Analyzing Wealth-Dependent Effects of WASH and Nutritional Resources on Child Health in Guatemala

ACS ES&T WATER(2024)

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Abstract
The effectiveness and accessibility of water, sanitation, hygiene (WASH), and nutrition-based services for underserved populations can be limited by a lack of understanding by providers of household investment priorities. In this study, we utilize three data sets from Guatemala along with a set of linear regression and path analysis models to evaluate 1) between which wealth levels the largest upward mobility occurs among households in specific WASH and nutrition resource acquisitions and 2) at which wealth levels does this upward mobility have the largest significant effect on child height-for-age (HAZ)? Results suggest that the largest upward mobility among WASH resources in households occurs in lower wealth levels, but investment timing is dependent on capital costs (e.g., cheap soap acquisition prior to costly toilet improvements). Furthermore, only two of six WASH resources were associated with child HAZ overall (sanitation and soap), but all WASH resources had specific wealth levels in which they were associated with HAZ. Finally, child diet diversity and number of antenatal visits were least affected by wealth and positively associated with child HAZ regardless of wealth level. These trends were robust over all data sets. These data and approaches to service targeting can aid in improving local services to underserved populations.
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Key words
water,sanitation,child malnutrition,stunting,diet diversity,antenatal visits
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