Does project-level aid for water and sanitation improve child health outcomes? evidence from household panel data in Uganda

ABSTRACT Map showing location of water and sanitation projects funded by aid and the number of households represented in the survey in each district. Table showing the regression estimates. Figure plots the percent of children that are stunted by relative age and distance to a completed project. Colors refer to the different relative ages of the children. Empirical studies on the effectiveness of aid to the water, sanitation, and hygiene sector (WASH aid) have focused primarily on whether WASH aid increases access to water and sanitation. However, given the importance of WASH services for public health in low- and middle-income countries, the effectiveness of WASH aid should also be evaluated in terms of its impact on health outcomes. This paper combines geocoded sub-national data on the location of WASH aid projects in Uganda with six waves of nationally representative household-level panel survey data covering the period 2005–16 to examine the impact of WASH aid on child health outcomes. We examine the impact of proximity to aid-funded WASH projects on child stunting using a difference-in-differences strategy that incorporates group-based control groups to account for unobservable factors. We find that proximity to aid-funded WASH projects is associated with a 14–21% lower probability of stunting. The intensity of this association dissipates with distance and diminishes for groups born in subsequent years, suggesting the benefits associated with these projects may fade over time. The results are consistent with the view that scaling up aid to the WASH sector can help improve child health outcomes in the country.