Publications by authors named "Soumya Balasubramanya"

This paper examines whether there are systematic differences in the historical behaviors of households that are affected and unaffected by chronic kidney disease (CKD) in Sri Lanka pertaining to their water source choices, water treatment practices, and agrochemical use. This analysis is motivated by the Sri Lankan government's largest policy response to this epidemic - to encourage communities to switch from untreated well water to publicly provided alternatives. We use recall methods to elicit information on the drinking water source and treatment choices of households over an 18-year period from 2000-2017.

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This analysis provides new estimates of chronic kidney disease (CKD) prevalence - including CKD of unknown etiology (CKDu) - across ten districts most affected by CKD in Sri Lanka, including an examination of rural households' historical reliance on groundwater consumption. A carefully designed household survey provides information on whether these households self-reported having a member in the decade prior to 2018, who had been clinically diagnosed with CKD. Households were classified according to whether or not they had used groundwater (from household wells, agro-wells or springs) as their primary source for drinking or cooking for at least five years between 1999 and 2018.

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Motivation: Proper management of fecal sludge has significant positive health and environmental externalities. Most research on managing onsite sanitation so far either simulates the costs of, or the welfare effects from, managing sludge in situ in pit latrines. Thus, designing management strategies for onsite rural sanitation is challenging, because the actual costs of transporting sludge for treatment, and sources for financing these transport costs, are not well understood.

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Article Synopsis
  • A national campaign in rural Bangladesh conducted in 2003 encouraged households to switch from high-arsenic wells to safer options for drinking water.
  • A follow-up study in 2008 revealed that not only did many households maintain their switch, but the number of new switches also increased significantly.
  • However, a downside was noted, as 22% of households had forgotten their arsenic test results, leading to some families returning to or remaining at unsafe wells, highlighting the need for ongoing well testing.
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We conducted a randomized controlled trial in rural Bangladesh to examine how household drinking-water choices were affected by two different messages about risk from naturally occurring groundwater arsenic. Households in both randomized treatment arms were informed about the arsenic level in their well and whether that level was above or below the Bangladesh standard for arsenic. Households in one group of villages were encouraged to seek water from wells below the national standard.

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