Diarrhea is the second highest cause of childhood mortality, affecting almost a million children in developing countries around the world. As the second highest cause of infant death after pneumonia, diarrhea is also one of the most treatable health malignant conditions today. The vast share of global media coverage on public health crises has focused our attention on the dangers of Ebola, HIV/AIDS, or the next animal borne flu. As natural scientists are hard at work on finding a cure to these diseases, developmental economists may be equipped to play a role in solving the lethal diarrhea health crises. How should public policy makers act, to save the lives of millions of children with existing and cheap health policies? It seems government officials have still not determined the most appropriate method to combat preventable health risks based on sanitation.

The World Health Organization defines diarrhea as a symptom of gastrointestinal infection, which can be caused by a variety of bacterial, viral, and parasitic organisms. These pathogens are spread through contaminated food, drinking water, or from person contact as a result of poor hygiene practices. Paired with illiteracy in health, many populations in developing countries naively use antibiotics or reduce the volume of water consumed as an attempt to prevent the condition. Deprivation of resources to treat diarrhea causes dehydration, undernourishment, and impaired immunity in children, which is life threatening. The question most governments are faced with is whether the choice between sanitation facilities or public education is the best policy to lower child diarrhea incidences?

According to the United Nations International Children Emergency Fund, in India more than 1 million child deaths can be prevented by improving known, cost effective interventions. Diarrhea is the second most lethal illness for children globally and a quarter of these deaths occur in India. Due to its young, ethnically heterogeneous demographics, and significant share, the Indian population is a suitable representative of this global health crisis. Using our sample size data from the Indian National Family Health Survey (NFHS-3) the protective effect of education or sanitation on child diarrhea incidence can be evaluated. The data is collected from children under the age of five in India and was attained through a questionnaire from various households. Based on this data sample there is roughly an 8.2% higher likelihood of death among children who have contracted diarrhea.

Figure 1 and Figure 2 illustrate the protective effects of education, which measures sanitary behavior and a lower incidence of child diarrhea. It is intuitive that educated parents are better endowed to cure the preventable health malignancy of their child. Wealthier households may also prevent the incidence of child diarrhea as can be seen in Figure 3. The wealth index is an appropriate indicator as it represents affordability and resources to access sanitation facilities.

Figure 1: Maternal Education and Child Diarrhea Incidence

Figure 1

Figure 2: Partner’s Education and Child Diarrhea Incidence

Figure 2

Figure 3: Wealth Index and Child Diarrhea Incidence

Figure 3


Table 1 and Table 2 categorize the heterogeneous nature of the sample by state and religion, showing a consistent inverse relationship is between diarrhea and literacy in India.

Table 1: Diarrhea Incidence and Literacy by Religion

Religion Diarrhea Incidence % Literacy %
Hindu 10.94% 56.33%
Muslim 8.46% 76.79%
Christian 7.46% 83.27%

Table 2: Diarrhea Incidence and Literacy by State

State Diarrhea Incidence % Literacy %
Gujrat 15.72% 45.75%
Kerala 7.31% 88.34%
Tamil Nadu 6.53% 57.52%


In this investigation there will be three indicators used to observe the effects of education on child diarrhea incidence: mother’s education; father’s education; and literacy. The mother’s educational attainment is insightful as they are the primary carers in a typical household in the developing world. Thereby the are seen to control the child’s environment from harmful pathogens. The father’s educational attainment is also essential because they typically control household resources as most of the developing world systems are based on a patriarchy. Literacy is included in these statistical regressions because it represents the ability for individuals to protect children from diarrhea through their abilities to read pamphlets entailing health education. As a result of their literacy, parents can practice health campaigns initiated by policy makers to impose appropriate sanitation practices.

As opposed to practices through education, sanitation facilities evaluate the effects to reduce child diarrhea incidences by using four indicators. Wealth index; urban or rural place of residence; source of water; and toilet treatment. Toilets are the primary sanitation facility to dispose of fecal matter that contain diarrhea inducing pathogens. Water sources are an equally important factor that plays a major role in carrying diarrhea inducing pathogens.


Table 3: Regression Results on Policies to Reduce Child Diarrheal Incidence

Variable Category Child Diarrhea Odds Ratio (Significance)
Maternal Education Incomplete Primary 1.144 (0.79)
Incomplete Secondary 1.549 (1.91)
Complete Secondary 0.898 (0.33)
Higher 1.019 (0.06)
Partner Education Incomplete Primary 0.817 (1.39)
Incomplete Secondary 1.031 (0.24)
Complete Secondary 0.447 (1.84)
Higher 0.751 (1.26)
Literacy Read whole/part sentences 0.712 (1.71)
Wealth Index Poorer 0.973 (0.17)
Middle 0.921 (0.58)
Richer 0.982 (0.10)
Richest 0.858 (0.68)
Water source Piped into dwelling 1.481 (2.89)**
Public tap/standpipe 0.916 (0.69)
Toilet treatment Pit toilet latrine 0.540 (3.17)**
Flush to somewhere else 0.326 (4.31)**
Flush to piped sewer system 0.588 (3.75)**
Place of residence Urban 1.103 (0.91)
Number of Observations= 6,316
*p<0.05, ** p<0.01


Table 3 shows the results of this investigation yielding statistical significance only for sanitation facilities, not education. It is interesting to note that the odds of contracting diarrhea reduces for secondary educated households than in comparison to uneducated households. Although these findings show that higher education correlates to lower diarrhea, they do not imply causation in a reduction of contractions. The absence of education causation reduced diarrhea is due to the fact that you cannot protect your child if you lack basic community resources.

The results of this investigation conclude that sanitation facilities reduce child diarrhea incidence with a 99% statistical significance. Toilet treatments are of importance as open defecation is a primary health risk that must be tackled to reduce diarrhea. Toilet flushing is the best protective factor and using a pit toilet latrine also reduces the risk of contracting diarrhea. However, flushing to sewer systems shows to be less effective than other forms of human waste disposal. In regards to water sources it is interesting to also note that supply from a piped dwelling source surprisingly makes you almost one-half times more likely to contract diarrhea than an unprotected well. The increase in risk from contracting diarrhea from piped dwellings is because piped systems for toilet treatment and water sources are highly prone to carry diarrhea inducing pathogens in developing countries with poor household infrastructure. Here a family’s access to basic community resources is a necessary precondition for education to be relevant in improved child health.

Emerging economies like India are undergoing exponential growth in their populations and public policy makers must address the poor infrastructure of piped water sources and toilet facilities. Education does not necessarily lead to lower child diarrhea incidence despite numerous graphics showing encouraging trends about the reduced incidence of child diarrhea within higher educated households. The most effective policy to prevent diarrhea deaths for government officials is to provide efficient and safe piped systems, create waste disposal, and carry safe drinking water.