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EPAR Technical Report #104
The Public Health Benefits of Sanitation Interventions
Publication Date: 10/12/2010
Type: Literature Review
Abstract

Limited sanitation infrastructure, poor hygienic practices, and unsafe drinking water negatively affect the health of millions of people in the developing world. Using sanitation interventions to interrupt disease pathways can significantly improve public health. Sanitation interventions primarily benefit public health by reducing the prevalence of enteric pathogenic illnesses, which cause diarrhea. Health benefits are realized and accrue to the direct recipients of sanitation interventions and also to their neighbors and others in their communities. In a report to the United Nations Development Programme (UNDP), Hutton et al. (2006) estimate that the cost-benefit ratio of sanitation interventions in all developing countries worldwide is 11.2. This literature review summarizes the risks of inadequate sanitation to public health and presents the empirical evidence on the public health benefits of complete, intermediate and multiple factor sanitation interventions. We find that complete or improved sanitary systems can offer concrete public health benefits by reducing exposure pathways to a variety of infectious diseases contained in human feces and wastewater. Substantial complementary economic gains are also predicted to accrue as a result of providing increased sanitation. In addition,  community-wide sanitation interventions seem to offer the greatest promise for reducing pathogenic health risks from feces.

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EPAR Technical Report #100
Agricultural & Diet Diversification: Evidence and Pathways to Improved Nutrition
Publication Date: 09/28/2010
Type: Literature Review
Abstract

Without availability and access to a variety of foods, populations in the developing world are suffering from deficiencies in iron, zinc, iodine, vitamin A, and other micronutrients in addition to deficiencies in energy and protein. Supplementation and fortification programs have demonstrated effectiveness, but there is an increasing interest in potentially more sustainable solutions via agricultural interventions. The review examines the literature regarding agricultural interventions and pathways to diet diversification and whether desired nutritional outcomes are achieved.  We find a strong sentiment that agricultural interventions can improve dietary diversity, and that dietary diversity can improve nutrition and related health outcomes. The programs with demonstrated ability to improve nutrition outcomes are most often cross-cutting interventions, borrowing from the agriculture, nutrition, and public health traditions. While these multi-platform programs can be costly to evaluate and difficult to implement, the evidence supports their potential to create sustainable quality-of-life improvements in target regions. The pathways by which agricultural interventions achieve impact are not fully clear, however. The greatest knowledge gaps are directly related to the lack of integration between program design and evaluation. Many evaluations are based on small sample sizes, lack control groups or baseline data, are subject to selection bias, or face other challenges to rigorous statistical analysis. 

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EPAR Technical Report #35
Research & Development Finance for Agriculture in SSA
Publication Date: 05/13/2009
Type: Literature Review
Abstract

This report provides a general overview of trends in public and private agricultural research and development (R&D) funding and expenditures in Sub-Saharan Africa (SSA). The request is divided into two sections, covering public funding and private funding. Within each section, relevant data is presented on historical funding patterns, the types of research conducted, and which countries within SSA are financing R&D at the highest level. We find that the majority of growth in African public agricultural research funding took place in the 1960s, when real public spending on agricultural research increased 6% a year. From 1971 to 2000 annual growth averaged 1.4% a year. Public financing of agricultural R&D experienced a moderate shift in the 1990s from bilateral and multilateral donor funding to domestic government financing. The shift varied by country, but donor funding dropped for all SSA countries an average of 10%. Private research and development funding is heavily concentrated in developed countries with the United States and Japan the two biggest spenders. Within SSA, private R&D expenditures comprise 2% of all R&D spending. The main private actors in SSA are companies based in South Africa and Nigeria. The private sector is focused on research areas that involve marketable inputs, such as chemicals, seeds, and machines/

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EPAR Research Brief #13
Using DALYs to Assess Agricultural Interventions
Publication Date: 01/27/2009
Type: Research Brief
Abstract

This brief presents an initial examination of the possibility of using Disability Adjusted Life Years (DALYs) as a way to evaluate agricultural interventions.  We review DALYs, their formulation, and the data necessary to compute values.  A review of relevant literature suggests that to use DALYs as an evaluative tool, an agricultural intervention must be tied to a specific disease, and from there, impacts on DALYs can be assessed.

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