The child health implications of privatizing Africa's urban water supply

J Health Econ. 2014 May:35:1-19. doi: 10.1016/j.jhealeco.2014.01.006. Epub 2014 Jan 31.

Abstract

Can private sector participation (PSP) in the piped water sector improve child health? I use child-level data from 39 African countries during 1986-2010 to show that PSP decreases diarrhea among urban-dwelling, under-five children by 2.6 percentage points, or 16% of its mean prevalence. Children from the poorest households benefit most. PSP is also associated with a 7.8 percentage point increase in school attendance of 7-17 year olds. Importantly, PSP increases usage of piped water by 9.7 percentage points, suggesting a possible causal channel explaining health improvements. To attribute causality, I exploit time-variation in the private water market share controlled by African countries' former colonizers. A placebo analysis reveals that PSP does not affect respiratory illness, nor does it affect a control group of rural children.

Keywords: Child health; Education; Infrastructure; Privatization; Water.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Africa South of the Sahara / epidemiology
  • Child
  • Child Welfare*
  • Child, Preschool
  • Diarrhea / etiology
  • Diarrhea / mortality
  • Diarrhea / prevention & control*
  • Drinking Water / adverse effects*
  • Drinking Water / microbiology
  • Drinking Water / standards
  • Educational Status
  • Humans
  • Infant
  • Infant, Newborn
  • Models, Statistical
  • Poverty
  • Prevalence
  • Private Sector / economics*
  • Sanitation / economics
  • Sanitation / methods
  • Sanitation / standards*
  • Toilet Facilities / economics
  • Toilet Facilities / standards*
  • Toilet Facilities / statistics & numerical data
  • Urban Health

Substances

  • Drinking Water