Second[3]

Motivation
Summary
Strengths/Economic Arguments
Critics
Does Piped Water Reduce Diarrhea for children in
Rural India?
Jyotsna Jalan and Martin Ravallion
Lucie ASSONFACK KANA,TOE Newton and Wilfried
ADOHINZIN
African School Of Economics
Fall 2016
Lucie, Newton and Wilfried Does Piped Water Reduce Diarrhea for children in Rural India?

Motivation
Summary
Critics
Motivation/Background
Four millions children under the age of ﬁve die each year from
diarrhea, mainly in developing countries (World Health Organi-
zation).
Unsafe drinking water is widely thought to be a major cause.
India undoubtedly accounts for more child death due to unsafe
water than any other single country.
Estimates indicate that one ﬁfth of the population of rural India
do not have access to safe drinking water, (World Bank, 2000).
Parikh et al (1999) quote an estimate of 1.5 million child deaths
per year in India due to diarrhea and others diseases related to
poor water quality.

Motivation
Summary
Critics
Research Objectives
The main objectives of this paper are to:
Estimate the impacts on child health of piped water in devel-
oping country.
Quantify the child health gains in terms of diarrheal disease
from policy interventions that expand access to piped water
and to see how this gains vary with household circumstances,
notably Income and Education.

Motivation
Summary
Critics
Research Questions
Is the child less vulnerable to diarrheal disease if he/she lives
in a household with access to piped water?
Do children in poor, or poorly educated households realized the
same health gains from piped water as others?
Does Income matter independently of parental education?

Motivation
Summary
Critics
Data
1993-1994 household survey conducted by the India’s National
council of Applied Economic Research.
Sample includes 9000 households with piped water and 24000
without.
Survey collect detailed information on education and health
status of 33000 rural households from 1765 villages covering
16 states in India.

Motivation
Summary
Critics
Identification Strategy
Propensity Score Matching
Two groups are identified:
Households with access to piped water(Di = 1) and
Households with no access(Di = 0).
So propensity score for individual i is given by:
P(xi) = Prob(Di = 1|xi), 0 < P(xi) < 1 (1)
Where xi is a vector of pre-exposure control variable.
Nearest neighbor to the i’th treated is defined as the non-treated
that minimizes [P(xi) − P(xj)]2 over all j in the set of non-
participant.

Motivation
Summary
Critics
Propensity Score Matching
P(xk) is the predicted odd ratio for observation k ie,
P(xi) =
ˆP(xi)
1 − ˆP(xi)
(2)
Let ∆Hj denote the gain in health status for the j’th child
attributable to access to piped water, the estimator of mean
impact is:
¯∆H =
T
j=1
ωj(hj1 −
C
i=1
Wijhij0) (3)
The propensity scores are estimated using a logistic regression.

Motivation
Summary
Critics
Notations
hj1 is the post-intervention health indicator.
hij0 is the outcome indicator of the i’th household non-treated
matched to the j’th household treated.
T is the total number of treated households.
C is the total number of non-treated households.
ωj’s are the sampling weights used to construct the mean im-
pact estimator and,
Wij’s are the weights applied in calculating the average income
of the matched non-participants.

Motivation
Summary
Critics
The Behavioural Model
Level of spending is chosen by parents to maximize
U(y − s, w, x) + h(s, w, x) (4)
U is the utility of the parents and h indicates the child health.
Given the optimal spending by the parents, their maximum util-
ity is given by:
V (w, y, x) ≡ H(w, y, x) + U(y − s(w, y, x), w, x) (5)
Child health when parental inputs are optimal is
H(w, y, x) = h(s(w, y, x), w, x)) (6)

Motivation
Summary
Critics
The Behavioural Model (2)
Eﬀect of w on child health
Hw = hsSw + hw (7)
Sw =
uyw)−hsw
hss − uyy
(8)
Income eﬀect on the health gain from piped water
Hwy = Sy(hsw − Swhss) + hsSwy (9)
Sy =
uyy
hss + uyy
(10)

Motivation
Summary
Critics
Results
No signiﬁcant diﬀerence in mean propensity scores for the groups.
0.3743 (0.189) for those with piped water versus
0.3742 (0.189) for the matched control group
Table: Summary statistics, Jallan, Ravallion (2003)

Motivation
Summary
Critics
Results(2)
Table: Estimates of logistic regression

Motivation
Summary
Critics
Results(3)
Table : Impacts on prevalence and duration for children under ﬁve

Motivation
Summary
Critics
Results(4)
Table : Child-Health Impacts of piped water by income and
education
Notes: Figures in parentheses are the respective standard errors; *indicates signiﬁcance at 5% or lower.

Motivation
Summary
Critics
Results(5)
Table: Diﬀerential impacts of piped water inside the house

Motivation
Summary
Critics
Conclusion
We find significantly lower prevalence and duration of the dis-
ease for children living in households with piped water as com-
pared to a comparison group of households matched on the
basis of their propensity scores. However, matching at village
level instead does not indicate lower diarrhea prevalence or du-
ration.
There are striking differences in child-health gains from piped
water according to family income and adult female education.

Motivation
Summary
Critics
Conclusion
Health gains from piped water tend to be lower for children
with less well-educated women in the household.
When we look at only the sub-sample of households with access
to either source of piped water and compare the prevalence and
duration of diarrhea among children under five across house-
holds with access from a tap inside the house versus access via
a public tap we find two striking effects: first the duration of
illness is reduced significantly if households have drinking water
source within the premise.
Second, the impact is greater in household where the female
member is illiterate.

Motivation
Summary
Critics
Strengths
This paper explained that combined infrastructure investments
with eﬀective public action to promote health knowledge and
income poverty reduction in order to improve child’s health
while recent study. August Ghooli et al. (2015) did not.
Jalan and Ravallion compares outcome indicators using indi-
vidual PSM versus village PSM jointly, which was not done in
previous studies, Esrey et al., (1991).
With the PSM procedure, only 650 households were lost in the
process over 33000 (about 2%).
Strong external validity as the context in India is very similar
to that of many other countries especially in Africa.

Motivation
Summary
Critics
Strengths (2)
This paper uses rich data for analysis which is a key ingredient
to well-written research paper.
Unlike other papers that just measure the impact of pipe water
on health of a child, this paper is the only paper that saw in-
depth relevance and roles mothers play in the health status of
a child.
To reduce morbidity and mortality in developing countries, this
paper is necessary for policy makers to implement particularly
applicable in rural areas.

Motivation
Summary
Critics
Some critics/limitations
This study uses only PSM, a non-experimental method to esti-
mate casual effect of treatment on controls which is subject to
two specific critics:
PSM accounts for observed (and observable) covariates, Garido
MM et al. (2014), Shadish, W. R; Cook, T. D. Campebll (2002).
Judea Pearl (2009) argues that bias may rise due to increase in
heterogeneity in unobserved factors.
Diarrhea is mostly a result of malnutrition and infection (World
Health Organization) for children under five years and malnu-
trition is a result of poor diet or unbalanced diet or even food
poison. Important factors might be omitted and end up then
in the error term.

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