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Arsenic contamination in shallow groundwater aquifers remains a major barrier to providing access to safe drinking water in Bangladesh. Chronic exposure to arsenic has been shown to cause serious health impacts, including various cancers, skin lesions, neurological damage, heart disease, and hypertension. Numerous epidemiological studies have shown cognitive impacts on memory, linguistic-abstraction, attention, learning, and physical ability. The neurotoxic effects of arsenic could be particularly harmful for children during their critical growth periods and have impacts on early childhood development. This study uses cross-sectional data from the nationally representative 2012-13 Bangladesh Multiple Indicator Cluster Survey to investigate the effects of arsenic contamination in drinking water on early childhood development outcomes in a sample of around 7,500 children ages 3-5 years. Early childhood development is measured in four skills domains: literacy-numeracy, physical, social-emotional, and learning using the Early Childhood Development Index. Arsenic contamination is measured in source drinking water at the cluster-level. After controlling for a range of demographic, social, and economic characteristics of households, the results show that arsenic contamination is significantly and negatively associated with the overall Early Childhood Development Index, on outcomes within the physical, social-emotional, and learning skills domains. Further, there is a clear dose-response relationship, where those children with exposure to higher concentrations of arsenic have worse developmental outcomes.
Arsenic --- Early Childhood Development --- Health --- Water Quality
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Water, sanitation, and hygiene interventions are increasingly recognized as essential for improving nutritional outcomes in children. Emerging literature describes the negative effects of poor sanitation on child growth. However, limited evidence has shown a link between water quality and nutritional outcomes. Similar to poor sanitation, it is plausible that water contaminated with E. coli could affect the nutritional status of children through various possible biological pathways, such as repeated episodes of diarrhea, environmental enteropathy, parasites, or other mechanisms that inhibit nutrient uptake and absorption. This study explores the relationship between contaminated water and stunting prevalence among children younger than age five years, using unique cross-sectional data from the 2012-13 Bangladesh Multiple Indicator Cluster Survey, which was one of the first nationally representative surveys to include water quality testing for E. coli. E. coli contamination in drinking water is measured at household and source points. Stunting is measured using height-for-age z-scores for children under five, where a child is considered stunted when he or she is two or more standard deviations below the median of the World Health Organization reference population. The results of multiple probit regression models indicate a 6 percent increase in the prevalence of stunting in children who are exposed to highly contaminated drinking water at household point compared with those exposed to low-to-medium contamination. When contamination is measured at the source level, the association is greater, with a 9 percent increase in the likelihood of stunting when exposed to a high level of contamination.
Drinking Water --- Early Child and Children's Health --- Early Childhood Development --- Fecal Contamination --- Health --- Health and Sanitation --- Health, Nutrition and Population --- Hygiene --- Hygiene Promotion and Social Marketing --- Sanitation --- Water --- Water and Human Health --- Water Quality --- Water Resources --- Water Supply and Sanitation
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Despite Bangladesh's notable progress toward the eradication of open defecation, the country still faces severe deficits in the availability of improved sanitation. This paper analyzes the impact of exposure to unimproved sanitation early in childhood on primary school enrollment status, using pseudo-panel data for children ages six to nine years in Bangladesh. The results indicate that unimproved sanitation has a negative and significant impact on primary school enrollment. A child's early exposure to unimproved sanitation decreases the likelihood of being enrolled in primary school by eight to ten percentage points on average compared with a child with access to improved sanitation. The effect is particularly strong-a difference of 8 to 10 percentage points-for children ages six to seven. It is also strong in rural areas. The results are statistically robust to errors due to potential omitted variable bias.
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