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The dirty business of eliminating open defecation: The effect of village sanitation on child height from field experiments in four countries

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  • Cameron, Lisa
  • Gertler, Paul
  • Shah, Manisha
  • Alzua, Maria Laura
  • Martinez, Sebastian
  • Patil, Sumeet

Abstract

We examine the impacts of a sanitation program designed to eliminate open defecation in at-scale randomized field experiments in four countries: India, Indonesia, Mali, and Tanzania. The programs – all variants of the widely-used Community-Led Total Sanitation (CLTS) approach - increase village private sanitation coverage in all four locations by 7–39 percentage points. We use the experimentally-induced variation in access to sanitation to identify the causal relationship between village sanitation coverage and child height. We find evidence of threshold effects where increases in child health of 0.3 standard deviations are realized once village sanitation coverage reaches 50–75%. There do not appear to be further gains beyond this threshold. These results suggest that there are large health benefits to achieving coverage levels well below the 100% coverage pushed by the CLTS movement. Open defecation decreased in all countries through improved access to private sanitation facilities, and additionally through increased use of sanitation facilities in Mali who implemented the most intensive behavior change intervention.

Suggested Citation

  • Cameron, Lisa & Gertler, Paul & Shah, Manisha & Alzua, Maria Laura & Martinez, Sebastian & Patil, Sumeet, 2022. "The dirty business of eliminating open defecation: The effect of village sanitation on child height from field experiments in four countries," Journal of Development Economics, Elsevier, vol. 159(C).
    • Handle: RePEc:eee:deveco:v:159:y:2022:i:c:s0304387822001328
    DOI: 10.1016/j.jdeveco.2022.102990
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    References listed on IDEAS

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    8. Cameron, Lisa & Shah, Manisha & Olivia, Susan, 2013. "Impact evaluation of a large-scale rural sanitation project in Indonesia," Policy Research Working Paper Series 6360, The World Bank.
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    Cited by:

    1. Kazuki Motohashi, 2023. "Unintended Consequences of Sanitation Investment: Negative Externalities on Water Quality and Health in India," ISER Discussion Paper 1210, Institute of Social and Economic Research, Osaka University.
    2. Maria Laura Alzua & Juan-Camilo Cardenas & Habiba Djebbari, 2023. "Effective community mobilization: Evidence from Mali," French Stata Users' Group Meetings 2023 23, Stata Users Group.

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    More about this item

    Keywords

    I12; I15; O15;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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