Toilets Can Work: Short and Medium Run Health Impacts of Addressing Complementarities and Externalities in Water and Sanitation

Esther Duflo, Michael Greenstone, Raymond Guiteras, Thomas Clasen

NBER Working Paper No. 21521
Issued in September 2015
NBER Program(s):The Environment and Energy Program, The Health Economics Program

Poor water quality and sanitation are leading causes of mortality and disease in developing countries. However, interventions providing toilets in rural areas have not substantially improved health, likely because of incomplete coverage and low usage. This paper estimates the impact of an integrated water and sanitation improvement program in rural India that provided household-level water connections, latrines, and bathing facilities to all households in approximately 100 villages. The estimates suggest that the intervention was effective, reducing treated diarrhea episodes by 30-50%. These results are evident in the short term and persist for 5 years or more. The annual cost is approximately US$60 per household.

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Document Object Identifier (DOI): 10.3386/w21521

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