The Impact of Access to Water on Child Health in Senegal

• Date: 01 August 2014
• Published date: 01 August 2014
• DOI: http://doi.org/10.1111/rode.12094

The Impact of Access to Water on Child Health

in Senegal

Lindsey Novak*

Abstract

This paper addresses the impact of access to water on child health in Senegal by using multinomial propen-

sity score matching to estimate the impact of five water sources on the incidence of diarrhea in children.

This information will facilitate a more informed cost-benefit analysis when implementing water projects.

Much research categorizes water sources into a binary variable: “improved” or “unimproved”. According

to the findings of this paper, this is an erroneous restriction, as I find heterogeneous impacts of water

sources on child health. In fact, water sources that are generally believed to be superior are not significantly

different, and some are significantly less effective in decreasing incidence of diarrhea.

1. Introduction

Two out of every five Sub-Saharan Africans lack access to safe drinking water (World

Health Organization/United Nations Children’s Fund (WHO/UNICEF), 2010), and

unsafe drinking water increases the risk of cholera, typhoid fever, dysentery and other

diarrheal diseases (WHO/UNICEF, 2010). Approximately 1.6 million people die from

diarrheal disease every year; an estimated 88% of those deaths are attributable to

unsafe water supply, poor sanitation and poor hygiene conditions (WHO, 2010). Chil-

dren are the most susceptible to adverse effects of poor water quality, evidenced by

the fact that as many as 90% of those deaths are among children under five years of

age, the majority of which are children in developing countries (UN-Water, 2008).

Early childhood diarrhea is highly correlated with reduced weight and height (Becker

et al., 1991; Checkley et al., 2003), and evidence suggests that severe early childhood

diarrhea and reduced weight and height are associated with decreased cognitive

ability (Niehaus et al., 2002; Tarleton et al., 2006).

Many projects are being implemented to increase access to potable water and to

improve sanitation facilities. The World Bank alone invested approximately 5.5

billion US dollars in rural water supply and sanitation projects between 1980 and 2005

(Iyer et al., 2005). Senegal’s water sector reforms have been proclaimed as particu-

larly successful in increasing access to water and creating a sustainable water market

through a public–private partnership between the Senegalese government and

Senegalaise des Eaux (Jammal and Jones, 2006). Such a partnership is in-line with

many economists’ recommendations for delivering water services (Fujiwara and Van

Long, 2012; Bjorvatn and Eckel, 2011). The partnership was established in 1996 with a

* Novak: Department of Applied Economics, University of Minnesota, 332 Ruttan Hall, 1994 Buford

Avenue, St Paul, MN 55108, USA. Tel: +1-612-625-1724; Email: novak352@umn.edu. The author would

like to thank Jean-Louis Arcand, Ugo Panizza, and Howard White for their invaluable inputs to this paper.

Special thanks to Enrico Berkes, Tomas Hozik, and Zacharias Ziegelhoefer for their patience in reading

earlier drafts and discussing the paper’s cardinal ideas. The author greatly appreciates comments from one

anonymous referee and for funding from the International Initiative for Impact Evaluation (3ie) and The

Graduate Institute of International and Development Studies.

Review of Development Economics, 18(3), 431–444, 2014

DOI:10.1111/rode.12094

© 2014 John Wiley & Sons Ltd