Santosh, Kumar and Sebastian, Vollmer (2011): Does improved sanitation reduce diarrhea in children in rural India?
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Nearly nine million children under five years of age die annually. Diarrhea is considered to be the second leading cause of Under-5 mortality in developing countries. About one out of five deaths are caused by diarrhea. In this paper, we use the newly available data set DLHS-3 to quantify the impact of access to improved sanitation on diarrheal morbidity for children under five years of age in India. Using Propensity Score Matching (PSM) and propensity-based weighted regression, we find that access to improved sanitation reduces the risk of contracting diarrhea. Access to improved sanitation decreases child diarrhea incidence by 2.2 percentage points. There is considerable heterogeneity in the impacts of improved sanitation. We neither find statistically significant treatment eects for children in poor household nor for girls, however, boys and high socioeconomic status (SES) children experienced larger treatment effects. The results show that it is important to complement public policies on sanitation with policies that alleviate poverty, improve parent's education and promote gender equity.
|Item Type:||MPRA Paper|
|Original Title:||Does improved sanitation reduce diarrhea in children in rural India?|
|Keywords:||Water, Sanitation, Diarrhea, Propensity score, Matching, India.|
|Subjects:||C - Mathematical and Quantitative Methods > C3 - Multiple or Simultaneous Equation Models ; Multiple Variables > C35 - Discrete Regression and Qualitative Choice Models ; Discrete Regressors ; Proportions
D - Microeconomics > D1 - Household Behavior and Family Economics > D10 - General
I - Health, Education, and Welfare > I1 - Health > I10 - General
O - Economic Development, Innovation, Technological Change, and Growth > O1 - Economic Development > O12 - Microeconomic Analyses of Economic Development
|Depositing User:||Santosh Kumar|
|Date Deposited:||23. Jun 2011 22:46|
|Last Modified:||21. Feb 2013 17:55|
Arnold BF, Colford JM. 2007 . Treating water with chlorine at point-of-use to improve water quality and reduce child diarrhea in developing countries: a systematic review and meta-analysis. American journal of tropical medicine and hygiene 76(2): 354-364.
Becker SO, Ichino A. 2002 . Estimation of Average Treatment Effects based on Propensity Scores. Biometrika 70(1): 41-55.
Borooah VK. 2004 . On the Incidence of Diarrhea among Young Indian Children. Economics and Human Biology 2: 119-138.
Bose R. 2009 . The impact of water supply and sanitation interventions on child health:evidence from DHS surveys Mimeo. International Initiative for Impact Evaluation: New Delhi.
Bryce J. et al. 2005 . WHO estimates of the causes of death in children. Lancet 365:1147-1152.
Curtis V, Cairncross S. 2003 . Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. Lancet infectious diseases 3(5): 275-281.
Cutler D, Miller G. 2005 . The role of public health improvements in health advances: the 20th century United States. Demography 42(1): 1-22
Dehejia RH, Wahba S. 2002. Propensity Score-Matching Methods for Nonexperimental Causal Studies. Review of Economics and Statistics 84 (n1):151-61.
Dasgupta P. 2004 . Valuing Health Damages from Water Pollution in Urban Delhi, India. Environment and Development Economics 9: 83-106.
Doraiswamy P. 2001 . Health Status and Curative Health Care in Rural India. National Council of Applied Economic Research (NCAER) Working paper no. 78.
Esrey SA et al. 1991 . Eects of improved water supply and sanitation on ascariasis, diarrhoea, dracunculiasis, hookworm infection, schistosomiasis, and trachoma. Bulletin of the World Health Organization 69(5): 609-621.
Fewtrell L, Colford J. 2004 . Interventions and diarrhea: a systematic review and metaanalysis. World Bank HNP Discussion Paper No. 34960. World Bank: Washington, DC.
Fewtrell L et al. 2005 . Water, sanitation, and hygiene interventions to combat childhood diarrhea in developing countries. Synthetic Review 001. International Initiative for Impact Evaluation.
Fewtrell L et al. 2009 . Water, sanitation, and hygiene interventions to reduce diarrhea in less developed countries: a systematic review and meta-analysis. Lancet infectious diseases 5: 42-52.
Fink G, Gunther I. 2010 . Water, Sanitation, and Children's Health: Evidence from 172 DHS Surveys. World Bank Policy Research Working Paper No 5275. World Bank: Washington DC.
Heckman JJ, Robb R. 1985 . Alternative Methods for Evaluating the Impact of Interventions: An Overview. Journal of Econometrics 30(1-2): 239-67.
Hirano K, Imbens G. 2001 Estimation of Causal Eects Using Propensity Score Weighting: An Application to Data on Right Hear Catherization. Health Services and Outcomes Research Methodology 2(3-4): 259-278.
Hirano K, Imbens G, Ridder G. 2003 . Ecient Estimation of Average Treatment Effects using the Estimated Propensity Score. Econometrica 71: 1161-1189.
India Country Paper. 2008 . Sustaining the Sanitation Revolution. Department of Drinking Water, Ministry of Rural Development, Government of India, New Delhi.
Jalan J, Ravallion M. 2003b . Does Piped Water Reduce Diarrhea for Children in Rural India? Journal of Econometrics 112: 153-173.
Khanna G. 2008 . The Impact of Child Health from Access to Water and Sanitation and other Socioeconomic Factors. HEI Working Paper No: 02/2008 Graduate Institute of International studies, Geneva.
Kremer M, Zwane A. 2007 . Cost-Eective Prevention of Diarrheal Diseases: A Critical Review. Working Paper, Center for Global Development.
McCarey DF et al. 2004 . Propensity Score Estimation with Boosted Regression for Evaluating Causal Effects in Observational Studies. Psychological Methods 9(4).
Ravallion M. 2001 . The Mystery of the Vanishing Benets: An Introduction to Impact Evaluation. World Bank Economic Review 15(1): 115-140.
Ravallion M. 2005 . Evaluating anti-poverty programs. TheWorld Bank, Policy Research Working Paper Series: 3625.
Rosenbaum PR, Rubin DB. 1983 . The Central Role of the Propensity Score in Observational Studies for Causal Eects. The Stata Journal 4: 358-377.
Rosenbaum PR. 1987 . Sensitivity analysis for certain permutation inferences in matched observational studies Biometrika 74(1): 13-26.
Sianesi B. 2004 . An Evaluation of the Swedish System of Active Labor Market Programs in the 1990s. Review of Economics and Statistics. 86 (n1): 133-55.
Snilstveit B, Waddington H. 2010 . Effectiveness and sustainability of water, sanitation, and hygiene interventions in combating diarrhea. Journal of Development Effectiveness 1(3): 295-335.
Watson T. 2006 . Public health investments and the infant mortality gap: evidence from federal sanitation interventions and hospitals on U.S. Indian reservations. Journal of Public Economics. 90(8-9): 1537-60
UNICEF/WHO. 2009 . Diarrhoea: Why children are still dying and what can be done.
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