Water system unreliability and diarrhea incidence among children in Guatemala

Jennifer Trudeau (), Anna-Maria Aksan () and William F. Vásquez ()
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Jennifer Trudeau: Sacred Heart University
Anna-Maria Aksan: Fairfield University
William F. Vásquez: Fairfield University

International Journal of Public Health, 2018, vol. 63, issue 2, No 11, 250 pages

Abstract: Abstract Objectives This article examines the effect of water system unreliability on diarrhea incidence among children aged 0–5 in Guatemala. Methods We use secondary data from a nationally representative sample of 7579 children to estimate the effects of uninterrupted and interrupted water services on diarrhea incidence. The national scope of this study imposes some methodological challenges due to unobserved geographical heterogeneity. To address this issue, we estimate mixed-effects logit models that control for unobserved heterogeneity by estimating random effects of selected covariates that can vary across geographical areas (i.e. water system reliability). Results Compared to children without access to piped water, children with uninterrupted water services have a lower probability of diarrhea incidence by approximately 33 percentage points. Conversely, there is no differential effect between children without access and those with at least one day of service interruptions in the previous month. Results also confirm negative effects of age, female gender, spanish language, and garbage disposal on diarrhea incidence. Conclusions Public health benefits of piped water are realized through uninterrupted provision of service, not merely access. Policy implications are discussed.

Keywords: Guatemala; Diarrheal incidence; Morbidity; Tap water; Service interruptions (search for similar items in EconPapers)
Date: 2018
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Citations: View citations in EconPapers (2)

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DOI: 10.1007/s00038-017-1054-6

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