Quantifying health improvements from water quantity enhancement: an engineering perspective applied to rainwater harvesting in West Africa.

Knowledge of potential benefits resulting from technological interventions informs decision making and planning of water, sanitation, and hygiene programs. The public health field has built a body of literature showing health benefits from improvements in water quality. However, the connection between improvements in water quantity and health is not well documented. Understanding the connection between technological interventions and water use provides insight into this problem. We present a model predicting reductions in diarrhea disease burden when the water demands from hygiene and sanitation improvements are met by domestic rainwater harvesting (DRWH). The model is applied in a case study of 37 West African cities. For all cities, with a total population of over 10 million, we estimate that DRWH with 400 L storage capacity could result in a 9% reduction in disability-affected life years (DALYs). If DRWH is combined with point of use (POU) treatment, this potential impact is nearly doubled, to a 16% reduction in DALYs. Seasonal variability of diarrheal incidence may have a small to moderate effect on the effectiveness of DRWH, depending on the storage volume used. Similar predictions could be made for other interventions that improve water quantity in other locations where disease burden from diarrhea is known.