Cost-effectiveness of interventions
Due to the cross-sectoral nature of many environmental health interventions, a number of methodological issues need to be addressed when assessing the cost-effectiveness of interventions aiming at improving health through environmental actions. Here are some of these issues:
- In the field of environmental health, both costs and benefits of interventions usually accrue to various sectors (e.g. health sector, agriculture sector, water sector, environment sector etc.). Besides health benefits, they may contribute to increased agricultural production, saved time, improved quality of life etc. How could/should these other benefits (i.e. non-health benefits) be taken into account in order to reflect overall benefits of environmental interventions?
- When multiple benefits are associated with environmental health interventions, people benefiting from the interventions (or even policy makers/budget holders) are usually willing to pay for part of them (e.g. provision of safe drinking water supply). Could this willingness-to-pay be taken into account, if yes how?
- The impacts of environmental health interventions are often observed in relatively long-term compared to medical interventions. The discounting of health, however, is not favourable to the cost-effectiveness of interventions that have long-term impacts rather than immediate effects. How can this be compatible with promoting the concept of sustainability?
To contribute to the discussion on methods, a background document has been prepared and contains a set of preliminary considerations: