Sangita dse conf-slides_13_8_1
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Transcript of Sangita dse conf-slides_13_8_1
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