Derek Headey|Giordano Palloni
Water, Sanitation, and Child Health: Evidence From Subnational Panel Data in 59 Countries
International Food Policy Research Institute|International Food Policy Research Institute
abstract water sanitation hygiene wash investments widely seen essential improving health early childhood however experimental literature wash interventions identifies inconsistent impacts child health outcomes relatively robust impacts diarrhea symptoms infection weak varying impacts child nutrition contrast observational research exploiting crosssectional variation water sanitation access much sanguine finding strong associations diarrhea prevalence mortality stunting practice literatures suffer significant methodological limitations experimental wash evaluations often subject poor compliance rural bias short duration exposure crosssectional observational evidence may highly vulnerable omitted variables bias overcome limitations literatures construct panel 442 subnational regions 59 countries multiple demographic health surveys using large subnational panel implement differenceindifference regressions allow us examine whether longerterm changes water sanitation subnational level predict improvements child morbidity mortality nutrition find results partially consistent literatures improved water access statistically insignificantly associated outcomes although water piped home predicts reductions child stunting improvements sanitation predict large reductions diarrhea prevalence child mortality associated changes stunting wasting estimate sanitation improvements account 10 decline child mortality 1990 2015