Is poor sanitation killing more children in rural Zimbabwe? Results of propensity score matching method

While studies in developing countries have examined the role of maternal and socio-demographic factors on child mortality, the role of poor sanitation (open defecation) on child mortality outcomes in rural communities of sub-Saharan Africa has received less attention. This study sought to examine the link between poor sanitation and child mortality outcomes in rural Zimbabwe. The analysis uses data from four rounds of the nationally representative Demographic and Health Survey for Zimbabwe conducted in 1994, 1999, 2005/06, and 2010/11. Using propensity score matching, we find that children living in households with no toilet facilities are 2.43 percentage points more liable to be observed dead by the survey date, 1.3, and 2.24 percentage points more likely to die before reaching the age of one and five years respectively. We also examined the possible differences in survival among female and male children. Our results indicate that male children are more liable to be observed dead by the survey date than female children. Also, female children have a slight survival advantage over boys during the under-five period. Our results suggest the need for more investments in basic sanitary facilities in Zimbabwe’s rural areas to mitigate the potential devastating impacts of poor sanitation on child survival.