Water treatment systems are critical for ensuring safe drinking water in Ethiopia, where access to clean water is a significant public health concern. A cluster-randomized design was employed, with participants randomly assigned to either the intervention group (receiving improved water treatment systems) or the control group (using existing facilities). Data collection involved pre- and post-treatment assessments of water quality parameters and economic evaluations using a cost-effectiveness analysis framework. The randomized trial revealed that the new water treatment system significantly reduced microbial contamination in treated water samples, with a reduction rate of 30% compared to baseline levels. Economic analyses indicated an average annual savings of 12 per household due to lower waterborne disease incidence and increased productivity from healthier populations. The results confirm the efficacy and cost-effectiveness of the improved water treatment systems in reducing both health risks and economic burdens, providing a robust evidence base for policymakers considering investment in such infrastructure initiatives. Based on this study's findings, it is recommended that Ethiopian authorities prioritise the implementation and maintenance of these advanced water treatment facilities to improve public health outcomes and support sustainable development goals. The maintenance outcome was modelled as Y₈ₓ=₀+₁X₈ₓ+uᵢ+₈ₓ, with robustness checked using heteroskedasticity-consistent errors.
Asfawöräd et al. (Fri,) studied this question.