sangita dse conf-slides_13_8_1
TRANSCRIPT
Growing Taller Among Toilets
Evidence from changes in sanitation and child height in Cambodia in 2005 and 2010
Phrym Kov, Susanna Smets, Dean Spears, Sangita Vyas
rice and WSP
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The ContextOpen defecation is widespread in Cambodia, but
significantly reduced from 2005 to 2010
Child height increased by 0.13 standard deviations – the entire India-Africa height gap
Question: How did the improvement in sanitation affect the height of children age 0-5 over the same period?
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Summary Statistics
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Medical/Epidemiological Literature
ChildStuntin
g
Fecal-oral contamination and diarrhea(Chekley et al 2008)
Environmental enteropathy
(Humphrey 2009, Lin et al 2013, Kosek et al
2013)
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Economic LiteratureHammer and Spears (2013) – randomized
sanitation motivation caused an increase in child height in Maharashtra
Spears (2013) - differences in child height between India and Africa explained by differences in sanitation
Cameron et al (2013) - Total Sanitation project in Indonesia increased the height of children living in households that did not have latrines at baseline
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Two is the Magic Number
Data from Cambodia DHS 2010.
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Good Toilets Make Good Neighbors
Data from Cambodia DHS 2010.
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Spurious Correlations?Fixed effects analysis: control for persistent
regional-level differences by looking at change over time within regionsWere regions where open defecation decreased by
more the regions where child height increased by more, on average?
Include control variables
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Change Within Regions
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Fixed Effects Estimation
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Controls Eilpt: Household socio-economic characteristics
household electrification; indicators for owning a radio, TV, and refrigerator; 10 indicators for floor material (an important indicator of disease exposure); 19 indicators for household size; indicators for level of literacy of the child's mother; indicators for cooking fuel type; and province-level measures of average consumption and population density.
Dilpt: Child demography 13 indicators for birth order and 11 indicators for birth month.
Hilpt: Health and healthcare an indicator for the child having a health and vaccination card; an
indicator for having had an institutional delivery; and indicators for being breastfed immediately and within the first day.
Age-in-month dummies for girls and boys
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Regression Results
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Regression Results
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Change Over Years
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Not Shown Here..Blinder-Oaxaca decomposition
Non-parametric reweighting decomposition
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Take-awaysLatrines spillover (effect)
Improvement in sanitation access likely played a big role in increasing average child height
The change in sanitation accounts for almost the entire change in height