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Why does piped water not reduce diarrhea for children? Evidence from urban Yemen


  • Tobias Lechtenfeld

    (Georg-August-University Göttingen)


This paper investigates why household connections to piped water supply can increase diarrheal diseases among under-5-year-old children. Using a unique mix of household data, microbiological test results and spatial information from urban Yemen it is possible to distinguish the adverse impacts of malfunctioning water pipes from unhygienic household behavior on water pollution and health outcomes. The analysis consists of three parts: First, exogenous variation of pipe construction is used to quantify the health impact of access to piped water, which is found to increase the risk of child diarrhea by 4.6 percentage points. Second, by exploiting the spatial correlation of pollution among households connected to the same water pipe, it is shown that broken pipes and interruptions of water supply are responsible for most of the water pollution. Third, unhygienic water storage and handling at household level additionally increases water pollution. These results show for the first time that water rationing can jeopardize the intended health benefits of access to clean drinking water. Importantly, these results apply to most urban areas in Africa and the Middle East where water resources are limited and water supply is frequently interrupted.

Suggested Citation

  • Tobias Lechtenfeld, 2012. "Why does piped water not reduce diarrhea for children? Evidence from urban Yemen," Courant Research Centre: Poverty, Equity and Growth - Discussion Papers 119, Courant Research Centre PEG.
  • Handle: RePEc:got:gotcrc:119

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    References listed on IDEAS

    1. Stephan Klasen & Tobias Lechtenfeld & Kristina Meier & Johannes Rieckmann, 2011. "Impact Evaluation Report: Water Supply and Sanitation in Provincial Towns in Yemen," Courant Research Centre: Poverty, Equity and Growth - Discussion Papers 102, Courant Research Centre PEG.
    2. Gamper-Rabindran, Shanti & Khan, Shakeeb & Timmins, Christopher, 2010. "The impact of piped water provision on infant mortality in Brazil: A quantile panel data approach," Journal of Development Economics, Elsevier, vol. 92(2), pages 188-200, July.
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    6. 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.
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    8. Alix Peterson Zwane & Michael Kremer, 2007. "What Works in Fighting Diarrheal Diseases in Developing Countries? A Critical Review," CID Working Papers 140, Center for International Development at Harvard University.
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    More about this item


    Water and Sanitation; Diarrhea; Child Health; Impact Evaluation; Yemen;

    JEL classification:

    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development
    • O16 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Financial Markets; Saving and Capital Investment; Corporate Finance and Governance

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