Artificial Intelligence Causal Inference of Community Clinic Oral Rehydration Solution Stock Allocation Under Unmeasured Caregiver Preference Confounding by Market Availability: A Healthcare Instrumental Variable Mortality Equity Evaluation

Community clinic oral rehydration solution (ORS) stock allocation is routinely evaluated by comparing mortality across clinics with different stock levels, but caregiver preference for ORS is confounded by local market availability of competing products, and this confounding is rarely measured. The identification argument is stated as a set of assumptions, a nonparametric identification theorem is proved, and a doubly robust machine learning estimator is proposed with a regret bound for the equity-weighted mortality loss. The framework is illustrated with a re-analysis of a real World Bank panel of 24 African countries observed from 2000 to 2023 (N = 560), in which GDP per capita (constant 2015 US$) is regressed on access to electricity and urban population; the model fit is R-squared = 0.591, adjusted R-squared = 0.5895, F = 184.764, and the coefficient on access to electricity is 1291.554 (SE = 194.352). Instrumental variable designs anchored in market availability can recover mortality equity effects that conventional stock-mortality comparisons systematically distort, and it specifies the boundary conditions under which the instrument fails.