Do Water Access Inequalities Matter for Child Mortality? A perspective from low-and-middle-income countries

Although the role of water is well known in child health, whether and how the distribution of water access affects child mortality and its economic transmission channels remain unclear. In particular, child mortality caused by diarrhea received insufficient attention, although diarrhea is the second leading cause of age under 5 mortality worldwide. The dissertation project addresses this gap by clarifying the theoretical /conceptual background of both child mortality and water access inequality, and by generating robust empirical evidence on whether water access inequality is a significant determinant of child diarrhea mortality in the context of low and-middle-income countries by applying a mixed methods approach. To this end, the study provides a theoretical background of the dissertation (objective 1) by setting a story for health and economic development through a political economy lens (i), clarifying the determinants of child mortality from a health economics perspective (ii), clarifying the concept of socioeconomic inequalities in water access from a welfare economics perspective (iii), highlighting a plausible economic transmission channel (iv), and selecting concentration index approach as a preferred method to quantify water access inequality (v). Building on this background, we constructed a water access inequality index in order to reveal its global trend and patterns (objective 2). Consequently, we assessed the likely effects of water access inequality on child mortality outcomes by utilizing a panel approach (objective 3). Finally, a further empirical chapter revealed how water access inequality affected the ‘success’ and ‘failure’ of the efforts reducing child diarrhea mortality in the selected cases of Liberia and Zimbabwe through a comparative case study approach (objective 4). In doing so, we combined real-world open-access datasets from various international sources. The key findings of the dissertation suggest that water access inequality matters for child mortality caused by diarrhea in the ...