Child Undernutrition following the Introduction of a Large-Scale Toilet Construction Campaign in India

Parvati Singh, Manisha Shah and Tim A Bruckner

Department of Agricultural & Resource Economics, UC Berkeley, Working Paper Series from Department of Agricultural & Resource Economics, UC Berkeley

Abstract: BACKGROUND: Lack of toilets and the widespread practice of open defecation may contribute to India's large burden of child undernutrition. OBJECTIVES: We examine whether a large national sanitation campaign launched in 2014, the Swachh Bharat Mission (SBM), precedes a reduction in stunting and wasting among under 5-y-old (u5) children in India. METHODS: In this observational study, we used district-level data from before (2013-2014) and after (2015-2016) SBM from 3 national surveys to derive, as our outcomes, the percentage of u5 children per district who are stunted and wasted. We defined our exposures as 1) binary indicator of SBM and 2) percentage of households with toilets per district. Our analytic sample comprised nearly all 640 Indian districts (with ∼1200 rural/urban divisions per district per time point). Linear regression analyses controlled for baseline differences in districts, linear time trends by state, and relevant covariates. RESULTS: Relative to pre-SBM, u5 stunting declines by 0.06% (95% CI: -0.10, -0.01; P = 0.009) with every percentage increase in households with toilets post-SBM. Rural regions and districts with higher pre-SBM toilet availability show greater decline in u5 stunting post-SBM. CONCLUSIONS: An increase in toilet availability on a national scale, precipitated by the SBM sanitation campaign, is associated with a reduction in undernutrition among u5 children in India over the early phase of the campaign.

Keywords: 32 Biomedical and Clinical Sciences (for-2020); 3202 Clinical Sciences (for-2020); Pediatric (rcdc); Nutrition (rcdc); 2 Zero Hunger (sdg); Bathroom Equipment (mesh); Child (mesh); Child Nutrition Disorders (mesh); Humans (mesh); India (mesh); Malnutrition (mesh); Sanitation (mesh); Toilet Facilities (mesh); open defecation; sanitation; child stunting; India; Swachh Bharat Mission; Humans (mesh); Child Nutrition Disorders (mesh); Malnutrition (mesh); Sanitation (mesh); Toilet Facilities (mesh); Child (mesh); India (mesh); Bathroom Equipment (mesh); India; Swachh Bharat Mission; child stunting; open defecation; sanitation; Bathroom Equipment (mesh); Child (mesh); Child Nutrition Disorders (mesh); Humans (mesh); India (mesh); Malnutrition (mesh); Sanitation (mesh); Toilet Facilities (mesh); child undernutrition; sanitation; open defecation; India; stunting; quasi-experiment; 0702 Animal Production (for); 0908 Food Sciences (for); 1111 Nutrition and Dietetics (for); Nutrition & Dietetics (science-metrix); 3003 Animal production (for-2020); 3006 Food sciences (for-2020); 3210 Nutrition and dietetics (for-2020) (search for similar items in EconPapers)
Date: 2021-08-01
References: Add references at CitEc
Citations:

Downloads: (external link)
https://www.escholarship.org/uc/item/2nt8n57h.pdf;origin=repeccitec (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:cdl:agrebk:qt2nt8n57h

Access Statistics for this paper

More papers in Department of Agricultural & Resource Economics, UC Berkeley, Working Paper Series from Department of Agricultural & Resource Economics, UC Berkeley Contact information at EDIRC.
Bibliographic data for series maintained by Lisa Schiff ().