Rainfall shocks, child mortality, and water infrastructure

Ponnusamy, Sundar

doi:10.1002/hec.4498

Cited by 5 publications

(3 citation statements)

References 81 publications

(124 reference statements)

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“…The sensitivity of changes in health or poverty to income is found to be a decreasing function of income inequality (Biggs et al., 2010; Fosu, 2010). In a recent study, Ponnusamy (2022) has shown that the effects of droughts on under‐five mortality tend to be higher in regions with higher income inequality, especially in low‐income group of countries. On the other hand, the studies that focus on the relationship between ethnic inequality and societal or developmental outcomes are limited, with the majority of studies focused on ethnic heterogeneity.…”

Section: Literaturementioning

confidence: 99%

Ethnic inequality and public health

Ponnusamy,

Hakeem

2023

Health Economics

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We examine the association between ethnic inequality and various key health outcomes for a global set of developed and developing countries. Our results show that higher ethnic inequality is associated with a poor state of public health, such as higher child and maternal mortality, increased stillbirths and child stunting, and reduced life expectancy at birth. This set of effects is found to be predominant mainly in developing countries, and Sub‐Saharan African countries. Results remain robust to the inclusion of various other measures of inequality, ethnic composition indices, geographic endowments, and other relevant controls. We argue that lower contraceptive usage and poor vaccination rates are potential mechanisms through which ethnic inequality affects health outcomes. Policies targeted at improving public health may need to focus more on these key intermediate channels in ethnic minority regions.

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Section: Literaturementioning

confidence: 99%

Ethnic inequality and public health

Ponnusamy,

Hakeem

2023

Health Economics

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“…The factors linking drought with increased health risks operate within the context of existing infrastructure and health service provision. Several studies have investigated mortalitymitigating channels, including exploiting quasi-experimental evidence on trade openness 4 , credit and liquidity access 5,6 , and water and sanitation infrastructure [7][8][9] . Yet, randomized controlled trial-based estimates of effective adaptation policies are missing 10 .…”

Section: Introductionmentioning

confidence: 99%

Weather Shocks, Child Mortality, and Adaptation: Experimental Evidence from Uganda

Nyqvist

Carnap

Guariso

et al. 2023

Preprint

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Background: Human-caused climate change is already increasing the intensity and frequency of extreme weather events, such as droughts. The health and economic consequences of these events are expected to be particularly severe for populations in low-income settings whose livelihoods rely on rain-fed agriculture. Within these populations, children are an especially vulnerable group, as undernutrition is linked to 45% of all child deaths across the globe. Despite progress, adaptation gaps exist. We still lack strong evidence on policies to effectively mitigate climate change's most severe consequences for children. In this paper we ask whether adaptation investments in the form of improved community healthcare can build climate resilience in a low-income country setting. Methods: We reanalyzed data from a clustered randomized controlled trial inducing spatial variation across 214 Ugandan villages in community-health program strengthening, and combined it with quasi-experimental data on locality-specific rainfall shocks. In the intervention clusters, financially incentivized community health workers (CHWs) were deployed over a three-year period to conduct home visits and provide integrated community case management and maternal, newborn, and child health treatment and preventive services. The trial followed 7,018 households with young children (3,790 in 115 intervention clusters and 3,228 in 99 control clusters) over three years. We estimated the effect of low rainfall in the growing season on infant mortality in the following (post-harvest and lean) period, conditional on CHW deployment, over six season-pairs in 2011-2013. Findings: There were 134 infant deaths in the intervention clusters (38.6 deaths per 1000 infant-years) over the three-year trial period. 60 deaths (40.7 deaths per 1000 infant-years) occurred in periods following growing seasons with rainfall below the long-run detrended mean (rainfall deficit seasons), and 74 deaths (36.8 deaths per 1000 infant-years) occurred in periods following growing seasons rainfall above the long-run detrended mean (rainfall surplus seasons). There were 160 infant deaths in the comparison clusters (61.3 deaths per 1000 infant-years). 83 deaths (81.5 deaths per 1000 infant-years) occurred in periods following rainfall deficit seasons, and 77 deaths (46.3 deaths per 1000 infant-years) occurred in periods following rainfall surplus seasons. Adjusting only for the stratified random assignment of clusters, the mean difference corresponded to a 46% reduction in under-five mortality rate (p=.000; adjusted rate ratio 0.54, 95% CI 0.39-0.73) following rainfall deficit seasons. The risk of infant deaths in the comparison relative to the intervention group increased in the magnitude of the rainfall deficit. Interpretation: Adaptation investments in a low-income context - here in the form of improved access to community health care - reduced the risk of infant mortality following adverse weather events.

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“…Child mortality rates are affected by all of these factors taken together. Low rainfall and drought can reduce the availability of clean water, which can raise the risk of waterborne diseases, while high temperatures can cause heat-related ailments [ 21 , 22 ]. Children's respiratory health is negatively impacted by rising CO 2 emissions, which contribute to air pollution [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Spatial spillover impact of determinants on child mortality in Pakistan: evidence from Spatial Durbin Model

Sheikh,

Khan,

Ahmed

et al. 2023

BMC Public Health

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Background Child mortality is a major challenge to public health in Pakistan and other developing countries. Reduction of the child mortality rate would improve public health and enhance human well-being and prosperity. This study recognizes the spatial clusters of child mortality across districts of Pakistan and identifies the direct and spatial spillover effects of determinants on the Child Mortality Rate (CMR). Method Data of the multiple indicators cluster survey (MICS) conducted by the United Nations International Children’s Emergency Fund (UNICEF) was used to study the CMR. We used spatial univariate autocorrelation to test the spatial dependence between contiguous districts concerning CMR. We also applied the Spatial Durbin Model (SDM) to measure the spatial spillover effects of factors on CMR. Results The study results showed 31% significant spatial association across the districts and identified a cluster of hot spots characterized by the high-high CMR in the districts of Punjab province. The empirical analysis of the SDM confirmed that the direct and spatial spillover effect of the poorest wealth quintile and MPI vulnerability on CMR is positive whereas access to postnatal care to the newly born child and improved drinking water has negatively (directly and indirectly) determined the CMR in Pakistan. Conclusion The instant results concluded that spatial dependence and significant spatial spillover effects concerning CMR exist across districts. Prioritization of the hot spot districts characterized by higher CMR can significantly reduce the CMR with improvement in financial statuses of households from the poorest quintile and MPI vulnerability as well as improvement in accessibility to postnatal care services and safe drinking water.

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Rainfall shocks, child mortality, and water infrastructure

Cited by 5 publications

References 81 publications

Ethnic inequality and public health

Ethnic inequality and public health

Weather Shocks, Child Mortality, and Adaptation: Experimental Evidence from Uganda

Spatial spillover impact of determinants on child mortality in Pakistan: evidence from Spatial Durbin Model

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