81366 enGender Impact: The World Bank’s Gender Impact Evaluation Database How valuable are environmental health interventions? Evidence from a quasi-experimental evaluation of community water projects Author(s) Subhrendu Pattanayak, Christine Poulos, Jui-Chen Yang, Sumeet Patil Contact subrendu@rti.org Country India Organizing Theme Health, Voice and Agency Status Completed Intervention Category Community Driven Development, Water and Sanitation Sector Environment The Millennium Development Goals reflect the world’s collective hope and resolve to reverse a particularly pernicious, pervasive, and persistent set of problems in much of the world: high rates of diarrhea (the number one killer of small children), insufficient water and sanitation, and seemingly unsafe and myopic behaviors. Environmental health policies related to water and sanitation (W&S) must address the usual efficiency criteria (e.g., externalities), but also significant equity concerns. Health, time, and energy costs fall disproportionately on the poor, women and children. While there is an extensive literature on the appropriate theoretical model for evaluating welfare impacts, these have been rarely used in estimating gains from environmental health interventions both because adequate data for such evaluations are scarce and because few practitioners have explored how the textbook elegance of these models correspond to field realities. Thus, our paper uses a Abstract large-scale community-demand-driven (CDD) water supply project to (a) describe the challenges of welfare estimation using revealed preference data on multiple inputs and outputs, and (b) showcase a unique combination of propensity-score ‘pre-matching’ and rich panel data for estimating welfare impacts of a multi-dimensional environmental health project. Three years after project initiation, we found that the CDD project had had a significant impact on reported use of taps (13% increase) and toilets (7% increase). Diarrhea incidence fell significantly during the evaluation period in both project and control villages, suggesting weak health impacts of the project. In terms of economic welfare, we derive several empirical regularities related to illness and coping costs. Overall, our estimates of benefits indicate savings in coping costs equivalent to 5% of monthly expenditures, suggesting potentially significant gains from rural water and sanitation policies. Gender Connection Gender Informed Analysis Gender Outcomes Hand washing, sanitation IE Design Propensity Score Matching The program was launched by the government of Maharashtra to improve the state of water and sanitation in rural areas. The project promotes community-led service provisions Intervention using a Community Driven Development framework. The main objective of the program is to increase access to rural drinking water and sanitation services, institutionalize Last updated: 14 August 2013 1 enGender Impact: The World Bank’s Gender Impact Evaluation Database decentralized delivery and improve rural livelihoods. The project is being implemented in 2800 villages in 26 of the state's 33 districts. The intervention has three stages. First, communities participate in pre-planning and mobilization that establishes a Village Water and Sanitation Committee. Next, the committee plans interventions subject to review of a social audit committee. Finally, the committee establishes ongoing operation and maintenance procedures. Intervention Period 2003-2009 All households with at least one child under five were identified. A random sub-sample of Sample population 50 households within each village were interviewed. In total, 9500 households were interviewed The study compares villages that received the program to similar villages that did not Comparison conditions receive the program. Unit of analysis Community and individual level Evaluation Period Data were collected before and after the monsoon season in 2005 Overall, the program had a moderate but significant positive impact on the use of taps and toilets. In general, prevention behaviors such as hand washing and safe water handling do Results not change. Diarrhea incidence fell significantly, but no difference between treatment and control villages. The program significantly reduced the households' costs of coping with the dry season. It is hard to determine if the costs of coping are exogenous or endogenous to the treatment and health improvements. The intervention was not randomly allocated, making it more Primary study limitations difficult to identify the impact. The study claims the costs of procuring water mostly fall on the women in the household, but the study does not provide evidence to substantiate this claim. Funding Source World Bank SASES Pattanak, S., Poulos, C., Y ang, J, Patil, S. (2005) "How Valuable are environmental health Reference(s) interventions? Evidence from a quasi-experimental evaluation of community water projects." Link to Studies http://www.aere.org/meetings/documents/0608ValEval-pattanayak.pdf Microdata Last updated: 14 August 2013 2