Doctoral Dissertation Research in Economics: Improving Drinking Water Quality amongst Poor Households

饮用水供应不足是发展中国家最严重和最持久的环境健康问题之一，影响到10亿多人，并扼杀了数百万儿童的生命。这项研究选择的地点是卡拉奇（巴基斯坦），与发展中国家的许多大城市一样，这里的水质很差，儿童因腹泻病死亡率很高（五岁以下儿童死亡率为11%）。许多干预措施发现，对饮用水进行氯化是一种有效的解决方案。然而，大多数干预措施发现，干预后的使用显着下降。这项研究将有助于回答以下问题：缺乏长期的使用和需求，因为家庭的结论是，该技术并没有使他们受益？还是住户无法观察到任何真实的收益（记录和观察信息方面的问题）？为了实现这一目标，将进行为期一年的实地实验，试图确定为什么在免费提供技术的项目干预措施之后，家庭长期使用廉价、容易获得和易于使用的净化技术（如氯片）的情况会随着时间的推移而下降。具体而言，它将测试家庭是否能够观察到改善饮用水质量的短期健康效益，方法是让家庭使用一种易于理解的信息工具，记录家庭成员腹泻的发生率/流行率和氯片的使用情况。通过明确记录和观察腹泻的流行情况和氯的使用情况，边缘家庭应该选择使用氯。政策可以通过影响价格和信息来影响行为。在价格方面，已经广泛研究了免费供水对家庭健康和饮用水质量的影响，结果是明确的：使用率高，疟疾发病率大幅下降，饮用水质量得到改善。然而，尽管在这些项目的干预阶段，人们对处理技术的接受程度很高，而且效果明显，但项目后对处理技术的需求和使用往往很低（即使干预后价格很低/为零）。信息干预有一个混合的记录：他们建议在行为上的小调整，而长期的行为变化的问题是没有解决。没有一项使用信息的研究能够清楚地追踪信息改变饮用水处理行为的特定机制。此外，还没有研究探讨让家庭产生和使用自己的信息的想法。Jalan and Somanathan（2008）和Madaenicz（2007）提供了第三方/权威信息，而Kremer等人（2009）和Dupas（2010）研究了同行的影响，所有这些都是“外部”信息渠道。此外，大多数研究假定，家庭充分观察到干预与影响之间的联系，但这一假设值得质疑。最后，Dupas（2010年）和Kremer等人（2009年）认为，较脆弱的家庭并不更有可能使用和持续使用卫生技术。这意味着家庭信息集与“真实”信息集之间存在差距。这项研究将试图通过使水氯化对家庭的影响显而易见来弥补这一差距。

Inadequate drinking water access is one of the most significant and persistent environmental health problems in developing countries, affecting more than a billion people and extinguishing the lives of millions of children. The site chosen for this study, Karachi (Pakistan), like many large cities in the developing world, has poor water quality and high child mortality due to diarrheal disease (11% of under-five deaths). Numerous interventions have found that chlorinating drinking water is an effective solution. However, most interventions find a significant drop in post-intervention usage.This study will help to answer the following questions:Is the lack of long-term usage and demand because households conclude that the technology does not benefit them?Or, is it that households are unable to observe any real gain (a problem in recording and observing information? To accomplish this, a yearlong field experiment will be undertaken that attempts to determine why households' long run use of cheap, easily accessible and easy-to-use decontamination technologies (like chlorine tablets) declines over time after project interventions that provide the technology for free. Specifically, it will tested whether households are able to observe the short-term health benefits of improved drinking water quality by having households use an easy-to-understand information tool that records both the incidence/prevalence of diarrhea amongst household members and the use of chlorine tablets. By explicitly recording and observing the prevalence of diarrhea and the use of chlorine, the marginal household should choose to use chlorine.The proposed project is different to other studies for the following reasons. Policy can influence behavior by impacting price and information. In terms of price, the impact of free provision on household health and drinking water quality has been extensively studied and the results are clear: uptake is high, diarrheal morbidity is drastically reduced and drinking water quality is improved. However, despite high uptake and apparent effectiveness during the intervention phase of such projects, post-project demand and use for treatment technologies tends to be low (even with low/zero prices post-intervention). Information interventions have a mixed record: they suggest minor adjustments in behavior, while the problem of long term behavioral change is left unaddressed. No study that uses information is able to clearly trace the particular mechanism through which information changes drinking water treatment behavior. Additionally, no study has yet looked at the idea of getting households to generate and use their own information. Jalan and Somanathan (2008) and Madajewicz (2007) provide third-party/authority information, while Kremer et al. (2009) and Dupas (2010) look at the impact of peers, all "outside" information channels. Moreover, most studies assume that the link between intervention and impacts is fully observed by households but it is worth questioning this assumption. Finally, Dupas (2010) and Kremer et al. (2009) suggest that more vulnerable households are not more likely to use and sustain usage of a health technology. This implies that there is a gap between households' information-set and the "true" information-set. This study will attempt to bridge this gap by making the impacts of water chlorination apparent to households.