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Does improved sanitation reduce diarrhea in children in rural India?

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  • Santosh, Kumar
  • Sebastian, Vollmer

Abstract

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.

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Bibliographic Info

Paper provided by University Library of Munich, Germany in its series MPRA Paper with number 31804.

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Date of creation: 21 Mar 2011
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Handle: RePEc:pra:mprapa:31804

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Keywords: Water; Sanitation; Diarrhea; Propensity score; Matching; India.;

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  1. Ravallion, Martin, 2005. "Evaluating anti-poverty programs," Policy Research Working Paper Series 3625, The World Bank.
  2. Becker, Sascha O. & Caliendo, Marco, 2007. "mhbounds – Sensitivity Analysis for Average Treatment Effects," IZA Discussion Papers 2542, Institute for the Study of Labor (IZA).
  3. Guido Imbens, 2000. "Efficient Estimation of Average Treatment Effects Using the Estimated Propensity Score," Econometric Society World Congress 2000 Contributed Papers 1166, Econometric Society.
  4. Duraiswamy, P., 2001. "Health status and curative health care in rural India," Working Papers, National Council of Applied Economic Research 78, National Council of Applied Economic Research.
  5. Jalan, Jyotsna & Ravallion, Martin, 2001. "Does piped water reduce diarrhea for children in rural India ?," Policy Research Working Paper Series 2664, The World Bank.
  6. Jeffrey Smith & Petra Todd, 2003. "Does Matching Overcome Lalonde's Critique of Nonexperimental Estimators?," University of Western Ontario, CIBC Centre for Human Capital and Productivity Working Papers 20035, University of Western Ontario, CIBC Centre for Human Capital and Productivity.
  7. Victoria Yue-May Fan & Ajay Mahal, 2011. "What prevents child diarrhoea? The impacts of water supply, toilets, and hand-washing in rural India," Journal of Development Effectiveness, Taylor & Francis Journals, Taylor & Francis Journals, vol. 3(3), pages 340-370, September.
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  9. Michael Kremer & Alix Peterson Zwane, 2007. "Cost-Effective Prevention of Diarrheal Diseases: A Critical Review," Working Papers 117, Center for Global Development.
  10. Sascha O. Becker & Andrea Ichino, 2002. "Estimation of average treatment effects based on propensity scores," Stata Journal, StataCorp LP, StataCorp LP, vol. 2(4), pages 358-377, November.
  11. Watson, Tara, 2006. "Public health investments and the infant mortality gap: Evidence from federal sanitation interventions on U.S. Indian reservations," Journal of Public Economics, Elsevier, vol. 90(8-9), pages 1537-1560, September.
  12. Barbara Sianesi, 2004. "An Evaluation of the Swedish System of Active Labor Market Programs in the 1990s," The Review of Economics and Statistics, MIT Press, vol. 86(1), pages 133-155, February.
  13. Dasgupta, Purnamita, 2004. "Valuing health damages from water pollution in urban Delhi, India: a health production function approach," Environment and Development Economics, Cambridge University Press, vol. 9(01), pages 83-106, February.
  14. Heckman, James J & Ichimura, Hidehiko & Todd, Petra E, 1997. "Matching as an Econometric Evaluation Estimator: Evidence from Evaluating a Job Training Programme," Review of Economic Studies, Wiley Blackwell, Wiley Blackwell, vol. 64(4), pages 605-54, October.
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