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Environmental quality, gender and health outcomes in Southern Ghana

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Abstract

Using panel data collected from two administrative districts in Southern Ghana, this study investigates the relationship between environmental quality and health outcomes of households and individuals for a large set of water, sanitation and hygiene (WASH) indicators. The WASH indicators included in this study are comprehensive than those in most studies. Data analyses are undertaken using standard econometric techniques and double-robust multivalued treatment effects estimator. The study finds that there are relative and multiple overlapping policy effects of water and sanitation options in decreasing household diarrhea incidence. The estimates suggest that households’ use of improved water sources led to a statistically significant reduction in illness incidence of males but had little effect on females. The effects of households’ use of improved sanitation were generally mixed. Drinking water quantity decreased household diarrhea incidence but had little effects on individual illness incidence and distribution. The study does not find evidence that high microbial water quality decreases individual illness and household diarrhea incidence. The results suggest that the efficiency of water and sanitation interventions may depend on the gender of individuals, and indicators and unit of measurement of health outcomes.

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References

  • Aquagenx, L. L. C. (undated). Compartment bag test (CBT) instructions for use: Drinking water. Aquagenx, USA. www.aquagenx.com.

  • Arnold, B., Colford, J., Fernald, L., Kariger, P., Kremer, M., Lin, A., et al. (2017). WASH benefits: The effects of water quality, sanitation, handwashing, and nutrition interventions on child health, growth and development in rural Kenya. Retrieved June 17, 2017 from, https://www.povertyactionlab.org/evaluation/wash-benefits-effects-water-quality-sanitation-handwashing-and-nutrition-interventions.

  • Brainerd, E., & Menon, N. (2014). Seasonal effects of water quality: The hidden costs of the green revolution to infant and child health in India. Journal of Development Economics, 107, 49–64.

    Article  Google Scholar 

  • Cattaneo, M. D. (2010). Efficient semiparametric estimation of multi-valued treatment effects under ignorability. Journal of Econometrics, 155, 138–154.

    Article  Google Scholar 

  • Checkley, W., Gilman, R. H., Black, R. E., Epstein, L. D., Cabrera, L., Sterling, C. R., et al. (2004). Effect of water and sanitation on childhood health in a poor peruvian peri-urban community. Lancet, 363, 112–118.

    Article  Google Scholar 

  • Clasen, T. F., Roberts, I. G., Rabie, T., Schmidt, W. P., & Cairncross, S. (2006). Interventions to improve water quality for preventing diarrhoea (review). Cochrane Database of Systematic Reviews, 3, 1–115. https://doi.org/10.1002/14651858.CD004794.pub2.

    Article  Google Scholar 

  • Clasen, T., Schmidt, W., Rabie, T., Roberts, I., & Cairncross, S. (2007). Interventions to improve water quality for preventing diarrhoea: Systematic review and meta-analysis. British Medical Journal, 334(7597), 782.

    Article  Google Scholar 

  • Currie, J., Zivin, J. G., Meckel, K., Neidell, M., & Schlenker, W. (2013). Something in the water: Contaminated drinking water and infant health. The Canadian Journal of Economics, 46(3), 791–810.

    Article  Google Scholar 

  • Dangour, A. D., Watson, L., Cumming, O., Boisson, S., Velleman, Y., Cavill, S., et al. (2011). Interventions to improve water quality and supply, sanitation and hygiene practices, and their effects on the nutritional status of children (protocol). Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD009382.

    Article  Google Scholar 

  • Devoto, F., Duflo, E., Dupas, P., Pariente, W., & Pons, V. (2012). Happiness on tap: Piped water adoption in urban Morocco. American Economic Journal: Economic Policy, 4(4), 68–99.

    Google Scholar 

  • Drukker, D. (2015). In the spotlight: Double-robust treatment effects (two wrongs don’t make a right, but one does). Retrieved July 7, 2017 from, http://www.stata.com/stata-news/news29-1/double-robust-treatment-effects/#.

  • Duflo, E. (2003). Grandmothers and granddaughters: Old-age pensions and intrahousehold allocation in South Africa. World Bank Economic Review, 17(1), 1–25.

    Article  Google Scholar 

  • Fewtrell, L., Kaufmann, R., Kay, D., Wayne, E., Haller, L., & Colford, J. (2005). Water, sanitation and hygiene interventions to reduce diarrhoea in less developed countries: A systematic review and meta-analysis. The Lancet Infectious Diseases, 5(1), 42–52.

    Article  Google Scholar 

  • Freeman, M. C., Garn, J. V., Sclar, G. D., Boisson, S., Medlicott, K., Alexander, K. T., et al. (2017). The impact of sanitation on infectious disease and nutritional status: A systematic review and meta-analysis. International Journal of Hygiene and Environmental Health, 220, 928–949.

    Article  Google Scholar 

  • Grossman, G. M., & Krueger, A. B. (1995). Economic growth and the environment. The Quarterly Journal of Economics, 110(2), 353–377.

    Article  Google Scholar 

  • Günther, I., & Schipper, Y. (2013). Pumps, germs and storage: The impact of improved water containers on water quality and health. Health Economics, 22, 757–774.

    Article  Google Scholar 

  • Hunter, P. R., MacDonald, A. M., & Carter, R. C. (2010). Water supply and health. PLoS Medicine, 7(11), e1000361. https://doi.org/10.1371/journal.pmed.1000361.

    Article  Google Scholar 

  • Jalan, J., & Ravallion, M. (2003). Does piped water reduce diarrhea for children in rural India? Journal of Econometrics, 112, 153–173.

    Article  Google Scholar 

  • Kremer, M., Leino, J., Miguel, E., & Zwane, A. P. (2011). Spring cleaning: Rural water impacts, valuation, and property rights institutions. The Quarterly Journal of Economics, 126, 145–205.

    Article  Google Scholar 

  • Lagro-Janssen, T., Wong, S. L. F., & van den Muijsenbergh, M. (2008). The importance of gender in health problems. The European Journal of General Practice, 14(1), 33–37.

    Article  Google Scholar 

  • Okyere, C. Y. (2018). Water quality in multipurpose water systems, sanitation, hygiene and health outcomes in Ghana (pp. 1–183). Doctoral thesis submitted to Faculty of Agriculture, University of Bonn, Germany. Available online at http://hss.ulb.uni-bonn.de/2018/4854/4854.htm.

  • Okyere, C. Y., & Asante, F. A. (2017). Perceptions and determinants of households’ participation in a randomized evaluation on water quality testing and information in Southern Ghana. Water Policy, 19, 1206–1224.

    Article  Google Scholar 

  • Okyere, C. Y., Pangaribowo, E. H., Asante, F. A., & von Braun, J. (2017). The impacts of household water quality testing and information on safe water behaviors: Evidence from a randomized experiment in Ghana (p. 57). Bonn: ZEF-Discussion Papers on Development Policy No. 234, Center for Development Research. Available online at http://www.zef.de/uploads/tx_zefnews/zef_dp_234.pdf.

  • Okyere, C. Y., Pangaribowo, E. H., & Gerber, N. (2019). Household water quality testing and information: Identifying impacts on health outcomes, and sanitation and hygiene-related risk-mitigating behaviors. Evaluation Review. https://doi.org/10.1177/0193841X19885204.

    Article  Google Scholar 

  • Pal, S. (1999). An analysis of childhood malnutrition in rural India: Role of gender, income and other household characteristics. World Development, 27(7), 1151–1171.

    Article  Google Scholar 

  • Pitt, M. M., & Rosenzweig, M. R. (1985). Health and nutrient consumption across and within farm households. The Review of Economics and Statistics, 67(2), 212–223.

    Article  Google Scholar 

  • StataCorp. (2015). Stata statistical software: Release 14. College Station, TX: StataCorp LP.

    Google Scholar 

  • Tofail, F., Fernald, L. C. H., Das, K. K., Rahman, M., Ahmed, T., Jannat, K. K., et al. (2018). Effect of water quality, sanitation, hand washing, and nutritional interventions on child development in rural Bangladesh (WASH Benefits Bangladesh): A cluster-randomised controlled trial. The Lancet Child and Adolescent Health, 2, 255–268.

    Article  Google Scholar 

  • Wang, A., McMahan, L., Rutstein, S., Stauber, C., Reyes, J., & Sobsey, M. D. (2017). Household microbial water quality testing in a peruvian demographic and health survey: Evaluation of the compartment bag test for Escherichia coli. The American Journal of Tropical Medicine and Hygiene, 96(4), 970–975.

    Article  Google Scholar 

  • Zhang, J. (2012). The impact of water quality on health: Evidence from the drinking water infrastructure program in rural China. Journal of Health Economics, 31, 122–134.

    Article  CAS  Google Scholar 

  • Zwane, A., & Kremer, M. (2007). What works in fighting diarrheal diseases in developing countries? A critical review. National Bureau of Economic Research (NBER) Working Paper 12987, May, Cambridge, US.

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Acknowledgements

Data from the AG-WATSAN project undertaken by Center for Development Research (ZEF), University of Bonn, Germany, are duly acknowledged. The data collection was funded by Bill and Melinda Gates Foundation and Dr. Hermann Eiselen Doctoral Programme of the Fiat Panis Foundation under the AG-WATSAN project at the Center for Development Research (ZEF), University of Bonn, Germany. I thank the editor and anonymous reviewers for their comments and suggestions which greatly improved the content of this article.

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Okyere, C.Y. Environmental quality, gender and health outcomes in Southern Ghana. Environ Dev Sustain 22, 7865–7886 (2020). https://doi.org/10.1007/s10668-019-00550-x

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