Freshwater availability and water fetching distance affect child health in sub-Saharan Africa
Abstract
Currently, more than two-thirds of the population in Africa must leave their home to fetch water for drinking and domestic use. The time burden of water fetching has been suggested to influence the volume of water collected by households as well as time spent on income generating activities and child care. However, little is known about the potential health benefits of reducing water fetching distances. Data from almost 200, 000 Demographic and Health Surveys carried out in 26 countries were used to assess the relationship between household walk time to water source and child health outcomes. To estimate the causal effect of decreased water fetching time on health, geographic variation in freshwater availability was employed as an instrumental variable for one-way walk time to water source in a two-stage regression model. Time spent walking to a household's main water source was found to be a significant determinant of under-five child health. A 15-min decrease in one-way walk time to water source is associated with a 41% average relative reduction in diarrhea prevalence, improved anthropometric indicators of child nutritional status, and a 11% relative reduction in under-five child mortality. These results suggest that reducing the time cost of fetching water should be a priority for water infrastructure investments in Africa.
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- Authors
- Pickering, A. J., & Davis, J.
- Affiliations
- Stanford University (US)
- Corresponding author
- Pickering, Amy J.
- Davis, Jennifer
- Venue
- Environmental Science & Technology
- Publisher
- American Chemical Society (ACS)
- Published
- 2012-02-09
- Volume
- 46
- Issue
- 4
- Pages
- 2391-2397
- ISSN
- 0013-936X (ISSN-L)
- 1520-5851
- OpenAlex
- W1996840718
- Cited by
- 264
- References
- 36
- Citations by year
- 2026: 11 · 2025: 24 · 2024: 17 · 2023: 20 · 2022: 16 · 2021: 25 · 2020: 17 · 2019: 25 · 2018: 22 · 2017: 16 · 2016: 21 · 2015: 20 · 2014: 14 · 2013: 14 · 2012: 1
- FWCI
- 14.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Environmental Science & Technology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Earth Sciences
- Ministry of Education, India
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Physical Sciences › Environmental Science › Water Science and Technology › Water Resource Management and Quality
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- water fetching, child health, under-five mortality, diarrhea, child nutritional status, anthropometric indicators, time burden, water infrastructure investment, freshwater availability, sub-Saharan Africa
- MeSH terms
- Body Height, Body Weight, Child, Preschool, Cough, Diarrhea, Fever, Fresh Water, Humans, Infant, Infant, Newborn, Water Supply, Walking, Africa South of the Sahara, Child Mortality, Drinking Water
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