Orphans and stunted growth: Investigating the potential of spatial network effects in service delivery for reducing stunting in orphans

Stunted growth in early life has serious implications for children and is a wellestablished constraint to productivity, life expectancy, and cognitive development. This paper evaluates the relative contributions of household resources and public service delivery in reducing the orphan-stunting penalty-the higher likelihood of orphans to be stunted. The results indicate that the effects of access to sanitation significantly reduce this penalty. Moreover, sanitation is at least as important as private wealth in reducing the penalty while access to other services is not. The results indicate that co-ordination of services and economies of scale, as well as regional herd immunity in stopping diarrhoea among children, could play an important role in providing lasting solutions to stunting more generally and orphan vulnerability in particular. This evidence is crucial as a case study in understanding how best to care for vulnerable children in South Africa but also for developing countries.