The Impact of Water Supply and Sanitation on Child Health: Evidence from Egypt

Using a combination of qualitative and quantitative data, this paper investigates whether access to improved sources of water and sanitation is an effective ―treatment‖ for the incidence of diarrhea among children under five years of age in Egypt. The qualitative component of the paper draws on in-depth interviews and focus group discussions with residents of three governorates to present an account of Egypt’s drinking water and sanitation services. The quantitative analysis then uses 2008 Egypt Demographic and Health Survey data to investigate the insights obtained from the qualitative research conducted on a large nationally representative sample. Both the quantitative and qualitative components of the study indicate that widespread access to improved sources of drinking water and toilet facilities exists across Egypt; however, service quality remains a significant problem in many areas. In particular, cuts in water supply— and the resulting practice of storing water—are quite common. A sizable percentage of flush toilet facilities are not connected to the public sewer system, and evacuation and disposal services for septic tanks are inadequate. Quantitative analysis, using propensity score matching techniques, indicates that having an uninterrupted water supply has a significant negative effect on the incidence of childhood diarrhea. Nevertheless, having a flush toilet facility connected to the sewer system is found to have a positive effect on the incidence of childhood diarrhea, leading us to conclude that there are other important measures of service quality not captured by the survey data used.