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1 sangita - dse conf-slides_13_7_28

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1 sangita - dse conf-slides_13_7_28

  1. 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
  2. 2. The Context  Open 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? 2
  3. 3. Summary Statistics 3
  4. 4. Medical/Epidemiological Literature Child Stunting Fecal-oral contamination and diarrhea (Chekley et al 2008) Environmental enteropathy (Humphrey 2009, Lin et al 2013, Kosek et al 2013) 4
  5. 5. Economic Literature  Hammer 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 5
  6. 6. Two is the Magic Number 6 Data from Cambodia DHS 2010.
  7. 7. Good Toilets Make Good Neighbors 7 Data from Cambodia DHS 2010.
  8. 8. Spurious Correlations?  Fixed effects analysis: control for persistent regional- level differences by looking at change over time within regions  Were regions where open defecation decreased by more the regions where child height increased by more, on average?  Include control variables 8
  9. 9. Change Within Regions 9
  10. 10. Fixed Effects Estimation 10
  11. 11. 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 11
  12. 12. Regression Results 12
  13. 13. Regression Results 13
  14. 14. Change Over Years 2005 2010 -2-1.8-1.6-1.4-1.2 height-for-agez-score 0 .2 .4 .6 .8 1 open defecation in child's locality 2010 2005 year averages 14
  15. 15. Not Shown Here..  Blinder-Oaxaca decomposition  Non-parametric reweighting decomposition 15
  16. 16. Take-aways  Latrines 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 16

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