Environmental quality, gender and health outcomes in Southern Ghana
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Environmental quality, gender and health outcomes in Southern Ghana Charles Yaw Okyere1,2 Received: 22 August 2018 / Accepted: 5 December 2019 © Springer Nature B.V. 2020
Abstract Using panel data collected from two administrative districts in Southern Ghana, this study investigates the relationship between environmental quality and health outcomes of households and individuals for a large set of water, sanitation and hygiene (WASH) indicators. The WASH indicators included in this study are comprehensive than those in most studies. Data analyses are undertaken using standard econometric techniques and double-robust multivalued treatment effects estimator. The study finds that there are relative and multiple overlapping policy effects of water and sanitation options in decreasing household diarrhea incidence. The estimates suggest that households’ use of improved water sources led to a statistically significant reduction in illness incidence of males but had little effect on females. The effects of households’ use of improved sanitation were generally mixed. Drinking water quantity decreased household diarrhea incidence but had little effects on individual illness incidence and distribution. The study does not find evidence that high microbial water quality decreases individual illness and household diarrhea incidence. The results suggest that the efficiency of water and sanitation interventions may depend on the gender of individuals, and indicators and unit of measurement of health outcomes. Keywords Health · Microbial water quality · Multiple overlapping treatment effects · Sanitation · Water quantity
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s1066 8-019-00550-x) contains supplementary material, which is available to authorized users. * Charles Yaw Okyere [email protected]; [email protected] 1
Department of Agricultural Economics and Agribusiness, College of Basic and Applied Sciences, University of Ghana, P. O. Box LG 68, Legon, Ghana
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Center for Development Research (ZEF), University of Bonn, Genscherallee 3, 53113 Bonn, Germany
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C. Y. Okyere
1 Introduction Environmental quality, particularly water, sanitation and hygiene (WASH), is important determinant of health in developing countries. Hence, economists and public health researchers have analyzed the correlates of health outcomes using various WASH indicators. For instance, Pitt and Rosenzweig (1985) found that household dietary intakes are affected by the source of drinking water. However, the source of drinking water has limited effects on illness incidence of husband or wife. According to Hunter et al. (2010), inadequate water supply has both direct and indirect negative effects on health of individuals. Pipe water is known to reduce diarrhea in rural India (Jalan and Ravallion 2003). However, studies on the interaction effects between WASH options are few. The interaction effects [i.e., substitutability (negative coefficient) or complementarity (positive c
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