Footnotes for "Answering some questions about water quality programs"

[1] "Dispensers can break for a variety of reasons, such as vandalism, disruption caused by animals, or wear and tear. DSW staff conduct functionality spot checks when delivering the chlorine and when conducting M&E surveys." GiveWell, Dispensers for Safe Water Organization basics, based on field notes, 2022, p. 2.

[2] "Promoters are volunteers who refill the chlorine dispensers and promote the use of the dispensers…" GiveWell, Dispensers for Safe Water Organization basics, based on field notes, 2022, p. 2.

"The two promoters are trained by DSW program staff on their roles. Their key roles are to educate those who might not have attended the meeting, do dispenser promotional activities, receive chlorine from program staff, refill the dispenser, and inform DSW program staff/call center when dispenser repair, maintenance or additional chlorine is needed." GiveWell, Dispensers for Safe Water Organization basics, based on field notes, 2022, p. 4.

"Promoters are also asked to report faults (they are provided with a phone number they can use to report problems). Promoters and staff delivering chlorine are trained to address basic functionality problems; engineers are mobilised for more serious faults. When promoters call to report maintenance issues, the issues are logged and tracked using a cloud based application (issue tracker) in Kenya. The issue tracker app just launched for testing in Uganda in Sept. 2021 and we hope to begin testing in Malawi in 2022." GiveWell, Dispensers for Safe Water Organization basics, based on field notes, 2022, p. 2.

[3] SDI, a metric developed by the Institute for Health Metrics and Evaluation (IHME), is expressed on a scale between 0 and 1, as explained on this page. A "low-SDI" country is one that measures below 0.454. See the range of scores in each quintile here.

See columns "2019 SDI" and "Cost-effectiveness" in the "Long term RFMF" tab of this spreadsheet for SDI and estimates of cost-effectiveness by potential expansion country. Of the 18 countries in the list that are at least 8x as cost-effective as cash transfers, 16 are low-SDI countries.

At the time of our decision to recommend the grant to Dispensers for Safe Water, we were looking primarily for funding opportunities that we estimated to be at least eight times as cost-effective as unconditional cash transfers ("8x cash"). We've since raised our bar for funding to 10x cash (more here).

[4] See Global Burden of Disease, GBD Compare, Age distribution of enteric infection mortality in sub-Saharan Africa, 2019. Deaths from enteric infection drop sharply after age five, but the age group with the next highest number of deaths in 2019 was children between five and nine.

[5] For more information about how we generated our pooled estimate, see the "Randomized controlled trials" section of our water quality intervention report (beginning with "To limit these concerns and generate an estimate…").

[6] See Kremer et al. 2022 supplementary materials, p. 18, table S6, for a list of sensitivity analyses the authors conducted.

[7] More in the "Randomized controlled trials" section of our water quality intervention report (beginning with "We have reviewed Kremer et al. 2022 (working paper) internally…").

[8] "Depending on the method used to pool results, the [Kremer et al.] analysis reports that water quality interventions reduce the odds of all-cause mortality in children under five by 28% (95% confidence interval, 8% to 45%) or 30% (95% credible interval, 8% to 51%)." GiveWell, "Water quality interventions," 2022, "Randomized controlled trials" section

"The resulting estimate [from GiveWell's analysis] suggests that chlorination interventions reduce all-cause mortality in children under five by approximately 14% in low-income settings (95% confidence interval, 32% reduction to 10% increase)." GiveWell, "Water quality interventions," 2022, "Randomized controlled trials" section

[9] "Across rural Kenya, Uganda, and Malawi, we consistently provide water treatment in areas that aren’t reached by municipal systems – and at no cost to users or their communities." Evidence Action, "Delivering safe water to millions."