Collaborative Research: Unintended Consequences of Behavior Change: An Examination of the Impacts on Child Health of Behavior Change in Response to Arsenic Mitigation in Bangladesh

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Policy recommendations often have unintended consequences. This study aims to investigate one such unintended consequence: persistent negative child health impacts of a massive shift in behavior that occurred in Bangladesh around 1999 as millions of households moved away from the use of convenient shallow tube- wells as a source of household drinking water to less convenient deep tube-wells. The shift was in response to concerns that arsenic contamination in shallow tube-wells would increase health risks. However, the associated health risks for young children of switching away from backyard water sources appear to have been sharply underestimated according to preliminary findings by the investigators, which point towards substantial increases in child deaths in households that switch water source.The empirical contribution of this study aims is to disentangle the impact of the behavioral shift from other socioeconomic factors that affect health. The researchers note that at the very local level there is quasi-random variation in arsenic contamination - with some households within the village contaminated and others, very close by, having uncontaminated wells. This analysis can therefore compare child mortality for households within the same village who do or do not have arsenic contamination in their water both before and after 1999, when the behavioral switch took place, and can thus identify the existence of unintended consequences. The work will contribute to determining the appropriate policy response to arsenic contamination across the world, and will develop methods that can be used to identify unintended consequences of multiple policy recommendations.