The effects of health aid on child health promotion in developing countries: cross-country evidence

Although epidemiological knowledge in relation to child health has improved in the last few decades, around 3 million children die each year in developing countries from preventable diseases. The international development community views increased immunization coverage for children as an important step in eliminating or reducing these deaths. Many developing countries have very limited resources to tackle major health problems and have to rely on external finance. This article examines the impact of foreign aid devoted to the health sector on child health promotion in developing countries. Two proxies for child health promotion are used: (a) immunization against measles and (b) immunization against Diphtheria–Pertussis–Tetanus (DPT). A range of model specifications and panel data econometric techniques are applied to data covering the period 1990 to 2005. This article finds a positive and statistically significant link between health aid and the measures of child health promotion.     

Consumption risk-sharing under terror shocks: Evidence from value-chain network rosters in Nigeria

Households in Nigeria live in inherently risky environments; accentuated by the preponderance of terror incidences, banditry, and farmer–herder-related clashes that are more concentrated in the northern than southern parts of the country. This study examines the proposition that households with a robust network roster—especially networks related to ethnicities and financial remittances from outside their communities—are better able to weather the idiosyncratic and aggregate impact of terror-related shocks; and thus, experience less consumption variability to terror-related shock than other similar households without the “insurance” of an external network. Our main empirical strategy applies a panel difference-in-differences specification to three waves of the LSMS-ISA surveys for Nigeria. The results from the study indicate that having external networks outside the community is an important coping mechanism for terror-related shocks, both for overall welfare and food consumption. The difference in consumption variability between groups with outside network “insurance” and those without could be as high as 20 percentage points. Thus, risk-sharing arrangements for households should exploit outside network insurance mechanisms to mitigate welfare losses from terror-related shocks.     

Demand for different types of public goods: evidence from Nigeria

Preferences of Nigerian households vary across different types of public goods. For example, some prefer roads while others favor education even after controlling for the existing supply of these goods. What explains this variation? We argue that the perceived distributional consequences of specific public goods differ conditional on the personal characteristics of households. In particular, households demand the type of public good that (a) increases the utility of assets they already own and (b) resonates with their past experiences involving the lack of particular public goods. We test our argument with data on 123,000 Nigerian households. We find strong evidence for our argument across six types of public goods.     

Family decision-making for educational expenditure: new evidence from survey data for Nigeria

This study examines the determinants of educational expenditures by households in Nigeria. Data from the Nigerian General Household Survey, Panel 2012/2013, Wave 2 was used and a double-hurdle model was employed for the analysis. The results suggest household income, the age, education, gender of the household heads and urban versus rural residence have a significant impact on the decision to spend on education. Such expenditures are income elastic overall, but are very different in magnitude for low income compared to higher income families. It is found that the income elasticity of education expenditures are approximately four times greater for households in the bottom two-thirds of the income distribution than for those on the top one-third of the income distribution.     

The health consequences of hazardous and nonhazardous child labor

The health consequences of child labor are ambiguous. On the one hand, heavy lifting, using dangerous tools and handling fertilizers may impact negatively on health. On the other, child labor could be used to achieve a minimal subsistence standard, without which the child could experience deteriorating health. Previous empirical studies are inconclusive because, until now, existing data sources could not disentangle between different activities performed by child workers. To establish how work is related to health, it is essential to know what activities are being performed. This study fills this gap with a unique child labor survey conducted in Peru in 2015. Child labor is classified into hazardous and nonhazardous activities. The econometric results suggest that children doing nonhazardous work are less likely to have health problems than nonworking children. Conversely, those that work in hazardous activities are potentially more likely to exhibit health concerns. A series of robustness tests confirm these findings. The results give impetus to the notion that child work increases total resources available for households, which can improve child health. Therefore, it is over and above this potential increment in resources that some hazardous activities worsen working children's health.     

No time to look after the kids: The unintended consequences of export expansion on child health*

In this paper, we examine the effect of export expansion on the health of children under the age of 6 years in China. Using the CHNS survey, we exploit trade exposure variation among regions after China's entry into the WTO to construct a difference-in-differences and instrumental variable identification. We show that 1% increase in export expansion over GDP share exacerbates child' illness rates by 0.6%, and the effect is more pronounced for less educated parents. The increasing workloads and having less time to look after the child account for the increasing illness rates, especially for mothers.     

The effect of fair trade affiliation on child schooling: evidence from a sample of Chilean honey producers

We evaluate the impact of Fair Trade (FT) affiliation on child schooling within a sample of Chilean honey producers with a retrospective panel data approach. From a theoretical point of view, we argue that FT should have a positive effect on child schooling since it generates a short-run pure income effect together with a medium-run productivity effect on both adult and child wages. On the other hand, because of the higher productivity generated by the medium-run effect, the opportunity cost of child education increases if they work with their parents. The direction of the impact of FT affiliation on child schooling is therefore uncertain and requires empirical testing. Our econometric findings document a positive and significant impact of affiliation years on child schooling after controlling for endogeneity and heterogeneity between the treatment and control sample.     

The Determinants of Firm Performance and Bribery: Evidence from Manufacturing Firms in Nigeria

This paper uses ordinary least squares with firm effects and Probit regression models to investigate the determinants of firm performance and the likelihood of firms to pay bribes. Results for the manufacturing firms in Nigeria show that skilled workforce, exports, foreign ownership and capital investment influence firm performance. Conversely, poor electricity delivery and difficulty obtaining finance impede firm performance. Total sales and time spent dealing with government regulations increase the likelihood of firms to pay bribes. Surprisingly, foreign firms are as much likely to pay bribes as domestic firms. Policy implications from the findings are important considering that the manufacturing sector assumes an important role in the Lewis theory of economic development.     

The effects of education on agricultural productivity under traditional and improved technology in northern Nigeria: an endogenous switching regression analysis

This paper estimates a more efficient version of an endogenous switching regression model to examine the effects of farmer education—schooling and extension contact—on cowpea production under traditional and improved technology in northern Nigeria. The results revealed significant productivity-enhancing effects of schooling and extension contact only under improved technology. Factors that promote technology adoption will thus indirectly raise the marginal contributions of farmer education; these include schooling, participatory technology evaluation, improved seed supply, and market access. The results demonstrate that schooling not only enhances agricultural productivity following technology adoption but also promotes adoption itself.     

Dirty hands on troubled waters: Sanitation,access to water and child health in Ethiopia

In this paper, we investigate the impact of access to drinking water sources and sanitation facilities on the incidence of diarrheal diseases among children below 5 years of age in Ethiopia using the propensity score matching technique with a polychotomous treatment variable. We find that among the water sources traditionally considered as improved, only water piped into dwelling, yard or plot leads to a large percentage point reduction in diarrhea incidence. The other water sources, generally believed as clean, are not effective in reducing diarrhea even compared with some of the unimproved water sources. We also find that some unimproved water sources and sanitation facilities are less inferior than they are believed to be. These results suggest that the traditional way of categorizing different types of improved and unimproved water sources and sanitation facilities into a dichotomous variable, “improved” or “unimproved”, could be misleading as it masks the heterogeneous effects of the water sources and the sanitation facilities.     

The long-run effect of aid on health: evidence from panel cointegration analysis

Although a major objective of aid donors is to improve health outcomes in recipient countries, there is relatively little research on whether aid to the health sector leads to improved health outcomes, and even less on the impact of total aid. This paper examines the relationship between total aid and population health using panel cointegration and causality techniques designed to deal with problems afflicting previous aid-health studies: spurious regressions, omitted variables, endogeneity, cross-sectional dependence, and parameter heterogeneity. The main results are: (i) aid has, on average, a small but negative long-run effect on health, (ii) while the long-run (or trend) effect of aid on health is negative, the short-run (temporary) effect of aid on health is positive, (iii) causality runs in only one direction, from aid to health, and (iv) aid worsens health mainly in sub-Saharan countries, but has a positive, albeit statistically insignificant, long-run impact on health in Latin American and Caribbean countries and in countries with negative values of net ODA.     

Unexpected windfalls,education, and mental health: evidence from lottery winners in Germany

This paper investigates the causal impact of large unexpected windfalls on individual mental health, physical health, as well as health behaviors. I use a large individual-level panel data set of lottery winners from Germany between the years 2000 and 2011 and observe lottery winners before and after winning a large lottery prize. Mental health declines immediately after winning a large lottery prize for individuals with low education and low levels of financial literacy. While these individuals report being happier after winning the lottery, evidence from commonly used SF-12 measures of mental health indicates that winners with low education experience increased role limitations due to emotional problems, are more anxious, and have less energy after their win. The impact on various measures of mental health is highly robust, statistically significant, economically significant, and persists for up to two years after the win. Unexpected windfalls have no impact on the mental health of individuals with high education or high financial literacy. Winning the lottery has no impact on individuals’ health behaviors such as smoking or alcohol consumption, and it has no impact on doctor visits, hospital stays, or illness-related work absences regardless of education level.     

The U.S. health care expenditure: evidence from 2001 to 2009

This study utilizes state-level data from 2001 to 2009 to estimate the impact of the 2007 financial crisis upon health care expenditures. Higher death rates are consistently found to have a positive and statistically significant impact on health expenditures. While mental health and COPD are not generally found to impact expenditures, increases in the percentage of the population diagnosed with cholesterol and obesity tend to increase health expenditures. Increases in health expenditures slowed considerably after the financial crisis. Even though recessions (high unemployment rates) are generally found to have a positive impact on health expenditures, the post-financial crisis time period is estimated to have much lower health expenditures than in other time periods. Our results can be used to give insight into the conditions under which the slower rate of increase in health expenditures can be expected to increase. More research will be needed to be able to more completely explore not only the reasons for these changes in health expenditures but also whether they are likely to continue into the future.     

Impact of terrorism on tourism in Turkey: empirical evidence from Turkey

This article aims at investigating the causal impact of terrorist attacks on the tourism industry in Turkey based on the Autoregressive Distributed Lag (ARDL) bounds testing procedure for the period between 1986 and 2006. The ARDL bounds test reveals that tourism is in a long-run equilibrium level relationship with terrorism. The evidence obtained from the long-run and short-run parameter estimates indicates the existence of a negative causal effect of terrorism on tourism.     

Determinants of child morbidity and factors governing utilization of child health care: evidence from rural India

Prevention as well as effective treatment of respiratory infections and diarrhoea depends on several individual, household and community level factors. The objective of this article is to estimate the role played by such factors in determining the occurrence of such diseases and utilization of formal health care for children under the age of three in India. The major findings are briefly enlisted as follows. First, a woman with greater educational qualification and autonomy in terms of her power to take decisions on her own, control over household resources and complete freedom to move beyond the confines of her household exerts a significant influence on the probability of seeking care. In addition to this, formal care is more likely to be sought for children whose mothers are more exposed to the media. Programmes devised to enhance utilization of formal health care for children should be targeted to catering for the needs of the vulnerable group i.e. female child, predominantly, residing in households belonging to Scheduled Tribe. In addition to this, children belonging to Muslim households are at higher risk of contracting the diseases but there is no significant difference in their health seeking behaviour as compared to other religious groups.     

How do income and education affect health inequality: evidence from four developing countries

Using household survey data from four countries ? Albania, Nepal, Tajikistan and Tanzania ? this article calculates income-related inequality in health care utilization. We measure health disparity separately for generally and chronically ill individuals by constructing two models: one for the probability of a visit to a physician and another for the number of visits. Following model-based measurements, we decompose inequality into two major parts: one accounted for by identity-related factors and another by socioeconomic and other factors such as education, geography and distance to a clinic. We propose a new method to quantify the effect of changes in income and education on health disparity. One of our important findings suggests that health disparity is pro-rich in all our sample countries. The pro-rich disparity is prevalent among generally ill as well as chronically ill patients, in both visit probability and visit frequency models. Health inequality seems primarily driven by income differences followed by nonidentity factors. Further, the principle of equal treatment for equal need is not fulfilled in any of our countries. Among policy implications, increasing average income and education in a way that also reduces disparity in income and education, respectively, will substantially shrink inequality in health care utilization.     

Effects of health insurance on labour supply: evidence from the health care fund for the poor in Vietnam

The expansion of health insurance in emerging countries raises concerns about the unintended negative effects of health insurance on labour supply. This article examines the labour supply effects of the Health Care Fund for the Poor (HCFP) in Vietnam in terms of the number of work hours per month and labour force participation (the probability of employment). Employing various matching methods combined with a Difference-in-Differences approach on the Vietnam Household Living Standard Surveys 2002–2006, we show that the HCFP, which aims to provide poor people and disadvantaged minority groups with free health insurance, has a negative effect on labour supply. This is manifested in both the average number of hours worked per month and the probability of employment, suggesting the income effect of the HCFP. Interestingly, the effects are mainly driven by the non-poor recipients living in rural areas, raising the question of the targeting strategy of the programme.     

Later is better: mobile phone ownership and child academic development,evidence from a longitudinal study

ABSTRACT

Digital technologies have become an increasingly prominent feature of children’s lives both within and outside educational environments (McCoy, Quail, and Smyth 2012. Influences on 9-Year-Olds’ Learning: Home, School and Community. Dublin: Department of Children and Youth Affairs). Despite considerable media debate, we have little robust evidence on the impact of technology use on children’s development, both academically and socially. Much of the literature in this area relies on small-scale cross-sectional studies. Using longitudinal data on 8500 9-year-old children in Ireland, we examine the influence of early mobile phone ownership on children’s performance in reading and maths between 9 and 13 years of age. Across both reading and maths domains, children who already report owning a phone by the age of nine fare less well in terms of their academic development as they move into adolescence. The measured effects are sizeable, implying about 4 percentile lower ranking on standardised tests for an average student. Our results are consistent with the idea that there may be significant educational costs arising from early mobile phone use by children. Parents and policymakers should consider whether the benefits of phone availability for children are sufficiently large to justify such costs. We suggest a range of direct and indirect cognitive effects that could help explain these results.     

Efficiency of health care delivery systems: effects of health insurance coverage

Health insurance expansions may increase the demand for care-creating incentives for health systems to increase input consumption. The possibility remains that added capacity and personnel will have little effect on health outcomes, decreasing the technical efficiency of health care delivery systems. We estimate that a 1 percentage point increase in health insurance coverage decreases the technical efficiency of health care delivery by 1.3 percentage points, translating into approximately 50 billion dollars in additional health expenditures. This finding uncovers a previously unexplored consequence of changes in health insurance on the supply side of health care markets suggesting one avenue through which health care costs growth may occur.     

The impact of universal child benefits on family health and behaviours

In 2006, the Universal Child Care Benefit was introduced in Canada for all children aged less than 6 years. This program aims to help cover the cost of children and to provide financial assistance to families with young children in their choice of childcare. We exploit this policy change to estimate the effects of unconditional family cash transfers on the health and behaviours of two-parent families and their children. Using a difference-in-differences model, we find no evidence that the program improved child and parental outcomes in aggregate. A modest but fragile beneficial effect is found for low-education families and for girls.