Next Article in Journal
A Location Intelligence System for the Assessment of Pluvial Flooding Risk and the Identification of Storm Water Pollutant Sources from Roads in Suburbanised Areas
Next Article in Special Issue
A Review of In-Situ and Remote Sensing Technologies to Monitor Water and Sanitation Interventions
Previous Article in Journal
Uptake Fluoride from Water by Starch Stabilized Layered Double Hydroxides
Previous Article in Special Issue
Assessment of Nitrate in Wells and Springs in the North Central Ethiopian Highlands
Article Menu
Issue 6 (June) cover image

Export Article

Open AccessReview
Water 2018, 10(6), 744; https://doi.org/10.3390/w10060744

Quantifying Averted Disability-Adjusted Life Years as a Performance Indicator for Water Quality Interventions: A Review of Current Methodologies and Challenges

1
Department of Environment Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
2
Mortenson Center for Engineering in Developing Communities, University of Colorado at Boulder, Boulder, CO 80309, USA
Current affiliation: Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC 27599, USA.
*
Author to whom correspondence should be addressed.
Received: 23 April 2018 / Revised: 24 May 2018 / Accepted: 5 June 2018 / Published: 7 June 2018
Full-Text   |   PDF [428 KB, uploaded 7 June 2018]   |  

Abstract

Sustainable access to safe drinking water protects against infectious disease and promotes overall health. Despite considerable progress toward increasing water access, safe water quality and reliable service delivery remain a challenge. Traditional financing strategies pay implementers based on inputs and activities, with minimal incentives for water quality monitoring and sustained service operation. Pay-for-performance offers an alternative financing strategy that delivers all or a portion of payment based on performance indicators of desired outputs or outcomes. A pay-for-performance approach in the water sector could quantify and incentivize health impact. Averted disability-adjusted life years (ADALYs) have been used as a performance indicator to measure the burden of disease averted due to environmental health interventions. Water-related disease burden can be measured for application as an ADALYs performance indicator following either comparative risk assessment or quantitative microbial risk assessment. Comparative risk assessment models disease burden using water source type as a proxy indicator of microbial water quality, while quantitative microbial risk assessment models disease burden using concentrations of indicator pathogens. This paper compares these risk assessment methodologies, and summarizes the limitations of applying these approaches toward quantifying ADALYs as a performance indicator for water quality interventions. View Full-Text
Keywords: water quality; disease burden; ADALYs; pay for performance; results based financing; monitoring water quality; disease burden; ADALYs; pay for performance; results based financing; monitoring
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Anderson, D.M.; Thomas, E.A.; Clasen, T.F. Quantifying Averted Disability-Adjusted Life Years as a Performance Indicator for Water Quality Interventions: A Review of Current Methodologies and Challenges. Water 2018, 10, 744.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Water EISSN 2073-4441 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top