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Expanding Access to Clean Water for the Rural Poor: Experimental Evidence from Malawi

Author

Listed:
  • Pascaline Dupas
  • Basimenye Nhlema
  • Zachary Wagner
  • Aaron Wolf
  • Emily Wroe

Abstract

Data from an 18-month randomized trial show large and sustained impacts on water purification and child health of a program providing monthly coupons for free water treatment solution to households with young children. The program is more effective and much more cost effective than asking Community Health Workers (CHWs) to distribute free chlorine to households during routine monthly visits. This is because only 40 percent of households use free chlorine, targeting through CHWs is worse than self-targeting through coupon redemption, and water treatment promotion by CHWs does not increase chlorine use among beneficiaries of free chlorine.

Suggested Citation

  • Pascaline Dupas & Basimenye Nhlema & Zachary Wagner & Aaron Wolf & Emily Wroe, 2023. "Expanding Access to Clean Water for the Rural Poor: Experimental Evidence from Malawi," American Economic Journal: Economic Policy, American Economic Association, vol. 15(1), pages 272-305, February.
    • Handle: RePEc:aea:aejpol:v:15:y:2023:i:1:p:272-305
    DOI: 10.1257/pol.20210121
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    Cited by:

    1. Sun, Yucheng & Li, Jiaolong & Shen, Xiuheng & Pan, Zhewen, 2025. "Early-life access to primary healthcare and educational attainment: Evidence from community health centers in China," Social Science & Medicine, Elsevier, vol. 380(C).
    2. Wagner, Zachary & Asiimwe, John Bosco & Levine, David I., 2020. "When financial incentives backfire: Evidence from a community health worker experiment in Uganda," Journal of Development Economics, Elsevier, vol. 144(C).
    3. Aisha Aziz & Kashif Akram & Muhammad Abrar ul Haq & Iqbal Thonse Hawaldar & Mustafa Raza Rabbani, 2022. "Examining the Role of Clean Drinking Water Plants in Mitigating Drinking Water-Induced Morbidity," Sustainability, MDPI, vol. 14(15), pages 1-21, August.
    4. Angelucci, Manuela & Bennett, Daniel M, 2022. "Depression, Pharmacotherapy, and the Demand for a Novel Health Product," IZA Discussion Papers 15832, IZA Network @ LISER.
    5. Martín Rossi & Giulia Buccione, 2023. "Familiar Taste, Safer Choices: Sensory Heuristics and the Adoption of Clean Water," Working Papers 167, Universidad de San Andres, Departamento de Economia, revised Oct 2025.
    6. Pakhtigian, Emily L. & Aziz, Sonia & Boyle, Kevin J. & Akanda, Ali S. & Hanifi, S.M.A., 2024. "Early warning systems, mobile technology, and cholera aversion: Evidence from rural Bangladesh," Journal of Environmental Economics and Management, Elsevier, vol. 125(C).
    7. Rafi Amir‐ud‐Din & Muhammad Khan & Zahra Murad & Irene Mussio, 2025. "Clear Waters, Bright Futures: Do Low‐Cost Information Interventions Increase Health Preventive Behaviors," Health Economics, John Wiley & Sons, Ltd., vol. 34(9), pages 1578-1594, September.

    More about this item

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development
    • O13 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Agriculture; Natural Resources; Environment; Other Primary Products
    • Q53 - Agricultural and Natural Resource Economics; Environmental and Ecological Economics - - Environmental Economics - - - Air Pollution; Water Pollution; Noise; Hazardous Waste; Solid Waste; Recycling

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