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Sanitation, Disease Externalities and Anaemia: Evidence From Nepal

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  • Diane Coffey
  • Michael Geruso
  • Dean Spears

Abstract

Anaemia impairs physical and cognitive development in children and reduces human capital accumulation. The prior economics literature has focused on the role of inadequate nutrition in causing anaemia. This article is the first to show that sanitation, a public good, significantly contributes to preventing anaemia. We identify effects by exploiting rapid and differential improvement in sanitation across regions of Nepal between 2006 and 2011. Within regions over time, cohorts of children exposed to better community sanitation developed higher haemoglobin levels. Our results highlight a previously undocumented externality of open defaecation, which is today practiced by over a billion people worldwide.

Suggested Citation

  • 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.
    • Handle: RePEc:wly:econjl:v:128:y:2018:i:611:p:1395-1432
    DOI: 10.1111/ecoj.12491
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    9. 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.
    10. Amy Finkelstein, 2007. "The Aggregate Effects of Health Insurance: Evidence from the Introduction of Medicare," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(1), pages 1-37.
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    Cited by:

    1. Kresch, Evan Plous & Walker, Mark & Best, Michael Carlos & Gerard, François & Naritomi, Joana, 2023. "Sanitation and property tax compliance: Analyzing the social contract in Brazil," Journal of Development Economics, Elsevier, vol. 160(C).
    2. Gelli, Aulo & Headey, Derek D. & Ngure, Francis & Becquey, Elodie & Ganaba, Rasmané & Huybregts, Lieven & Pedehombga, Abdoulaye & Sanou, Armande & Traore, Abdoulaye & Zongo, Florence & Zongrone, Aman, 2017. "Assessing the health and nutrition risks of smallholder poultry production in Burkina Faso: Insights from formative research," IFPRI discussion papers 1665, International Food Policy Research Institute (IFPRI).
    3. Derek Headey & Giordano Palloni, 2019. "Water, Sanitation, and Child Health: Evidence From Subnational Panel Data in 59 Countries," Demography, Springer;Population Association of America (PAA), vol. 56(2), pages 729-752, April.
    4. Kristensen, Frederikke Frehr & Sharp, Paul, 2021. "Disease Surveillance, Mortality and Race: The Case of HIV/AIDS in the United States," CAGE Online Working Paper Series 553, Competitive Advantage in the Global Economy (CAGE).
    5. repec:rre:publsh:v:51:y:2021:i:1 is not listed on IDEAS
    6. Gautam, Sanghmitra, 2023. "Quantifying welfare effects in the presence of externalities: An ex-ante evaluation of sanitation interventions," Journal of Development Economics, Elsevier, vol. 164(C).
    7. Johann Caro-Burnett & Ahmed Mushfiq Mobarak & Judith A. Chevalier, 2021. "Is Habit a Powerful Policy Instrument to Induce Prosocial Behavioral Change?," Cowles Foundation Discussion Papers 2275, Cowles Foundation for Research in Economics, Yale University.
    8. Joseph, George & Hoo, Yi Rong & Moqueet, Nazia Sultana & Chellaraj, Gnanaraj, 2023. "Early-life exposure to unimproved sanitation and delayed school enrollment: Evidence from Bangladesh," World Development Perspectives, Elsevier, vol. 32(C).
    9. Ray, Rita & Datta, Rajlakshmi, 2017. "Do separate female toilets in primary and upper primary schools improve female enrollment? A case study from India," Children and Youth Services Review, Elsevier, vol. 79(C), pages 263-273.
    10. Spears, Dean, 2020. "Exposure to open defecation can account for the Indian enigma of child height," Journal of Development Economics, Elsevier, vol. 146(C).
    11. repec:ags:aaea22:335640 is not listed on IDEAS
    12. Ray, Rita, 2020. "Mother’s autonomy and child anemia: A case study from India," Children and Youth Services Review, Elsevier, vol. 112(C).

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    More about this item

    JEL classification:

    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • J1 - Labor and Demographic Economics - - Demographic Economics
    • O1 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development

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