Systems Thinking for More Holistic Analysis of Low- and Middle-Income Country Water Utility Problems and Solutions

被引:2
作者
Jeuland, Marc [1 ,2 ]
机构
[1] Duke Univ, Sanford Sch Publ Policy, Durham, NC 27708 USA
[2] Duke Univ, Duke Global Hlth Inst, Durham, NC 27708 USA
关键词
Cost recovery; economic analysis; systems dynamics models; utility reform; water institutions; CONTINGENT VALUATION; SERVICE DELIVERY; PRIVATE; POOR; EFFICIENCY; DYNAMICS; SECTOR; COSTS; MODEL; PAY;
D O I
10.1142/S2382624X22710023
中图分类号
F [经济];
学科分类号
02 ;
摘要
Globally, billions of people rely on piped water and sanitation services delivered by municipal water utilities, but many of these systems, particularly in low- and middle-income countries (LMICs) are plagued by chronic problems of inequitable access, intermittent supply, and poor water quality. While improving service quality in these persistently underperforming systems will certainly require substantial infrastructure investment and supportive maintenance, a parallel strengthening of utilities and regulators' capacity and management is at least as fundamental. And though prior research highlights the lack of capacity, misaligned incentives, and ineffective policies that lead LMIC utilities to perform so poorly, the identification of sustainable and replicable solutions to these problems, that extends beyond a small set of cases, has proven difficult. This paper argues for greater use of systems dynamics models to facilitate more holistic thinking about the potential of different intervention strategies, acknowledging that the behavior of utility-based water management systems is defined by complex interactions. This complexity plays out in reinforcing and balancing feedback between variables, lagged responses, and dynamics that often preclude moving past critical thresholds that define poverty or low performance traps. The paper then discusses how several basic archetypes relate to experiences of institutional reform failure and success described in the broader literature,with the goal of motivating future application of these methods for comparative analysis of different utility water system improvements.
引用
收藏
页数:17
相关论文
共 44 条
[31]   Assessing research activity on priority interventions for non-communicable disease prevention in low- and middle-income countries: a bibliometric analysis [J].
Jones, Amanda C. ;
Geneau, Robert .
GLOBAL HEALTH ACTION, 2012, 5 :1-13
[32]   PROTOCOL: Use of community participation interventions to improve child immunisation in low- and middle-income countries: A systematic review and meta-analysis [J].
Jain, Monica ;
Engelbert, Mark ;
Gaarder, Marie ;
Bagai, Avantika ;
Eyers, John .
CAMPBELL SYSTEMATIC REVIEWS, 2020, 16 (04)
[33]   Patient outcomes in public sector hepatitis C treatment programmes: a retrospective cohort analysis across five low- and middle-income countries [J].
Boeke, Caroline E. ;
Adesigbin, Clement ;
Adisa, Olayinka ;
Agwuocha, Chukwuemeka ;
Akanmu, Muhammad-Mujtaba ;
Anartati, Atiek ;
Aung, Khin Sanda ;
Azania, Amy ;
Bello Nabe, Ruth ;
Budiman, Arief ;
Chan, Yuhui ;
Chawla, Umesh ;
Fatchanuraliyah ;
Fernandes, Oriel ;
Grover, Gagandeep Singh ;
Naing, Thandar Su ;
Ngo, Dang ;
Ramers, Christian B. ;
Regan, Sean ;
Sindhwani, Siddharth ;
Tandy, Gertrudis ;
Tint, Khin ;
Nguyen, Kinh Van ;
Witschi, Magdalena ;
McClure, Craig .
BMJ OPEN, 2022, 12 (12)
[34]   Is the HPV-test more cost-effective than cytology in cervical cancer screening? An economic analysis from a middle-income country [J].
Vale, Diama Bhadra ;
Silva, Marcus Tolentino ;
Discacciati, Michelle Garcia ;
Polegatto, Ilana ;
Teixeira, Julio Cesar ;
Zeferino, Luiz Carlos .
PLOS ONE, 2021, 16 (05)
[35]   The Effectiveness of Peer-Delivered Services in the Management of Mental Health Conditions: a Meta-Analysis of Studies from Low- and Middle-Income Countries [J].
Vally Z. ;
Abrahams L. .
International Journal for the Advancement of Counselling, 2016, 38 (4) :330-344
[36]   Exporting Forest Loss? A Cross-National Analysis of the United States Export-Import Bank Financing in Low- and Middle-Income Nations [J].
Restivo, Michael ;
Shandra, John M. ;
Sommer, Jamie M. .
JOURNAL OF ENVIRONMENT & DEVELOPMENT, 2020, 29 (02) :245-269
[37]   Is women's empowerment associated with coverage of RMNCH interventions in low- and middle-income countries? An analysis using a survey-based empowerment indicator, the SWPER [J].
Ewerling, Fernanda ;
Wehrmeister, Fernando C. ;
Victora, Cesar G. ;
Raj, Anita ;
McDougal, Lotus ;
Barros, Aluisio J. D. .
JOURNAL OF GLOBAL HEALTH, 2021, 11 :1-9
[38]   The Evolving Demographic and Health Transition in Four Low- and Middle-Income Countries: Evidence from Four Sites in the INDEPTH Network of Longitudinal Health and Demographic Surveillance Systems [J].
Bawah, Ayaga ;
Houle, Brian ;
Alam, Nurul ;
Razzaque, Abdur ;
Streatfield, Peter Kim ;
Debpuur, Cornelius ;
Welaga, Paul ;
Oduro, Abraham ;
Hodgson, Abraham ;
Tollman, Stephen ;
Collinson, Mark ;
Kahn, Kathleen ;
Tran Khan Toan ;
Ho Dang Phuc ;
Nguyen Thi Kim Chuc ;
Sankoh, Osman ;
Clark, Samuel J. .
PLOS ONE, 2016, 11 (06)
[39]   The effects of development assistance on sexual and reproductive health services in low- and lower-middle-income countries: a cross-country panel data analysis [J].
Ekman, Bjorn ;
Sundewall, Jesper ;
Schmit, Jessy .
JOURNAL OF DEVELOPMENT EFFECTIVENESS, 2025,
[40]   Prevalence of Preferences for End-of-Life Place of Care and Death Among Patients With Cancer in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis [J].
Donkor, Andrew ;
Adotey, Prince Nyansah ;
Ofori, Esther Oparebea ;
Ayitey, Jennifer Akyen ;
Ferguson, Caleb ;
Luckett, Tim ;
Vanderpuye, Verna ;
Osei-Bonsu, Ernest Baawuah ;
Phelan, Caroline ;
Hunt, Katherine .
JCO GLOBAL ONCOLOGY, 2024, 10