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卫生问题之一，影响到10亿多人，并使数百万儿童的生命灭灭。本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，水质差，腹泻病导致的儿童死亡率高（占5岁以下儿童死亡的11%）。许多干预措施发现，饮用水加氯是一种有效的解决办法。然而，大多数干预措施发现干预后使用率显著下降。这项研究将有助于回答以下问题：缺乏长期使用和需求是因为家庭认为这项技术对他们没有好处吗？或者，是家庭无法观察到任何实际收益（记录和观察信息的问题）？为了实现这一目标，将进行为期一年的实地试验，试图确定为什么在免费提供技术的项目干预后，家庭长期使用廉价、容易获得和易于使用的去污技术（如氯片）的情况会随着时间的推移而减少。具体而言，它将测试家庭是否能够观察到改善饮用水质量带来的短期健康益处，方法是让家庭使用一种易于理解的信息工具，记录家庭成员中腹泻的发病率/流行率和氯片的使用情况。通过明确记录和观察腹泻患病率和氯的使用情况，边缘家庭应选择使用氯。拟议的项目与其他研究不同，原因如下。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提供对家庭健康和饮用水质量的影响，结果很明确：吸收率高，腹泻发病率大幅降低，饮用水质量得到改善。然而，尽管这些项目在干预阶段的吸收程度高，效果明显，但项目后对处理技术的需求和使用往往很低（即使干预后价格低/零）。信息干预的记录好坏参半：它们建议行为上的细微调整，而长期行为改变的问题却没有得到解决。没有一项利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，目前还没有研究关注让家庭生成和使用自己的信息的想法。Jalan和Somanathan（2008）以及Madajewicz（2007）提供第三方/权威信息，而Kremer等人（2009）和Dupas（2010）则关注同伴的影响，这些都是“外部”信息渠道。此外，大多数研究假设干预和影响之间的联系被家庭充分观察到，但值得质疑这一假设。最后，Dupas（2010）和Kremer等人（2009）认为，更脆弱的家庭不太可能使用和维持卫生技术的使用。这意味着家庭的信息集与“真实”信息集之间存在差距。这项研究将试图通过使氯化水对家庭的影响显而易见来弥合这一差距。

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.