Responses in child health to concerted reconstruction efforts in the aftermath of the 2016 earthquake in Ecuador

The paper explores the short-term impact of recovery in the aftermath of a natural disaster on a set of child health outcomes. We analyze the impacts of a major earthquake with a magnitude of 7.8 that occurred on the coast of Ecuador on April 16, 2016. As damage was geographically concentrated, affected infrastructure and individuals could be readily identified. We implement a quasi-experimental difference-in-difference (DiD) strategy with geo-referenced data to compare affected and non-affected children, which is complemented by the event study approach, inverse probability weighting, placebo tests, and a synthetic DiD, which together provide a robust empirical framework identifying that the quick and large response of the government compensated for the earthquake-induced destruction. Affected children aged 0-5 years show similar levels of nutrition (weight-, height-, and BMI-for-age) and anemia as non-affected children. There is even some indication from the heterogeneity analyses (birth cohorts) that weight-for-age might have improved after the disaster and in response to the concerted reconstruction. We present exploratory evidence suggesting that the reconstruction activities led to infrastructure improvements, that nutritional programs continued their operations, and mothers in affected areas engaged more in breastfeeding. All three channels are likely to contribute to the stable child health environment in earthquake-affected areas relative to the non-affected areas, suggesting that mitigation of negative health consequences for the weakest members of society, i.e., the children, is possible in the aftermath of a natural disaster if appropriate activities and policies are put in place.