Measuring the value of toilets: The effect of sanitation on children's height in Indonesia

The paper examines the causal link between access to sanitation and stunting in children in Indonesia. Stunting is a long-term health issue, where children are shorter relative to their age as measured by height-for-age z-scores. The research proposes improvements in access to sanitation to reduce stunting. Open defecation practice is rampant in areas without sanitation facilities. Bacteria and germs thrive in such environment and would harm children's health and lead to stunting. World Bank data indicate that the stunting prevalence rate in Indonesia was 36.4 percent for children under the age of five in 2013. Approximately 23 percent of the population in Indonesia practice open defecation, 70 percent of which are in the rural areas. Recent studies on other developing countries provide evidence on the relationship between sanitation and stunting using cross-sectional and randomized control trial (RCT) methods. This paper complements the literature by using a panel data analysis. It is the first attempt at using panel data to investigate the impact of sanitation on stunting. Height-for-age is considered a long-term health outcome for children, making the use of panel data appealing. The paper uses variation in access to sanitation in villages by combining two data sets, the Indonesia Family Life Survey (IFLS) and Village Potential Statistics (PODES). Both the IFLS and PODES have information on village level sanitation. Currently the IFLS has four waves available, 1993, 1997, 2000, and 2007. PODES sanitation data is used to fill-in information during the IFLS survey gaps. The longitudinal nature of the data which are nationally representative provide added benefits to using a panel approach. The research exploits the differences in access to sanitation at the village level to examine its impact on stunting. The paper compares children across household, time, and space. Preliminary analysis suggests children in areas with better sanitation have higher height-for-age z-scores compared to those without access to sanitation. This result confirms the findings of existing work in literature on the pathway between sanitation and stunting.