Water, sanitation, and child health: Evidence from subnational panel data in 59 countries
Water, sanitation, and hygiene (WASH) investments are widely seen as essential for improving health in early childhood. However, the experimental literature on WASH interventions identifies inconsistent impacts on child health outcomes, with relatively robust impacts on diarrhea and other symptoms o...
| Autores principales: | , |
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| Formato: | Journal Article |
| Lenguaje: | Inglés |
| Publicado: |
Springer
2019
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| Materias: | |
| Acceso en línea: | https://hdl.handle.net/10568/146073 |
| _version_ | 1855539201512046592 |
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| author | Headey, Derek D. Palloni, Giordano |
| author_browse | Headey, Derek D. Palloni, Giordano |
| author_facet | Headey, Derek D. Palloni, Giordano |
| author_sort | Headey, Derek D. |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Water, sanitation, and hygiene (WASH) investments are widely seen as essential for improving health in early childhood. However, the experimental literature on WASH interventions identifies inconsistent impacts on child health outcomes, with relatively robust impacts on diarrhea and other symptoms of infection but weak and varying impacts on child nutrition. In contrast, observational research exploiting cross-sectional variation in water and sanitation access is much more sanguine, finding strong associations with diarrhea prevalence, mortality, and stunting. In practice, both literatures suffer from significant methodological limitations. Experimental WASH evaluations are often subject to poor compliance, rural bias, and short duration of exposure, while cross-sectional observational evidence may be highly vulnerable to omitted variables bias. To overcome some of the limitations of both literatures, we construct a panel of 442 subnational regions in 59 countries with multiple Demographic Health Surveys. Using this large subnational panel, we implement difference-in-difference regressions that allow us to examine whether longer-term changes in water and sanitation at the subnational level predict improvements in child morbidity, mortality, and nutrition. We find results that are partially consistent with both literatures. Improved water access is statistically insignificantly associated with most outcomes, although water piped into the home predicts reductions in child stunting. Improvements in sanitation predict large reductions in diarrhea prevalence and child mortality but are not associated with changes in stunting or wasting. We estimate that sanitation improvements can account for just under 10 % of the decline in child mortality from 1990 to 2015. |
| format | Journal Article |
| id | CGSpace146073 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2019 |
| publishDateRange | 2019 |
| publishDateSort | 2019 |
| publisher | Springer |
| publisherStr | Springer |
| record_format | dspace |
| spelling | CGSpace1460732025-02-24T06:47:24Z Water, sanitation, and child health: Evidence from subnational panel data in 59 countries Headey, Derek D. Palloni, Giordano child health diarrhoea water children hygiene mortality impact assessment Water, sanitation, and hygiene (WASH) investments are widely seen as essential for improving health in early childhood. However, the experimental literature on WASH interventions identifies inconsistent impacts on child health outcomes, with relatively robust impacts on diarrhea and other symptoms of infection but weak and varying impacts on child nutrition. In contrast, observational research exploiting cross-sectional variation in water and sanitation access is much more sanguine, finding strong associations with diarrhea prevalence, mortality, and stunting. In practice, both literatures suffer from significant methodological limitations. Experimental WASH evaluations are often subject to poor compliance, rural bias, and short duration of exposure, while cross-sectional observational evidence may be highly vulnerable to omitted variables bias. To overcome some of the limitations of both literatures, we construct a panel of 442 subnational regions in 59 countries with multiple Demographic Health Surveys. Using this large subnational panel, we implement difference-in-difference regressions that allow us to examine whether longer-term changes in water and sanitation at the subnational level predict improvements in child morbidity, mortality, and nutrition. We find results that are partially consistent with both literatures. Improved water access is statistically insignificantly associated with most outcomes, although water piped into the home predicts reductions in child stunting. Improvements in sanitation predict large reductions in diarrhea prevalence and child mortality but are not associated with changes in stunting or wasting. We estimate that sanitation improvements can account for just under 10 % of the decline in child mortality from 1990 to 2015. 2019-03-07 2024-06-21T09:05:45Z 2024-06-21T09:05:45Z Journal Article https://hdl.handle.net/10568/146073 en https://hdl.handle.net/10568/146072 Open Access Springer Headey, Derek D.; and Palloni, Giordano. Water, sanitation, and child health: Evidence from subnational panel data in 59 countries. 2019. Demography 56(2): 729-752. https://doi.org/10.1007/s13524-019-00760-y |
| spellingShingle | child health diarrhoea water children hygiene mortality impact assessment Headey, Derek D. Palloni, Giordano Water, sanitation, and child health: Evidence from subnational panel data in 59 countries |
| title | Water, sanitation, and child health: Evidence from subnational panel data in 59 countries |
| title_full | Water, sanitation, and child health: Evidence from subnational panel data in 59 countries |
| title_fullStr | Water, sanitation, and child health: Evidence from subnational panel data in 59 countries |
| title_full_unstemmed | Water, sanitation, and child health: Evidence from subnational panel data in 59 countries |
| title_short | Water, sanitation, and child health: Evidence from subnational panel data in 59 countries |
| title_sort | water sanitation and child health evidence from subnational panel data in 59 countries |
| topic | child health diarrhoea water children hygiene mortality impact assessment |
| url | https://hdl.handle.net/10568/146073 |
| work_keys_str_mv | AT headeyderekd watersanitationandchildhealthevidencefromsubnationalpaneldatain59countries AT pallonigiordano watersanitationandchildhealthevidencefromsubnationalpaneldatain59countries |