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...

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Autores principales: Headey, Derek D., Palloni, Giordano
Formato: Journal Article
Lenguaje:Inglés
Publicado: Springer 2019
Materias:
Acceso en línea:https://hdl.handle.net/10568/146073
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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.
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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
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