Urban Water Disinfection and Mortality Decline in Lower-Income Countries

Abstract

Historically, improvements in municipal water quality led to substantial mortality decline in today’s wealthy countries. However, water disinfection has not consistently produced large benefits in lower-income countries. We study this issue by analyzing a large-scale municipal water disinfection program in Mexico that increased water chlorination coverage in urban areas from 58 percent to over 90 percent within 18 months. We estimate that the program reduced childhood diarrheal disease mortality rates by 45 to 67 percent. However, inadequate sanitation infrastructure and age (degradation) of water pipes may have attenuated these benefits substantially. (JEL I12, I18, L95, O13, O18, Q25, Q53)