Sanitation and child health in India

Our study contributes to the understanding of key drivers of stunted growth, a factor widely recognized as major impediment to human capital development. Specifically, we examine the effects of sanitation coverage and usage on child height for age in a semi-urban setting in Northern India. Although sanitation – broadly defined as hygienic means of promoting health through prevention of human contact with the hazards of wastes, particularly human waste – has long been acknowledged as an indispensable element of disease prevention and primary health care programmes, a large number of recent impact evaluation studies on sanitation interventions in low income countries fail to find any health improvements. We address endogeneity of sanitation coverage through an instrumental variable approach, exploiting variation in raw material construction prices. Doing so, we find that sanitation coverage plays a significant and positive role in height growth during the first years of life and that this causal relationship holds particularly for girls. Our findings suggest that a policy that aims to increase sanitation coverage in a context such as the one studied here, is not only effective in reducing child stunting but also implicitly targets girls.