Research / BFI Working Paper, Development Innovation LabJan 17, 2023

Water Treatment and Child Mortality: A Meta-analysis and Cost-effectiveness Analysis

Michael Kremer, Stephen Luby, Ricardo Maertens, Brandon Tan, Witold Więcek

Randomized controlled trials (RCTs) of water treatment are typically powered to detect effects on caregiver-reported diarrhea but not child mortality, as detecting mortality effects requires prohibitively large sample sizes. As a result, water treatment is often not included in lists of cost-effective, evidence-backed child survival interventions which are recommended for prioritization in health funding decisions, and health funds are typically not used to cover the cost of water treatment at scale. To increase statistical power, we conducted a meta-analysis that combined available RCT evidence on child mortality with new evidence on mortality obtained from authors of studies reporting only diarrhea outcomes.

We find that water treatment reduced the odds of child mortality (death before age five) by about 30%. This suggests that water treatment is a highly cost-effective way of saving lives. It costs roughly $3,000 to save a child’s life through water treatment, or around $40 per healthy life year (HLY). This analysis suggests that water treatment should be a priority for policymakers aiming to improve child health.

Additional Materials

More Research From These Scholars

BFI Working Paper Dec 7, 2020

Designing Advance Market Commitments for New Vaccines

Michael Kremer, Jonathan D. Levin, Christopher M. Snyder
Topics:  Health care, COVID-19
BFI Working Paper Jun 25, 2021

The Impact of Free Secondary Education: Experimental Evidence from Ghana

Esther Duflo, Pascaline Dupas, Michael Kremer
Topics:  K-12 Education
BFI Working Paper, Development Innovation Lab Sep 8, 2022

Blue Spoons: Sparking Communication About Appropriate Technology Use

Arun G. Chandrasekhar, Esther Duflo, Michael Kremer, João F. Pugliese, Jonathan Robinson, Frank Schilbach
Topics:  Development Economics