Water and Health in Egypt: An Empirical Analysis

Sammanfattning: This thesis is an empirical work dealing with water issues in Egypt where the emphasis is put on the analysis of the relationship: inadequate water quality and health impacts. The first chapter includes a general discussion of water resources in Egypt and other developing countries. This chapter briefly also deals with water tariffs and sustainable water pricing in Cairo. In the second chapter the impacts of water and sanitation on child mortality in Egypt are assessed. The analysis is conducted using a three-part model specification, comprising discrete choice to model the child prospects of dying during the neonatal period. The remaining parts use transition models, in which unobserved heterogeneity is accounted for, to model infant and childhood risk of death. The results show that access to municipal water decreases the risk, and sanitation is found to have a more pronounced impact on mortality than water. The results suggest that increasing the awareness of the Egyptian population relative to health care and hygiene is an important means to decrease the risk of child mortality. Moreover, gender discrimination is found to have an important effect beyond the neonatal period. In the third chapter, controlling for the Egyptian households' choice of health infrastructure (i.e., sanitation facility and water accessibility) is done by means of a discrete choice approach consistent with the random utility model. Evidence of the importance of the indirect effect of the source of drinking water on neonatal mortality is found, but generally the indirect effect is negligible. Furthermore, changes in wealth and educational levels are assessed taking into consideration a priori the choice of health infrastructure. The analysis suggests that wealth and education contribute loosely to the child mortality reduction. The fourth chapter analyzes the impact of better water quality on health improvements using two stated preference methods: choice experiments and the contingent valuation method. These methods were administered to a random sample of 1500 households in metropolitan Cairo, Egypt. The results show that both methods give quite the same welfare measures. Moreover, households in metropolitan Cairo do have a positive willingness to pay for reducing health risks owing to water quality that amounts to roughly double their current water bills. This finding suggests that the willingness to pay is rather small compared to the likely cost.