Access to proper sanitation helps keep children healthy, but millions of people in the developing world still practice open defecation, putting children at risk.
... See More + Diarrhea, which can result from the spread of fecal material into food or mouths, kills around 800,000 children under the age of five every year and leaves millions more malnourished and stunted. What's the best way to create lasting change? Previous efforts often focused on encouraging individuals to invest in toilets for their households, but gains are limited if not everyone in the village does the same. One reason may be that sanitation has a communal element because even if only one family in a neighborhood practices open defecation, all families may be at risk of ingesting fecal matter. Sanitation therefore presents a unique challenge: If an individual family invests in a toilet, but their neighbors don't, are there still positive benefits? What proportion of households need to have improved sanitation for benefits to be seen across the whole village? And what's the impact in a village that goes from zero toilet use to full coverage? The World Bank is committed to helping countries develop the necessary infrastructure and practices to improve sanitation, reducing barriers families may face in raising healthy children. To better understand the impact of a whole village using improved sanitation – such as private toilets or pit latrines – compared with just a few people in the village having access to toilets, World Bank researchers analyzed a national survey database on more than 200,000 children younger than four years old in rural India. More than two-thirds of the people in the rural areas defecate in the open. The study found that diarrhea prevalence halved when sanitation coverage at community level is fully achieved. The study says that these results are mostly due to the positive spillover effects on everyone's health that occurs when all (or the overwhelming majority of) households have toilets. The findings can help governments and development practitioners understand the importance of taking a communal approach to the problem.
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This paper estimates two sources of benefits related to sanitation infrastructure access on early childhood health: a direct benefit a household receives when moving from open to fixed-point defecation or from unimproved sanitation to improved sanitation, and an external benefit (externality) produced by the neighborhood's access to sanitation infrastructure.
... See More + The paper uses a sample of children under 48 months in rural areas of India from the Third Round of District Level Household Survey 2007-08 and finds evidence of positive and significant direct benefits and concave positive external effects for both improved sanitation and fixed-point defecation. There is a 47 percent reduction in diarrhea prevalence between children living in a household without access to improved sanitation in a village without coverage of improved sanitation and children living in a household with access to improved sanitation in a village with complete coverage. One-fourth of this benefit is due to the direct benefit leaving the rest to external gains. Finally, all the benefits from eliminating open defecation come from improved sanitation and not other sanitation solutions.
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Policy Research Working Paper WPS6737 JAN 01, 2014
Andres, Luis A.; Briceno, Bertha; Chase, Claire; Echenique, Juan A.Disclosed
