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Evaluating the Impact on Child Mortality of a Water Supply and Sewerage Expansion in Quiro:Is Water Enough?

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Author Info
Virgilio Galdo () (Office of Evaluation and Oversight at the Interamerican Development Bank.)
Bertha Briceño () (Office of Evaluation and Oversight at the Interamerican Development Bank.)

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Abstract

This paper explores the impact that a water supply and sewerage (W&S) expansion had on child mortality in Quito, Ecuador. Studies have typically estimated the effects of this type of interventions comparing outcome indicators -at the aggregate level- of areas with the facilities and areas that lack them, quite often neglecting systematic differences between treated and non-treated areas. Moreover, at aggregate levels, on the one hand, less comprehensive information may imply greater unobserved and uncontrolled heterogeneity; on the other, heterogeneity within areas may jeopardize identification of impacts. To account for these key observations, we used propensity score matching (PSM) analysis at the individual level. Using indirect methods based on census data we constructed a mortality index at the motherhood level, and calculated five different impact estimators based on the propensity scores. We found that the average impact of the program ranged from 7.2 percent (local linear regression-kernel matching) to 9.0 percent (5-nearest neighbors matching). Matching difference-in-differences estimators also evidenced about an 8 percent reduction in child mortality levels. The reflexive or naïve evaluation for the cross-section would have estimated an average impact of 16.5 percent and the difference- indifferences naïve evaluation would have estimated an average impact of 19 percent, both clearly overstating the intervention's effects. When exploring heterogeneity of impacts, we stratified the sample by quartiles based on expenditure per capita, and surprisingly, no significant improvement among those in the bottom quartile was evidenced in relation to their matched individuals. However, we also observed that even in the poorest quartiles, if a woman had at least primary education, then the household obtained significant gains from W&S interventions. This would suggest the interesting observation that the overall insignificant effect for the bottom quartile was driven by the absence of impact in those who completely lacked education, thus stressing the importance of complimentary private inputs in order to reap the benefits of piped water, as other studies have suggested.

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Publisher Info
Paper provided by Inter-American Development Bank, Office of Evaluation and Oversight (OVE) in its series OVE Working Papers with number 0105.

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Length: 35 pages
Date of creation: Jul 2005
Date of revision:
Handle: RePEc:idb:ovewps:0105

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Related research
Keywords: water supply; sewerage; child mortality; propensity score matching.;

Find related papers by JEL classification:
I12 - Health, Education, and Welfare - - Health - - - Health Production
O12 - Economic Development, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development
H43 - Public Economics - - Publicly Provided Goods - - - Project Evaluation; Social Discount Rate

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  1. Hentschel, Jesko, et al, 2000. "Combining Census and Survey Data to Trace the Spatial Dimensions of Poverty: A Case Study of Ecuador," World Bank Economic Review, Oxford University Press, vol. 14(1), pages 147-65, January.
  2. Cebu Study Team, 1992. "A child health production function estimated from longitudinal data," Journal of Development Economics, Elsevier, vol. 38(2), pages 323-351, April. [Downloadable!] (restricted)
  3. Lee, Lung-fei & Rosenzweig, Mark R. & Pitt, Mark M., 1997. "The effects of improved nutrition, sanitation, and water quality on child health in high-mortality populations," Journal of Econometrics, Elsevier, vol. 77(1), pages 209-235, March. [Downloadable!] (restricted)
  4. James Heckman & Hidehiko Ichimura & Jeffrey Smith & Petra Todd, 1998. "Characterizing Selection Bias Using Experimental Data," Econometrica, Econometric Society, vol. 66(5), pages 1017-1098, September.
    Other versions:
  5. John Newman & Menno Pradhan & Laura B. Rawlings & Geert Ridder & Ramiro Coa & Jose Luis Evia, 2002. "An Impact Evaluation of Education, Health, and Water Supply Investments by the Bolivian Social Investment Fund," World Bank Economic Review, Oxford University Press, vol. 16(2), pages 241-274, August.
  6. Rajeev H. Dehejia & Sadek Wahba, 2002. "Propensity Score-Matching Methods For Nonexperimental Causal Studies," The Review of Economics and Statistics, MIT Press, vol. 84(1), pages 151-161, February. [Downloadable!] (restricted)
    Other versions:
  7. Heckman, James J. & Robb, Richard Jr., 1985. "Alternative methods for evaluating the impact of interventions : An overview," Journal of Econometrics, Elsevier, vol. 30(1-2), pages 239-267. [Downloadable!] (restricted)
  8. Heckman, James J & Ichimura, Hidehiko & Todd, Petra, 1998. "Matching as an Econometric Evaluation Estimator," Review of Economic Studies, Blackwell Publishing, vol. 65(2), pages 261-94, April. [Downloadable!] (restricted)
  9. Lavy, Victor & Strauss, John & Thomas, Duncan & de Vreyer, Philippe, 1996. "Quality of health care, survival and health outcomes in Ghana," Journal of Health Economics, Elsevier, vol. 15(3), pages 333-357, June. [Downloadable!] (restricted)
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  10. Menno Pradhan & Laura B. Rawlings, 2002. "The Impact and Targeting of Social Infrastructure Investments: Lessons from the Nicaraguan Social Fund," World Bank Economic Review, Oxford University Press, vol. 16(2), pages 275-295, August.
  11. Behrman, Jere R. & Wolfe, Barbara L., 1987. "How does mother's schooling affect family health, nutrition, medical care usage, and household sanitation?," Journal of Econometrics, Elsevier, vol. 36(1-2), pages 185-204. [Downloadable!] (restricted)
  12. Jalan, Jyotsna & Ravallion, Martin, 2001. "Does piped water reduce diarrhea for children in rural India ?," Policy Research Working Paper Series 2664, The World Bank. [Downloadable!]
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  13. Wolfe, Barbara L. & Behrman, Jere R., 1982. "Determinants of child mortality, health, and nutrition in a developing country," Journal of Development Economics, Elsevier, vol. 11(2), pages 163-193, October. [Downloadable!] (restricted)
  14. Heckman, James J. & Lalonde, Robert J. & Smith, Jeffrey A., 1999. "The economics and econometrics of active labor market programs," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 3, chapter 31, pages 1865-2097 Elsevier. [Downloadable!] (restricted)
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