Doctoral Dissertation Research in Economics: Improving Drinking Water Quality amongst Poor Households

Yale University, New Haven CT

Investigators

Abstract

Inadequate drinking water access is one of the most significant and persistent environmental health problems in developing countries, affecting more than a billion people and extinguishing the lives of millions of children. The site chosen for this study, Karachi (Pakistan), like many large cities in the developing world, has poor water quality and high child mortality due to diarrheal disease (11% of under-five deaths). Numerous interventions have found that chlorinating drinking water is an effective solution. However, most interventions find a significant drop in post-intervention usage. This study will help to answer the following questions: Is the lack of long-term usage and demand because households conclude that the technology does not benefit them? Or, is it that households are unable to observe any real gain (a problem in recording and observing information? To accomplish this, a yearlong field experiment will be undertaken that attempts to determine why households' long run use of cheap, easily accessible and easy-to-use decontamination technologies (like chlorine tablets) declines over time after project interventions that provide the technology for free. Specifically, it will tested whether households are able to observe the short-term health benefits of improved drinking water quality by having households use an easy-to-understand information tool that records both the incidence/prevalence of diarrhea amongst household members and the use of chlorine tablets. By explicitly recording and observing the prevalence of diarrhea and the use of chlorine, the marginal household should choose to use chlorine. The proposed project is different to other studies for the following reasons. Policy can influence behavior by impacting price and information. In terms of price, the impact of free provision on household health and drinking water quality has been extensively studied and the results are clear: uptake is high, diarrheal morbidity is drastically reduced and drinking water quality is improved. However, despite high uptake and apparent effectiveness during the intervention phase of such projects, post-project demand and use for treatment technologies tends to be low (even with low/zero prices post-intervention). Information interventions have a mixed record: they suggest minor adjustments in behavior, while the problem of long term behavioral change is left unaddressed. No study that uses information is able to clearly trace the particular mechanism through which information changes drinking water treatment behavior. Additionally, no study has yet looked at the idea of getting households to generate and use their own information. Jalan and Somanathan (2008) and Madajewicz (2007) provide third-party/authority information, while Kremer et al. (2009) and Dupas (2010) look at the impact of peers, all "outside" information channels. Moreover, most studies assume that the link between intervention and impacts is fully observed by households but it is worth questioning this assumption. Finally, Dupas (2010) and Kremer et al. (2009) suggest that more vulnerable households are not more likely to use and sustain usage of a health technology. This implies that there is a gap between households' information-set and the "true" information-set. This study will attempt to bridge this gap by making the impacts of water chlorination apparent to households.