Roads and child health in Sub-Saharan Africa

This paper examines the causal impact of road access on child health in Sub-Saharan Africa between 1980 and 2012 by combining geolocated data on child anthropometric outcomes with spatial data on road networks. To address endogeneity, we employ an instrumental variable approach based on the inconsequential units framework, constructing hypothetical road networks that connect historical cities and active mines. Our results show that closer proximity to paved roads significantly improves child health. The main mechanisms operate through improved healthcare access and utilization, higher household wealth, early signs of structural transformation, and cropland expansion. We find no evidence that these gains are offset by adverse environmental or epidemiological effects of improved road access. Overall, the findings underscore the role of road infrastructure in fostering development across Sub-Saharan Africa.