82nd International Atlantic Economic Conference

October 13 - 16, 2016 | Washington, USA

Public versus private investment in determining child health outcomes: Evidence from India

Friday, October 14, 2016: 9:20 AM
Divya Balasubramaniam, Ph.D. , Economics, Saint Joseph's University, Philadelphia, PA
This paper examines the relationship between access to drinking water, sanitation facilities, and health outcomes for children in India. We use the National Family Health Survey (NFHS) 2005-2006 household-level survey data to construct the conditional nutritional distribution for two anthropometric health measures for children between ages six months to two years that capture both short term and longer term health outcomes: the weight-for-height (“wasting”-short term) and height-for-age (“stunting”-long term) z-scores. Using a quantile regressions approach, we find that public goods such as piped water and access to healthcare facilities are not associated with improving child health outcomes. On the other hand, private investments within the home such as pit latrines and flush toilets do have a strong influence on health outcomes, with the magnitude of the effects being the largest in the middle of the respective conditional nutritional distributions. Further, rural children at the lower end of the nutritional distribution benefit much more than their urban counterparts. We also find that the educational attainment of the mother has a strong association with better health outcomes, both in the short run as well as the long run. Finally, access to well water and boiling drinking water also matter, though their effects depend on whether the underlying health measure is a short term or long term one, and the child’s relative position in the conditional nutritional distribution. Over all, our results provide evidence against “one size fits all” policies, and point towards incentives for private investments in sanitation and mother’s education, especially in rural areas and for children in the middle of the conditional nutritional distribution.