The benefit of clean water on child health: An empirical analysis with specific reference to Escherichia Coli water contamination

Microorganism-mediated degradation of water quality is a major public health concern in developing countries. Previous literature has shown an association between household water pollution and childhood diarrhoea; however, its effects on child growth and respiratory health have not been widely investigated. This study assessed the effects of household drinking water contaminated with Escherichia coli (E. coli) on child’s weight-for-height and weight-for-age-z-scores, acute respiratory infections (ARI), and diarrhoea incidence among five years children in Pakistan. We used district-level spatial information and the latest waves of unique Multiple Indicator Cluster Survey (MICS) data containing information on ‘point-of-service delivery’(POS) and ‘point-of-consumption’ (POC) water quality, collected for the first time on a large scale in five regions of Pakistan. We employed an instrumental variable approach to address potential endogeneity issues in household drinking water quality, finding that POC drinking water contamination significantly affected children’s weight-for-height and weight-for-age z-scores and ARI, in addition to its effects on diarrhoea. The sub-sample analyses indicated that the effects of contaminated water were particularly significant in children aged 6 months and older and in children who did not receive vitamin A supplements. To protect the children from growth failure and contracting ARI and diarrhoea, household water quality should be improved.