"Measuring the health and fiscal outcomes of solid waste management operations by intergovernmental arrangements: The case of public consortia in Brazil".

This study estimates the health-related and public expenditure impacts of the solid waste services provided by public consortia in Brazilian Municipalities from the enactment of Public Consortia law (2005) to 2019. To conduct the analysis, we applied the econometric method of staggered difference-in-differences to publicly available datasets at the municipality level. The results show that the operation of solid waste services by public consortia had statistically significant effects in reducing hospitalizations caused by Schistosomiasis, Diarrhea/gastroenteritis (up to 5 years age) and other intestinal diseases. The results also indicate a positive impact on the reduction of environmental expenses in treated municipalities, supporting the idea that a Solid Waste Consortium can serve as a local coordinator and improve health and fiscal indicators simultaneously. The findings provide quantitative evidence that policymakers at the local and regional level can use to better understand the benefits of adhering to public consortia when preparing new investments and operation developments for this sector. This paper contributes to the literature of applied research in solid waste by shedding light on the underexplored theme of the intergovernmental cooperative arrangements, which can be instrumental in accelerating and enhancing the development of solid waste services.