRM}Policy (mix)

InstitutionsWater Law

Organizations

ProcessIntegration/Coordination

Decentralization

Participation

WRM

IWRM

�Water resources

endowment/distribution/level

of development

�Level of economic

development Nation/RB

�Political factors (Democracy

National/local levels,

Decentralization, Governance)

�Social/cultural factors (local

experience with self

governance and service

provision)

�etc

Mohamed Ait Kadi – Zaragoza 0708

Improved Water: Total (Urban & Rural)

UNICEF and WHO. 2012. Progress on drinking water and sanitation: 2012 update.

Available at: http://www.wssinfo.org/fileadmin/user_upload/resources/JMP-report-2012-en.pdf Accessed on 28 Jan 2013.

Some Good News!

Childhood mortality rates are declining & the

rate of decline is accelerating.

Across 21 regions of the world, rates of

neonatal, post-neonatal, and childhood

mortality are declining, and there is evidence

of accelerating declines from 2000 to 2010

compared with 1990 to 2000 (including Sub-

Saharan Africa).

Rajaratnam et al. (2010). “Neonatal, post-neonatal, childhood, and under-5 mortality

for 187 countries, 1970–2010: a systematic analysis of progress towards

Millennium Development Goal 4.” The Lancet. May 24.

Water & sanitation-related mortality

1950-2050, by world region

WASH-related Mortality– China, India, Brazil, & Nigeria (1950-2050)

0.00

0.05

0.10

0.15

0.20

0.25

19

50

19

60

19

70

19

80

19

90

20

00

20

10

20

20

20

30

20

40

20

50

WSH

Mo

rta

lity

Ra

te (%

)

Year

China

India

Brazil

Nigeria

Emerging &Threshold Countries in SSA

Source: Radalet 2010

o 17 emerging countries: dramatic

changes in economic growth,

poverty reduction, and political

accountability since the mid-1990s.

o Avg. annual GDP growth of 3.2%,

between 1996 and 2008 (all 17

emerging countries)

o 6 threshold countries: considerable

but less dramatic change

WASH Mortality Categories

High Mortality

Low Mortality

Moderate Mortality;

Insufficient Decline

Moderate Mortality;

Sufficient Decline

High Mortality

Stagnant Moderate decline

High Mortality

High Mortality

Stagnant Moderate decline

o Highest WASH mortality rates, both

at baseline and in projections

o Stagnant progress in reducing

WASH mortality in some counties

(mostly fragile and oil states)

o Moderate decline in other

countries (mostly threshold and

emerging economies)

o Moderate WASH mortality rates,

for the Sub-Saharan Africa region

o Progress is insufficient to achieve

South Asian levels of WASH

mortality by 2050

Moderate Mortality;


Moderate Mortality, Insufficient Decline (Little Progress)

Moderate Mortality,

Sufficient Decline (Good Progress)

o Moderate WASH mortality rates,

for the Sub-Saharan Africa region

o Progress is sufficient to achieve

South Asian levels of WASH

mortality by 2050.

o Mostly threshold and emerging

economies

Moderate Mortality;

Sufficient Decline

Low Mortality

o Historically low WASH mortality

rates, comparable to South Asia

o By 2050, WASH mortality projected

to be near zero

Low Mortality

WASH Modeling Framework

Population

Growth

Economic

Growth

WASH

Coverage

WASH-Related

Mortality

Economic

Benefits

-

+

- +

That’s good! That’s good!

Baseline assumptions: representative countries

Population


GDP per Capita

Best and Worst Case Assumptions:

Nigeria

Base Best Worst

Avg. Annual GDP Growth 4.1% 4.5% 3.7%

Coverage

Piped Water Coverage GDP Elasticity 9.5 14.5 4.5

Piped Water Coverage % Urban Elasticity 0.35 0.6 0.1

Improved Water Coverage GDP Elasticity 4.5 9 0

Improved Water Coverage % Urban Elasticity 0.3 0.5 0.1

Improved Sanitation Coverage GDP Elasticity 8 14 2

Improved Sanitation Cov. % Urban Elasticity 0.45 0.8 0.1

Mortality

WSH Mortality GDP Elasticity -0.2 -0.3 -0.1

WSH Mortality Piped WatSan Elasticity -0.02 -0.03 -0.01

WSH Mortality Log Piped WatSan Elasticity -0.5 -0.7 -0.3

WSH Mortality Improved Water Elasticity -0.0275 -0.045 -0.01

Results …

WASH Mortality Categories:

Representative Countries

High Mortality

Low Mortality

Moderate Mortality;


Moderate Mortality;

Sufficient Decline

High Mortality

Nigeria

Kenya South Africa

Stagnant

Democratic Rep.

of Congo

Moderate decline

Ethiopia

WASH Mortality Categories

High Mortality

Low Mortality

Moderate Mortality;


Moderate Mortality;

Sufficient Decline

High Mortality

Stagnant

Burundi

Central African Rep.

Chad

DRC

Guinea Bissau

Niger

Somalia

Moderate decline

Angola

Burkina Faso

Ethiopia

Liberia

Mali

Sierra Leone

Benin

Cameroon

Comoros

Congo

Cote d'Ivoire

Ghana

Guinea

Madagascar

Malawi

Mauritania

Mozambique

Nigeria

Rwanda

Sudan

Tanzania

Togo

Uganda

Zambia

Zimbabwe

Botswana

Equatorial

Guinea

Eritrea

Gambia

Kenya

Lesotho

Namibia

Senegal

Swaziland

Cape Verde

Gabon

Mauritius

Seychelles

South Africa

WASH Mortality Rate by Country Grouping

WASH Mortality Rate: Projections

WASH-related Deaths by country grouping

Total WASH-Related Deaths: Projections

Population without Improved W&S coverage

(Representative Countries)

Model Overview

Assemble country-level data sets and estimate empirical relationships using regression analysis

Collect secondary data

Coverage with water & sanitation services

WASH-related mortality

Other control variables

Assess associations with WASH-related mortality rates

Assess associations with piped and improved water and

sanitation coverage

Simulate outcomes (1990-2050)

WASH-related mortality rates

Piped service + improved water coverage

Calculate WASH-related deaths (1990-2050)

Adjust coverage estimates for piped water + sewer

Calculate WTP to avoid mortality (1990-2050)

Sensitivity analyses on model

parameters


Improved Water Coverage

Economic & Population Projections

� Drivers of coverage and WASH-related

mortality

Population by country grouping

GDP by country grouping

GDP per Capita, by country grouping

Projections: Wash-mortality Rates,

Wash-related Death

Projections by Country Groupings

WASH Mortality Rate, by category

Best/Worst Cases

Oil and Mineral Exporters

WASH Mortality Rate, 2008


WASH Deaths, 2008


WASH Related Mortality Trends in Sub-Saharan Africa. By Dale Whittington.

Presentations & Public Speaking

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