IHDS User Paper Series: How Does Access to Water Affect Child Health?

How Does Access to Water Affect Child Health? Blog post by Esha Chatterjee in which IHDS Team members review papers published by IHDS users.


Studies on the impact of access to water on nutritional status (an indicator of health) are limited in the Indian context. One of the very few studies in this context was conducted by Herbert (1985) using data from a longitudinal survey conducted between 1978 and 1980 in Chennai, Tamil Nadu. Liu and Hunt are interested in updating knowledge on this topic. Their study (2015) is the first to use nationally representative survey data (obtained from the IHDS) to investigate an area in public health that has important implications for policy. As primary aged children gain access to water, the probability of their being super thin and thin declines by around 1 percent (converting to population estimates of around 1,841,101 children) while the probability of their having normal weight increases by around 2 percent (converting to population estimates of around 3,682,203 children). Thus, the study finds an association between access to water and children's nutritional status.


Liu et al. (2015) use individual level data from the India Human Development Survey (IHDS) 2004-05, and apply an ordered-response model to evaluate the effect of access to water on children's nutritional status outcomes. This study is based on data on 11,452 children aged 6-14 years. The dependent variable used in this study is children's nutritional status, which is construed by BMI-for-age z-scores. These scores take values ranging from 1 (obese if the z-score>2) to 5 (severe thinness if the z-score<-3). The most important independent variable used is the measure for the access to water for an individual child. The measure is based on the following question: ‘What is the main source of water for drinking?’ Answers to this question took values between 1 and 11, where each number represented the following sources of water: 1 (piped water), 2 (tubewell), 3 (hand pump), 4 (dug, open well), 5 (covered well), 6 (river, canal, stream), 7 (pond), 8 (tanker truck), 9 (rainwater), 10 (bottled water) and 11 (other).

On the basis of the above question, the authors constructed a binary variable that took a value of 1 if the child's main source of drinking water was bottled or piped water, or else the variable took a value of 0. The other independent variables included the number of children, area of residence, the socio-economic status of the child’s family, household sanitation (if the house has a toilet), the average number of hours that the children view television, variables related to food (that is, if the child receives free grain or midday meals and the number of meals a child has at home), gender, and regional dummies.


This study is a great example of how knowledge can be updated by using reliable data. Policy-related questions, in particular, need accurate and timely data to create avenues for targeted interventions. Given that the 2012 panel data of IHDS was released into the public domain recently, we at IHDS hope to see even more of the latest data being used to tackle questions that will improve the lives of children in India.



Hebert J.R. “Effects of water quality and water quantity on nutritional status: Findings from a south Indian community.” Bull World Health Org (1985), 63(1): 143–55.

Liu, E., D. Balasubramaniam, and A. F. Hunt. "Does access to water matter? A study on the nutritional status of primary-aged children in India." Journal of Public Health (2015): fdv149.