Working Paper: NBER ID: w23239
Authors: Sonia R. Bhalotra; Alberto Diaz-Cayeros; Grant Miller; Alfonso Miranda; Atheendar S. Venkataramani
Abstract: Historically, improvements in municipal water quality reduced mortality substantially in wealthy countries. However, water disinfection has not produced equivalent benefits in developing countries today. We investigate this puzzle by analyzing a large-scale municipal water disinfection program in Mexico that increased water chlorination coverage from 55% to 90% within 18 months. On average, the program reduced childhood diarrheal disease mortality rates by 50%. However, age (degradation) of water pipes and inadequate sanitation infrastructure attenuated these benefits substantially, ranging from no decline in cities with the worst infrastructure to 80% in those with the best – a decline consistent with historical experience.
Keywords: water disinfection; child mortality; sanitation; infrastructure
JEL Codes: H41; I18; J11
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Programa Agua Limpia (PAL) (Q25) | childhood diarrheal disease mortality rates (I15) |
| better infrastructure (H54) | childhood diarrheal disease mortality rates (I15) |
| older and degraded water systems (Q25) | effectiveness of PAL (O22) |
| extensive sewage infrastructure (H76) | health benefits from PAL (I14) |
| compensatory behavior (D91) | health benefits from PAL (I14) |