اصلاحات آب، تمرکز زدایی و مرگ و میر کودکان در کلمبیا، 1990-2005

This paper attempts to determine the municipal level impact of the 1994 Law 142 water and sewerage services reforms on child mortality and service coverage. The objective of these reforms was to transfer service provision from the municipalities to specialized companies. These reforms were undertaken within the 1990s decentralization process which established that the provision of water and sewerage services was the responsibility of local governments. The results obtained indicate that municipalities that reformed exhibit a slower reduction of child mortality rates and lower increases in water coverage than the ones that did not reform.

High quality provision of water and sewerage services is fundamental to overcome poverty and to improve quality of life. In particular, access to potable water and basic sanitation facilities is strongly related to the prevention of gastrointestinal diseases in children and adults1 (Esrey, Potash, Roberts, & Shiff, 1991). The World Health Organization estimates that 1.8 million people die every year from diseases related to an inadequate provision of water and sanitation; 90% of them are children under five (OMS, 2004). As part of the Millennium Goals, Colombia committed to reduce mortality in children under five from 37 to 17 deaths per 1,000 live births. Achieving such an objective inherently entails improved provision of water and sanitation services. By the late 1980s, Colombia had already begun to reform water and sanitation service provision through two strategies. First, the central government sought to enhance service provision by gradually transferring it to the local governments. Second, the government also transformed the regulation of the service provision sector in order to allow for the participation of specialized private or mixed firms. The final stage of the latter strategy was the enactment of Law 142 of 1994 which established a new institutional framework for the provision the services. One key aspect of the Law was to authorize the participation of private capital in the provision of those services. In this regard, the Law facilitated the creation of companies specialized in the provision of water and sewerage services as a way to stimulate coverage expansion and quality improvement. The entrance of specialized companies would lead eventually to the gradual elimination of local governments as direct providers of those services. To date, however, local governments remain the principal providers, as specialized companies mainly operate in municipalities with more than 20,000 subscribers (Roda, 2004). The reform was implemented more than 15 years ago, yet as of now its impact is not completely known.

This paper has attempted to evaluate impact of the water and sewerage services reforms of at municipal level established in Colombia by the Law 142 of 1994 on child mortality. The timing of these reforms coincided with the strengthening of the national decentralization process that began in 1993. In fact, the municipalities’ burgeoning autonomy in relation to water and sewerage provision allowed them to decide whether to reform or not. The results obtained indicate that municipalities that reformed with more than 2,500 subscribers and with some degree of private participation in providing company provision experience a lower reduction of child mortality rates than the municipalities that did not reform. Child mortality from infectious and transmissible diseases in the municipalities that reformed and had more than 2,500 subscribers also exhibited as a smaller drop than the rates observed in municipalities that maintained service provision in the hands of the local government. The estimated difference was 0.096 mortality rate points (approximately 19% of the mean mortality rate for 1990). Private sector participation in the provision of water and sewerage services in the reformed municipalities was not related to child mortality from infectious and transmissible diseases. As for the expansion of service coverage the results are mixed. The reform had a positive impact on sewerage coverage. Municipalities that reformed sewerage increased coverage levels by 4 percentage points compared to municipalities that did not reform. The number of subscribers or the mixed or private nature of the providing company had no impact on sewerage coverage. In the case of water service, however, the opposite effect took place. Municipalities with mixed or private capital and more than 2,500 subscribers experienced a lower coverage increase than those that did not reform the provision. In this case, the estimated difference is 6 percentage points (or 12 percentage points in the municipalities that exhibited both features).