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World Bank Document WATER AND SANITATION PROGRAM: TECHNICAL PAPER Public Disclosure Authorized Economic Assessment of Sanitation Interventions in Yunnan Province, Public Disclosure Authorized People’s Republic of China A six-country study conducted in Cambodia, China, Indonesia, Lao PDR, the Philippines and Vietnam under the Economics of Sanitation Public Disclosure Authorized Initiative (ESI) September 2012 Public Disclosure Authorized The Water and Sanitation Program is a multi-donor partnership administered by the World Bank to support poor people in obtaining affordable, safe, and sustainable access to water and sanitation services. THE WORLD BANK Water and Sanitation Program East Asia & the Pacific Regional Office Indonesia Stock Exchange Building Tower II, 13th Fl. Jl. Jend. Sudirman Kav. 52-53 Jakarta 12190 Indonesia Tel: (62-21) 5299 3003 Fax: (62 21) 5299 3004 Water and Sanitation Program (WSP) reports are published to communicate the results of WSP’s work to the development community. Some sources cited may be informal documents that are not readily available. The findings, interpretations, and conclusions expressed herein are entirely those of the author and should not be attributed to the World Bank or its affiliated organizations, or to members of the Board of Executive Directors of the World Bank or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of the World Bank Group concerning the legal status of any territory or the endorsement or acceptance of such boundaries. The material in this publication is copyrighted. Requests for permission to reproduce portions of it should be sent to [email protected]. WSP encourages the dissemination of its work and will normally grant permission promptly. For more information, please visit www.wsp.org. Economic Assessment of Sanitation Interventions in Yunnan Province, People’s Republic of China A six-country study conducted in Cambodia, China, Indonesia, Lao PDR, the Philippines and Vietnam under the Economics of Sanitation Initiative (ESI) Economic Assessment of Sanitation Interventions in Yunnan Province, People’s Republic of China Executive Summary A. INTRODUCTION The “Economics of Sanitation Initiative” (ESI) in Yunnan, associated with sanitation, particularly in the less developed China, is part of a study conducted by the World Bank’s and rural parts of China such as Yunnan Province, and the Water and Sanitation Program in East Asia. As one of the importance of sanitation in promoting economic develop- underdeveloped western provinces of China, Yunnan has ment. By providing decision makers at national and pro- achieved huge progress in sanitation improvement. Since vincial levels with comprehensive information to support the early 1990s, the Chinese government has set sanitation policies on public sanitation investment, the goal of this improvement as one of the top priorities in the national study is to increase the efficiency of sanitation investments. development plan. As a result, the access to sanitary latrines and toilets in both rural and urban areas has increased B. STUDY AIMS AND METHODS rapidly. In rural areas of Yunnan, access to improved sani- This study evaluates the costs and benefits of technical sani- tary latrines has increased from 2.4% in 1990 to 53.7% tation options and sanitation programs in Yunnan Province. in 2008. In urban areas of China, coverage with improved Sanitation options evaluated in the study include the facili- private facilities has increased by 10 percentage points from ties to collect and convey human excreta, household waste- 48% to 58% since 1990, and a further 30% of the urban water treatment and related hygiene practices. The benefits population using shared facilities in 2008. of sanitation evaluated include health, water quality, time to access sanitation facilities, external environment, reuse Still, in comparison with the rest of China, Yunnan lags of human excreta, quality of life improvement and other in access to improved sanitation and faces significant chal- intangible benefits such as privacy, cleanliness and com- lenges in catching up with the pace of development in east- fort. The costs of sanitation measured include investment ern provinces. The average national coverage with improved costs and recurrent costs (operations and maintenance). sanitary latrines (including shared) was 59.7% for rural ar- The study compares the costs and benefits of alternative eas in 2008, while Yunnan reached only 53.7%. In the year improved sanitation options over the expected life of each 2007, only 30% of urban areas in Yunnan were equipped technology, to estimate efficiency of alternative sanitation with sewerage systems, in comparison with 70% nationally. options. The “optimal” performance of technologies as- In Yunnan Province, 6.4% of the total population of 45 sumes 100% adoption rates and correct utilization by the million is living under the poverty line, which mostly lacks beneficiaries, while the “actual” performance is adjusted access to safe and sanitary latrines. downwards based on adoption rates observed in the field. The main barrier to achieving the national sanitation targets C. DATA SOURCES AND STUDY SITES lies in the efficiency and effectiveness of sanitation invest- This study focuses on recent sanitation programs in Yun- ments. This study aims to provide evidence for decision nan Province, implemented and co-financed by the govern- making on future options for sustainable sanitation devel- ment and other partners. For the study, sanitation options opment, focusing on the selection of economically viable in eight different sites throughout Yunnan Province were technology options, as well as efficient delivery modes. In selected, representing urban, peri-urban and rural areas as doing so, the study attempts to demonstrate the benefits well as different socio-economic levels and cultural settings. www.wsp.org iii Economic Assessment of Sanitation Interventions in Yunnan Province, People’s Republic of China | Executive Summary The three rural sites include: a) villages in Luquan county’s sentation, the benefit-cost ratio (BCR) is the cost-benefit mountainous rural villages (R1), located near Yunlong res- indicator presented in this executive summary, while cost ervoir, wich supplies drinking water to Kunming city and per disability-adjusted life-year (DALY) is the main cost- where Yi and MIao are the dominant ethinic groups; b) effectiveness indicator presented. The reader is referred to Dali Shangguan (R2) lakeside plain, with the Bai ethnic Chapter 8 for a full presentation of the efficiency indicators. group; and c) villages in Qiubei county (R3) which are both laekside and mountainous, and where the dominantt ethnic In rural areas, all the sanitation options have very high BCR groups are Zhuang, Miao and Yi. Shared and pit latrines are as follows: UDDT (9.4), private pit latrines (8.5), 3-in-1 widely used in rural areas together with improved sanita- biogas units (6.9), shared toilets (6.0), and private septic tion options like biogas units, septic tanks and urine-divert- tanks (4.7). The cost-effectiveness of these measures range ing dehydration toilets (UDDT). Open defecation is still from US$272 per DALY averted for UDDT to US$479 commonly practiced in mountainous rural villages. per DALY averted for septic tanks. As a health intervention, these results indicate sanitation as a highly cost-effective The three urban sites represent different classes of urbaniza- intervention, represented by the cost per DALY being less tion: a) Kunming (U1), the provincial capital of Yunnan than the GDP per capita (see Figure D)1. However, there is located in the center of the province, with high population a significant loss of efficiency between ideal and actual per- density and water scarcity challenges; b) Dali (U2), a pre- formance of each sanitation option, as shown in Figure A. fectural capital, located on Erhai Lake in western Yunnan Province. Flush toilets with sewerage are the main sanita- In urban areas, the BCR of sanitation options are as follows: tion option in these two cities; c) Qiubei (U3), a county public toilets (4.5), septic tanks (2.8), and sewerage (1.9). capital, is located in the Karst area by Puzhehe Lake in Other less commonly applied options in urban areas – pit southern Yunnan Province. Public and private flush toilets latrines and UDDT – have higher economic returns, but with septic tanks and pit latrines are Qiubei’s main sanita- are generally less relevant for the majority of urban areas tion options. in China. Cost-effectiveness ratios are US$558 per DALY averted for public toilets, US$886 per DALY averted for The two peri-urban sites include a) Kunyang town of Jin- septic tanks, and US$1,385 per DALY averted for sewer- ning County (PU1), a small town located on the southern age. While these figures represent a higher cost than that of side of Dianchi Lake and part of the wider urban agglom- rural areas for the same health return, they are still under eration of Kunming city; and b) Dali Zhoucheng (PU2), the benchmark for a cost-effective intervention. As in rural a rapidly urbanizing rural area, located on Erhai Lake near areas, there is a significant loss of efficiency between ideal Dali, with Bai as the dominant ethnic group. Public dry toi- and actual program performance in urban areas, as shown lets, pit latrines, shared latrines, UDDTs, and septic tanks in Figure B. are widely used in these peri-urban areas. In peri-urban areas, the BCR of sanitation options are low- D. RESULTS er compared with rural areas, but still significant, as fol- lows: UDDT (8.7), private latrines (7.6), septic tanks (6.1) D1. COST-BENEFIT ANALYSIS RESULTS and shared latrines (4.2). As in urban and rural areas, The economic returns on all improved sanitation options there is a significant loss of efficiency between ideal are significant in all the sites evaluated, when compared and actual program performance in peri-urban areas with no access to basic sanitation.
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