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Village sanitation and child health: Effects and external validity in a randomized field experiment in rural India

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  • Hammer, Jeffrey
  • Spears, Dean

Abstract

Over a billion people worldwide defecate in the open, with important consequences for early-life health and human capital accumulation in developing countries. We report a cluster randomized controlled trial of a village sanitation intervention conducted in rural Maharashtra, India designed to identify an effect of village sanitation on average child height, an outcome of increasing importance to economists. We find an effect of approximately 0.3 height-for-age standard deviations, which is consistent with observations and hypotheses in economic and health literatures. We further exploit details of the planning and implementation of the experiment to study treatment heterogeneity and external validity.

Suggested Citation

  • Hammer, Jeffrey & Spears, Dean, 2016. "Village sanitation and child health: Effects and external validity in a randomized field experiment in rural India," Journal of Health Economics, Elsevier, vol. 48(C), pages 135-148.
    • Handle: RePEc:eee:jhecon:v:48:y:2016:i:c:p:135-148
    DOI: 10.1016/j.jhealeco.2016.03.003
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    Cited by:

    1. Jorge M. Agüero & Trinidad Beleche, 2016. "Health Shocks and the Long-Lasting Change in Health Behaviors: Evidence from Mexico," Working papers 2016-26, University of Connecticut, Department of Economics.
    2. Orgill-Meyer, Jennifer & Pattanayak, Subhrendu K., 2020. "Improved sanitation increases long-term cognitive test scores," World Development, Elsevier, vol. 132(C).
    3. Mulmi, Prajula & Block, Steven A. & Shively, Gerald E. & Masters, William A., 2016. "Climatic conditions and child height: Sex-specific vulnerability and the protective effects of sanitation and food markets in Nepal," Economics & Human Biology, Elsevier, vol. 23(C), pages 63-75.
    4. Augsburg,Britta & Caeyers,Bet & Malde,Bansi Khimji, 2019. "Can Micro-Credit Support Public Health Subsidy Programs ?," Policy Research Working Paper Series 8846, The World Bank.
    5. Calvi, Rossella & Mantovanelli, Federico G., 2018. "Long-term effects of access to health care: Medical missions in colonial India," Journal of Development Economics, Elsevier, vol. 135(C), pages 285-303.
    6. Deepak Saraswat, 2018. "Gender Composition of Children and Sanitation Behavior In India," Working papers 2018-12, University of Connecticut, Department of Economics.
    7. Otterbach, Steffen & Rogan, Michael, 2017. "Spatial Differences in Stunting and Household Agricultural Production in South Africa: (Re-)Examining the Links Using National Panel Survey Data," IZA Discussion Papers 11008, Institute of Labor Economics (IZA).
    8. Cameron, Lisa & Olivia, Susan & Shah, Manisha, 2019. "Scaling up sanitation: Evidence from an RCT in Indonesia," Journal of Development Economics, Elsevier, vol. 138(C), pages 1-16.
    9. Hatton, Timothy J. & Sparrow, Robert & Suryadarma, Daniel & van der Eng, Pierre, 2018. "Fertility and the health of children in Indonesia," Economics & Human Biology, Elsevier, vol. 28(C), pages 67-78.
    10. Agüero, Jorge M. & Beleche, Trinidad, 2017. "Health shocks and their long-lasting impact on health behaviors: Evidence from the 2009 H1N1 pandemic in Mexico," Journal of Health Economics, Elsevier, vol. 54(C), pages 40-55.
    11. Diane Coffey & Michael Geruso & Dean Spears, 2018. "Sanitation, Disease Externalities and Anaemia: Evidence From Nepal," Economic Journal, Royal Economic Society, vol. 128(611), pages 1395-1432, June.
    12. Makate, Marshall & Makate, Clifton, 2016. "Is poor sanitation killing more children in rural Zimbabwe? Results of propensity score matching method," MPRA Paper 72831, University Library of Munich, Germany, revised 02 Aug 2016.
    13. Evan Plous Kresch & Molly Lipscomb & Laura Schechter, 2020. "Externalities and Spillovers from Sanitation and Waste Management in Urban and Rural Neighborhoods," Applied Economic Perspectives and Policy, John Wiley & Sons, vol. 42(3), pages 395-420, September.
    14. Singh, Prakarsh & Masters, William A., 2017. "Impact of caregiver incentives on child health: Evidence from an experiment with Anganwadi workers in India," Journal of Health Economics, Elsevier, vol. 55(C), pages 219-231.
    15. Payal Hathi & Sabrina Haque & Lovey Pant & Diane Coffey & Dean Spears, 2017. "Place and Child Health: The Interaction of Population Density and Sanitation in Developing Countries," Demography, Springer;Population Association of America (PAA), vol. 54(1), pages 337-360, February.
    16. Rahman, Mohammad Hifz Ur & Malik, Manzoor Ahmad & Chauhan, Shekhar & Patel, Ratna & Singh, Ashish & Mittal, Anshu, 2020. "Examining the linkage between open defecation and child malnutrition in India," Children and Youth Services Review, Elsevier, vol. 117(C).
    17. Spears, Dean, 2020. "Exposure to open defecation can account for the Indian enigma of child height," Journal of Development Economics, Elsevier, vol. 146(C).
    18. Kanika Mahajan & Sheetal Sekhri, 2020. "Access to Toilets and Violence Against Women," Working Papers 44, Ashoka University, Department of Economics.
    19. Jacob Katuva & Rob Hope & Tim Foster & Johanna Koehler & Patrick Thomson, 2020. "Modelling Welfare Transitions to Prioritise Sustainable Development Interventions in Coastal Kenya," Sustainability, MDPI, Open Access Journal, vol. 12(17), pages 1-1, August.
    20. Otterbach, Steffen & Rogan, Michael, 2017. "Spatial differences in stunting and household agricultural production in South African: (re-)examining the links using national panel survey data," Hohenheim Discussion Papers in Business, Economics and Social Sciences 13-2017, University of Hohenheim, Faculty of Business, Economics and Social Sciences.
    21. Ashwini Deshpande & Rajesh Ramachandran, 2020. "Which Indian Children are Short and Why? Social Identity, Childhood Malnutrition and Cognitive Outcomes," Working Papers 27, Ashoka University, Department of Economics.

    More about this item

    Keywords

    Sanitation; Health; Experiment; External validity; India;

    JEL classification:

    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development

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