On the Effects of Water and Sanitation on Child Mortality: Global Evidence from Demographic and Health Surveys

Isabel Gunther, Eidgenössische Technische Hochschule Zürich
Guenther Fink, Harvard School of Public Health

We combine all available DHS data sets with complete household information as well as birth and mortality records to estimate the effect of water and sanitation on child mortality. The estimates from our global data set comprising close to 800,000 observations across 68 countries and 174 surveys confirm the generally observed negative correlation between access to safe water and sanitation and infant mortality. However, the magnitude of the estimated effects is significantly smaller than the estimates typically found in the literature: we find that both improved sanitation and access to safe water decrease child mortality by about 5 to ten percent, less than half the magnitude typically reported. We discuss publication bias, model mis-specification and measurement error as possible explanations of these diverging results, and investigate the stability of the results across time and regions.