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.
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Data from the AG-WATSAN project undertaken by Center for Development Research (ZEF), University of Bonn, Germany, are duly acknowledged. The data collection was funded by Bill and Melinda Gates Foundation and Dr. Hermann Eiselen Doctoral Programme of the Fiat Panis Foundation under the AG-WATSAN project at the Center for Development Research (ZEF), University of Bonn, Germany. I thank the editor and anonymous reviewers for their comments and suggestions which greatly improved the content of this article.
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Okyere, C.Y. Environmental quality, gender and health outcomes in Southern Ghana. Environ Dev Sustain 22, 7865–7886 (2020). https://doi.org/10.1007/s10668-019-00550-x
- Microbial water quality
- Multiple overlapping treatment effects
- Water quantity