Water Engineering and Development Centre
Attempts to measure the health impact of water supplies and sanitation have a long and chequered history. Many of them have been made by amateur epidemiologists at the behest of the agencies funding the construction of the facilities, and with insufficient planning and rigour. Even some studies supervised by eminent specialists have produced almost useless or meaningless results, after taking years to complete and costing substantial sums of money. This unhappy experience led a panel of experts, convened in 1975 by the World Bank, to conclude that the Bank should not undertake any long-term longitudinal studies of the question. (1)
There were brief hopes during the 1980s, the International Water Decade, that a new technique, the case-control method, would provide a quicker, cheaper means of measuring the impact on diarrhoeal disease (2). However, several experimental studies of this type produced disappointing results, and it became clear that they suffered from similar shortcomings to studies of the more conventional design.
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