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

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  • 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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    References listed on IDEAS

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    1. Anderson, Michael L, 2008. "Multiple Inference and Gender Differences in the Effects of Early Intervention: A Reevaluation of the Abecedarian, Perry Preschool, and Early Training Projects," Department of Agricultural & Resource Economics, UC Berkeley, Working Paper Series qt15n8j26f, Department of Agricultural & Resource Economics, UC Berkeley.
    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. Zachary Wagner & John Bosco Asiimwe & William H Dow & David I Levine, 2019. "The role of price and convenience in use of oral rehydration salts to treat child diarrhea: A cluster randomized trial in Uganda," PLOS Medicine, Public Library of Science, vol. 16(1), pages 1-18, January.
    4. Jessica Cohen & Pascaline Dupas, 2010. "Free Distribution or Cost-Sharing? Evidence from a Randomized Malaria Prevention Experiment," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 125(1), pages 1-45.
    5. Milkman, Katherine L. & Beshears, John Leonard & Choi, James J. & Laibson, David I. & Madrian, Brigitte, 2011. "Using Implementation Intentions Prompts to Enhance Influenza Vaccination Rates," Scholarly Articles 8057976, Harvard Kennedy School of Government.
    6. Martina Björkman Nyqvist & Andrea Guariso & Jakob Svensson & David Yanagizawa-Drott, 2019. "Reducing Child Mortality in the Last Mile: Experimental Evidence on Community Health Promoters in Uganda," American Economic Journal: Applied Economics, American Economic Association, vol. 11(3), pages 155-192, July.
    7. Dizon-Ross, Rebecca & Dupas, Pascaline & Robinson, Jonathan, 2017. "Governance and the effectiveness of public health subsidies: Evidence from Ghana, Kenya and Uganda," Journal of Public Economics, Elsevier, vol. 156(C), pages 150-169.
    8. Anett John & Kate Orkin, 2022. "Can Simple Psychological Interventions Increase Preventive Health Investment?," Journal of the European Economic Association, European Economic Association, vol. 20(3), pages 1001-1047.
    9. Florencia Devoto & Esther Duflo & Pascaline Dupas & William Parienté & Vincent Pons, 2012. "Happiness on Tap: Piped Water Adoption in Urban Morocco," American Economic Journal: Economic Policy, American Economic Association, vol. 4(4), pages 68-99, November.
    10. Anderson, Michael L., 2008. "Multiple Inference and Gender Differences in the Effects of Early Intervention: A Reevaluation of the Abecedarian, Perry Preschool, and Early Training Projects," Journal of the American Statistical Association, American Statistical Association, vol. 103(484), pages 1481-1495.
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    Cited by:

    1. 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).
    2. Angelucci, Manuela & Bennett, Daniel M, 2022. "Depression, Pharmacotherapy, and the Demand for a Novel Health Product," IZA Discussion Papers 15832, Institute of Labor Economics (IZA).
    3. 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).
    4. 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.

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    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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