The child health implications of privatizing Africa’s urban water supply

Identifying policies which can improve water sector management is critically important given the global burden of water-related disease. Each year, 1 in 10 child deaths—roughly 800,000 in total—is the direct result of diarrhea. Can private-sector participation (PSP) in the urban piped water sector improve child health? The author uses child-level data from 39 African countries during 1986–2010 to show that introducing PSP decreases diarrhea among urban dwelling children under five years of age by 5.6 percentage points, or 35 percent of its mean prevalence. PSP also leads to greater reliance on piped water. To attribute causality, the author exploits time variation in the private water market share controlled by African countries’ former colonizers. A placebo analysis reveals that PSP does not affect symptoms of respiratory illness in the same children, nor does it affect a rural control group unaffected by PSP.