Health outcomes can be remarkably dependent on the quality of drinking water. This study employs primary survey data collected in May 10 – July 27, 2016 to investigate the effects of water quality, measured by the presence of the Escherichia Coli (E. Coli) bacteria, on the health outcomes of households in Nepal. The health outcomes are based on the self-reported health status as well as the actual health condition of the members of the household. The novel contribution of this paper is that we investigate the health impacts of water quality by considering water quality itself as an intermediary process that could be affected by factors like household's cleanliness behaviors and hygienic infrastructures. Using a control function approach to account for potential endogeneity issues, the results indicate a significant effect of E. coli on the health status of individuals. Findings indicate the difference in expected diarrheal incidence to be about 0.913 units higher when E. coli is present in households' drinking water. The impact of E. coli is evident in both the self-reported health status and the actual health outcome, and the results hold across various empirical models and specifications. From a policy perspective, our results indicate the pressing need for policymakers to implement water quality tracking programs, and also to raise awareness among households regarding adequate cleanliness practices and hygiene infrastructures.

健康结果可能明显取决于饮用水的质量。这项研究采用2016年5月10日至7月27日收集的主要调查数据来调查水质的影响，该影响通过大肠杆菌的存在来衡量（E. Coli）细菌对尼泊尔家庭健康的影响。健康结果基于自我报告的健康状况以及家庭成员的实际健康状况。本文的新颖之处在于，我们通过将水质本身作为一个中间过程来研究水质对健康的影响，该过程可能会受到家庭清洁行为和卫生基础设施等因素的影响。使用控制功能方法解决潜在的内生性问题，结果表明大肠杆菌对个体的健康状况具有重大影响。研究结果表明，大肠杆菌的预期腹泻发生率的差异要高出约0.913个单位存在于家庭的饮用水中。大肠杆菌的影响在自我报告的健康状况和实际健康结果中均很明显，并且结果适用于各种经验模型和规范。从政策的角度来看，我们的结果表明，决策者迫切需要实施水质跟踪计划，并提高家庭对适当的清洁做法和卫生基础设施的认识。