Effectiveness of large scale water and sanitation interventions : the one million initiative in Mozambique

The One Million Initiative of the Government of Mozambique aims at supplying access to clean drinking water and adequate sanitation for one million people. The program has constructed hundreds of new boreholes and implemented trainings on sanitation in communities from three provinces. To evaluate the program, a panel survey design was set up with a baseline in 2008, a midterm in 2010 and an end-line in 2013. The survey covers interviews with 1600 households, focus group discussions about the community and water points in 80 clusters in 9 districts. To our knowledge this is the first rigorous evaluation of such a large scale program in the water and sanitation sector. This paper
summarizes the findings of the baseline and midterm surveys in terms of health impacts, latrine ownership and the use of improved water sources. Our results indicate that the water point intervention had a sizeable impact on the use of improved water sources and on the health outcome of children under 5 but no impact for older individuals, while the sanitation component of the program had a strong impact on latrine ownership and health outcome for older individuals, and a limited impact on hand-washing with soap and the use of improved water sources when it was available in the community. [authors abstract]