Don't shit on your own doorstep

I was talking to a water and sanitation programme manager a few weeks ago, who seemed frustrated that these stupid people kept crapping everywhere. Why would you shit on your own doorstep? The programme had several "behaviour change" interventions (horrible phrase, slightly Orwellian no?), but really, how hard should it be to not shit in the open?

One of the great things about economics is that it does not assume that people are just being dumb. It treats people with respect, and assumes first that there is probably a good reason why they are doing something which might seem irrational. I don't really know enough about water and sanitation, but I was suspicious of the idea that these recalcitrant natives just couldn't figure out what was good for them.

Does this paper prove me right?

"latrine use constitutes an externality rather than a pure private gain: It is the open defecation of one’s neighbors, rather than the household’s own practice, that matters most for child survival. The gradient and mechanism we uncover have important implications for child health and mortality worldwide, since 15% of the world’s population defecates in the open. To put the results in context, we find that moving from a locality where everybody defecates in the open to a locality where nobody defecates in the open is associated with a larger difference in child mortality than moving from the bottom quintile of asset wealth to the top quintile of asset wealth."

The problem then is a "simple" collective action problem (simple in the sense of understanding the nature of the problem, not at all simple to solve). This isn't that complicated stuff.

HT: kim yi dionne

Does slum upgrading work?

A new colleague at OPM Ruhi Saith is a co-author of a new Cochrane systematic review on the impact of slum upgrading programmes on health and wellbeing (full summary here).

They find only 5 studies which can demonstrate any causality, from which they find:

• "Limited but consistent evidence to suggest that slum upgrading may reduce diarrhoea in slum dwellers and that slum dweller’s water related expenses may also be reduced
• Mixed results for whether slum upgrading can reduce parasitic infections, educational outcomes, financial poverty and unemployment outcomes
• Very little information on other health or social outcomes, or which types of interventions were most beneficial"

Which reminds me of two things,

first, John Snow and the 1854 Broad Street cholera epidemic, when John used a mixed methods approach based on KII*, and a pathbreaking geographic data visualization infographic** which founded the science of epidemiology using one of the first natural experiments.

second, that there is really weak evidence that area-based initiatives have any impact on employment and well-being in the UK, and so policy should target people not places. 

Which suggests that slum upgrading should focus on providing the public goods and infrastructure with clear evidence of impact and cost effectiveness - namely clean water and sanitation - and be more modest about expectations for impacts on other outcomes which are not primarily determined by the slum environment, such as poverty, unemployment, and low education.

*Key informant interviews. Or talking to people. Yes I am mocking your terminology, quals.

**A map. Yes you too, data monkeys.