Special Paper No. 09 of 2024 on Effect of Access to Clean and Safe, Adequate, Reliable and Affordable Water on Child Nutrition in Kenya

Abstract

Water security, which includes availability, physical accessibility, usage, and stability over time, is a crucial factor for improving nutrition. This paper goes beyond the dominant view of water access as mere ‘coverage’ to assess the relationship between the dimensions of water security and the nutritional status of children under five years old living in households with piped water in Kenya. Using data from the 2015/16 Kenya Integrated Household Budget Survey (KIHBS) and administrative records from the Water Services Regulatory Board (WASREB), a probit regression model was employed to estimate the effects of water accessibility, adequacy, quality, reliability, and affordability on child stunting. The findings of the study show that there is a rural-urban divide in water physical accessibility, quality, and adequacy. The study reveals that having sufficient drinking water at the household level significantly reduces child stunting. Adequacy of water of 20-49 litres per person per day as opposed to below 20 litres lowers the probability of stunting by 6.3 percentage points. Further, water reliability, affordability, access and quality have a potential to reduce stunting among children aged below five years. This evidence supports the importance of increased investment in water infrastructure to achieve universal access, improved water quality by implementing stringent monitoring and purification measures, strengthening the regulatory frameworks to ensure compliance and accountability, and expanded access to reliable water by developing efficient distribution systems, especially in rural areas where 65 per cent of people receive less than 20 litres of water a day. This strategic focus will not only improve child nutritional outcomes but also align with the country’s constitutional mandate to ensure the population has access to sufficient quantities of clean and safe water for drinking and personal use.