Skip to content


Sanitation, Disease, and Anemia: Evidence From Nepal

Research, Sanitation1 min read

Authors: Diane Coffey, Michael Geruso, Dean Spears

Published in: National Bureau of Economic Research

Download Paper


Anaemia impairs physical and cognitive development in children and reduces human capital accumulation. The prior economics literature has focused on the role of inadequate nutrition in causing anemia.

This paper is the first to show that sanitation, a public good, significantly contributes to preventing anaemia. We identify effects by exploiting rapid and differential improvement in sanitation across regions of Nepal between 2006 and 2011. Within regions over time, cohorts of children exposed to better community sanitation developed higher hemoglobin levels. Our results highlight a previously undocumented externality of open defecation, which is today practiced by over a billion people worldwide.


r.i.c.e. is a nonprofit research organization, dedicated to understanding the lives of poor people, especially young children, in India, and to promoting their well-being.

Research Themes

Content by Category

© 2021 r.i.c.e.