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Water accessibility and child health: Use of the leave-out strategy of instruments


  • Lamichhane, Dirga Kumar
  • Mangyo, Eiji


This paper investigates the leave-out strategy of instruments by using the leave-out community ratio of household access to in-yard water sources and community water infrastructure as instruments for hours in fetching water time, and the data on disease symptoms. The results show that community-level access to clean water is significantly associated with both water-relevant and irrelevant disease symptoms, which suggests that the correlation between community-level access to clean water and child health is at least partially due to endogenous project placement potentially with respect to unobserved community wealth. The paper concludes that the OLS estimates have a potential endogeneity bias problem and that IV estimates under this strategy is subject to endogenous project placement and is not valid. A policy implication of this study is that careful attention should be paid to both self-selection and endogenous project placement in studying the effect of water accessibility on child health.

Suggested Citation

  • Lamichhane, Dirga Kumar & Mangyo, Eiji, 2011. "Water accessibility and child health: Use of the leave-out strategy of instruments," Journal of Health Economics, Elsevier, vol. 30(5), pages 1000-1010.
  • Handle: RePEc:eee:jhecon:v:30:y:2011:i:5:p:1000-1010
    DOI: 10.1016/j.jhealeco.2011.07.001

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    References listed on IDEAS

    1. Roberto G. Gutierrez, 2008. "Analyzing survey data using Stata 10," Summer North American Stata Users' Group Meetings 2008 18, Stata Users Group, revised 28 Aug 2008.
    2. Gary S. Becker, 1981. "A Treatise on the Family," NBER Books, National Bureau of Economic Research, Inc, number beck81-1, January.
    3. Jalan, Jyotsna & Ravallion, Martin, 2003. "Does piped water reduce diarrhea for children in rural India?," Journal of Econometrics, Elsevier, vol. 112(1), pages 153-173, January.
    4. Mangyo, Eiji, 2008. "The effect of water accessibility on child health in China," Journal of Health Economics, Elsevier, vol. 27(5), pages 1343-1356, September.
    5. Jere Behrman & Victor Lavy, "undated". "Child Health and Schooling Achievement: Association, Causality and Household Allocations," CARESS Working Papres 97-23, University of Pennsylvania Center for Analytic Research and Economics in the Social Sciences.
    6. Sebastian Galiani & Paul Gertler & Ernesto Schargrodsky, 2005. "Water for Life: The Impact of the Privatization of Water Services on Child Mortality," Journal of Political Economy, University of Chicago Press, vol. 113(1), pages 83-120, February.
    7. Thomas, Duncan & Strauss, John, 1992. "Prices, infrastructure, household characteristics and child height," Journal of Development Economics, Elsevier, vol. 39(2), pages 301-331, October.
    8. Barrera, Albino, 1990. "The role of maternal schooling and its interaction with public health programs in child health production," Journal of Development Economics, Elsevier, vol. 32(1), pages 69-91, January.
    9. Nakamura, Alice & Nakamura, Masao, 1998. "Model specification and endogeneity," Journal of Econometrics, Elsevier, vol. 83(1-2), pages 213-237.
    10. Mwabu, Germano, 2008. "The Production of Child Health in Kenya: A Structural Model of Birth Weight," Working Papers 52, Yale University, Department of Economics.
    11. Linnemayr, Sebastian & Alderman, Harold & Ka, Abdoulaye, 2008. "Determinants of malnutrition in Senegal: Individual, household, community variables, and their interaction," Economics & Human Biology, Elsevier, vol. 6(2), pages 252-263, July.
    12. Smith, Lisa C. & Ramakrishnan, Usha & Ndiaye, Aida & Haddad, Lawrence James & Martorell, Reynaldo, 2003. "The importance of women's status for child nutrition in developing countries:," Research reports 131, International Food Policy Research Institute (IFPRI).
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    Cited by:

    1. Abdullah Afzal & Jacques-Bernard Gauthier, 2017. "Project Management And Practitioners In The Health Sector: From The Quebec Healthcare System Perspective To Pm Literature Review," Working Papers hal-01579996, HAL.
    2. repec:spr:soinre:v:134:y:2017:i:3:d:10.1007_s11205-016-1454-7 is not listed on IDEAS
    3. Calzada, Joan & Iranzo Sancho, Susana, 2012. "Neither Private nor Public: The Effects of Communal Provision of Water on Child Health in Peru," Working Papers 2072/196649, Universitat Rovira i Virgili, Department of Economics.

    More about this item


    Fetching water time; Leave-out strategy; Endogenous project placement; Child health;

    JEL classification:

    • C31 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models; Quantile Regressions; Social Interaction Models
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • O10 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - General


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