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Water, sanitation, and child health: Evidence from subnational panel data in 59 countries

Demography Headey, D., Palloni, G. 2019-2-28
Article on water, sanitation, hygiene (WASH), and child health. WASH investments are widely seen as essential for improving health in early childhood. However, the experimental literature on WASH interventions identifies inconsistent impacts on child health outcomes, with relatively robust impacts on diarrhea and other symptoms of infection but weak and varying impacts on child nutrition. In contrast, observational research exploiting cross-sectional variation in water and sanitation access is much more sanguine, finding strong associations with diarrhea prevalence, mortality, and stunting. In practice, both literatures suffer from significant methodological limitations. Experimental WASH evaluations are often subject to poor compliance, rural bias, and short duration of exposure, while cross-sectional observational evidence may be highly vulnerable to omitted variables bias. To overcome some of the limitations of both literatures, a panel of 442 subnational regions in 59 countries with multiple Demographic Health Surveys was constructed. Using this large subnational panel, difference-in-difference regressions were implemented that allowed the examination of whether longer-term changes in water and sanitation at the subnational level predict improvements in child morbidity, mortality, and nutrition.
  • Economic
  • Food Insecurity
  • Health
  • Nutrition
  • Africa
  • Angola
  • Armenia
  • Asia
  • Bangladesh
  • Benin
  • Bolivia (Plurinational State of)
  • Brazil
  • Burkina Faso
  • Burundi
  • Cambodia
  • Cameroon
  • Central Asia
  • Chad
  • Colombia
  • Comoros
  • Congo-Kinshasa (Democratic Republic of the Congo (DRC))
  • Côte d'Ivoire
  • Dominican Republic
  • Egypt (Arab Republic)
  • Eritrea
  • Ethiopia
  • Europe
  • Gabon
  • Ghana
  • Global
  • Guatemala
  • Guinea
  • Guyana
  • Haiti
  • Honduras
  • India
  • Indonesia
  • Jordan
  • Kazakhstan
  • Kenya
  • Kyrgyzstan (Kyrgyz Republic)
  • Latin America
  • Lesotho
  • Liberia
  • Madagascar
  • Malawi
  • Mali
  • Moldova
  • Morocco
  • Mozambique
  • Namibia
  • Nepal
  • Nicaragua
  • Niger
  • Nigeria
  • Pakistan
  • Peru
  • Philippines
  • Rwanda
  • Senegal
  • Sierra Leone
  • South Asia
  • Tanzania (United Republic of)
  • Togo
  • Turkey/Türkiye
  • Uganda
  • Vietnam
  • Yemen
  • Zambia
  • Zimbabwe
  • Low- and Middle-Income Countries (LMICs)
  • Children (boys and/or girls 1-10 years old)
  • Children <5 years old
  • Country-level population(s)
  • Research
  • Article
  • Journal article

Highlighted Sources

Asia and the Pacific regional overview of food security and nutrition 2022: Urban food systems and nutrition – Launch recording, Key messages & Full report

  • Policy
  • Research
  • Article
  • Press release
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  • Video
  • COVID-19 Pandemic
  • Economic
  • Food Insecurity
  • Health
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2023-01-24
Press release on the launch and key messages of the fifth annual Asia-Pacific regional SOFI report. The report’s highlights capture the challenges and system-level determinants of unhealthy diets in urban areas, both regarding undernutrition and overweight. It presents, among others, data on food security and affordability and the state of progress on achieving the global nutrition targets. The findings profile various urban environments, interventions, experiences, and opportunities to innovate at multiple levels to transform urban areas into sustainable cities. A link to the report's virtual launch event is available including the recording, key messages, and full report. View Source

Impacts of the COVID-19 pandemic on diets, nutrition services & nutrition practices in UNICEF’s Eastern and Southern Africa Region (ESAR): Evidence from remote surveys

  • Research
  • Report
  • COVID-19 Pandemic
  • Economic
  • Food Insecurity
  • Health
  • Nutrition
  • Women and/or Girls
2023-01-01
Report on the impact of the COVID pandemic on diets, services, and practices in the Eastern and Southern Africa region. The report presents findings from remote surveys in six ESAR countries with data on breastfeeding, diet diversity, food consumption and insecurity, drivers of dietary changes, and disruptions to nutrition services. The survey provides important learning for the future use of remote methods for collecting nutrition data. Technical brief, pull report, and six country briefs are available. View Source

Economic shocks predict increases in child wasting prevalence

  • Research
  • Article
  • Journal article
  • COVID-19 Pandemic
  • Economic
  • Food Insecurity
  • Health
  • Nutrition
  • Other Crises
  • Social Support and Protection
2022-04-20
Article on the impact of severe negative economic shock on child acute malnutrition (wasting), a major risk factor for under-5 mortality. In low- and middle-income countries (LMICs) macroeconomic volatility is common, and severe negative economic shocks can substantially increase poverty and food insecurity. Less well understood are the implications of these contractions for child wasting. This study explores the nutritional impacts of economic growth shocks over 1990–2018 by linking wasting outcomes collected for 1.256 million children from 52 countries to lagged annual changes in economic growth. Estimates suggest that a 10% annual decline in national income increases moderate/severe wasting prevalence by 14.4–17.8%. An exploration of possible mechanisms suggests negative economic shocks may increase risks of inadequate dietary diversity among children. Applying these results to the latest economic growth estimates for 2020 suggests that COVID-19 could put an additional 9.4 million preschoolers at risk of wasting, net of the effects of preventative policy actions. View Source