A Logistic Analysis of Diarrhea Incidence and Access to Water and Sanitation

Few health issues are as common and insidious as diarrhea. Every year, there are more than 4 billion episodes that account for around 20% of children deaths. Yet, the pervasive effects of this malady do not stop with deaths: diarrhea can lead to malnutrition, stunting and wasting, especially if episodes are frequent. Moreover, long episodes of diarrhea weaken the immune system and make children more vulnerable to other diseases. Diarrhea is a symptom rather than a disease. There are several illnesses that can cause diarrhea but mostly it signals a gastrointestinal infection. Among the leading agents are cholera, typho, shinghella. Most of these agents have a common element: they can spread through contaminated water. Children in developing countries suffer on average three of such episodes each year (Kosek et al 2003). Although diarrhea related mortality has declined, it still represents the second largest single cause of child deaths. Evidence has shown that diarrhea causes malnutrition and more worryingly, this leads to a vicious circle where malnutrition leads to longer episodes of diarrhea. This paper is the second of a series of documents where we analyze the impact of water and sanitation on human development. While the companion paper looks at the effects of water and sanitation infrastructures on mortality, the aim of this study is to look at what can be termed an intermediate route through which poor water and sanitation infrastructure can have adverse effects on child survival. For this effect, we use a large set of Demographic and Health Surveys for 24 countries. We use statistical techniques extensively used in the medical research literature and in choice modeling.