Sanitation-related quality of life

Economic evaluations of sanitation programmes should value quality of life gains, for example those related to privacy and safety. By developing and using measures of SanQoL, we can enable this valuation, and better target resources as a result.

As and when peer-reviewed publications on SanQoL become available, they will be posted here. Until then, SanQoL is a work in progress, but please read on for some background.

What is SanQoL?

SanQoL stands for “sanitation-related quality of life”. Quality of life (QoL) is a multidimensional concept, comprising people’s subjective evaluations of positive and negative aspects of their lives. SanQoL is defined as those aspects of QoL which are affected by sanitation services, such as privacy, safety and shame. It is analogous to the ‘health-related quality of life’ concept widely used in health economics.

What would measuring SanQoL enable?

We cannot gauge the degree of any changes in privacy, safety or shame without quantitative means of measuring them. If we could quantify changes in those attributes, and weight them based on people’s relative valuation of the attributes, we could include them in economic evaluation (e.g. cost-effectiveness and cost-benefit analyses). That would mean broadening the focus of economic evaluations beyond either a ‘health only’ framework (e.g. disability-adjusted life years) or a cost-benefit framework that is not intuitive for comparing intervention options.

Who is working on SanQoL?

The study is being undertaken by Ian Ross, as part of an economics PhD at LSHTM supervised by Giulia Greco and Oliver Cumming.

What work has taken place so far?

An ongoing study in Maputo, Mozambique, aims to develop a user-reported measure of SanQoL. Based on initial qualitative work in 2018, and a quantitative survey in 2019, we have developed a five-item SanQoL measure for the purpose of economic evaluation. It enables SanQoL to be measured on a 0-1 interval scale with weights derived from users. Papers are under preparation.

Can I use SanQoL measures?

Not yet. We hope to publish academic papers in 2020 that would enable measures to be used by others.

Further information

Blog posts on SanQoL are available below.