The Unintended Consequences of Infrastructure Development: The Impact of Sewerage Diffusion on Early-Life Mortality in Peru

Antonella Bancalari , London School of Economics

Little is known about the effectiveness of sewerage diffusion initiatives from middle-income country governments. Although the aim is to increase access to improved sanitation and ensure a healthier environment, there are risks to infrastructure development that have been overlooked. This paper studies the effect of a nation-wide spread of sewerage that took place in Peru between 2005 and 2015 on infant and under-five mortality rates. I use original administrative and geographical data and rely on an instrumental variable approach exploiting the fact that gradient affects a district’s technical suitability for sewerage within provinces. My study finds that in districts that experienced greater sewerage diffusion, mortality rates increased. The adverse effects are sustained over time. These unintended lethal consequences seem to be linked to the construction works required to install sewerage lines, which exposed the population to hazards. The results are driven by deaths from infectious and respiratory diseases and accidents.

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 Presented in Session 220. Determinants of Child Health and Mortality