Market imperfections,access to information and technology adoption in Uganda: challenges of overcoming multiple constraints

Limited empirical evidence exists on how multiple binding constraints influence the adoption of improved technologies by smallholder farmers. This article uses the case of groundnut variety adoption in Uganda to investigate the role of information, seed supply, and credit constraints in conditioning technology uptake. New data from a household survey in seven groundnut growing districts (n = 945) indicate that 8% of farmers lack information on new varieties, while 18% and 6% of farmers, respectively, cannot adopt mainly due to seed supply and capital constraints. A tobit‐type specification that considers all nonadopters as being uninterested in the technology (i.e., corner solutions) would lead to inconsistent parameter estimates and incorrect conclusions in this context. We therefore estimate a modified multi‐hurdle specification of demand for new varieties, taking into account how information, seed supply, and capital constraints jointly determine adoption probability and intensity. The study reveals new empirical insights on why agricultural technology adoption in Africa has lagged behind: slow uptake is not mainly due to a lack of economic incentives, but rather a reflection of information, seed supply, and credit constraints that prevent farmers from translating their desired demand into adoption of modern varieties. Policy implications are discussed.     

Literacy Practices and Schooling: A Case Study from Mozambique

A novel approach to the assessment of literacy is used to tackle the issue of effectiveness of years of schooling. The dichotomy inherent in the literacy rate is rejected in favor of a “practice-based” approach, which considers literacy as a multifaceted phenomenon as advocated in anthropological and economic research. Primary data collected in the poorest region in Mozambique suggest that years of schooling have a differentiated impact on acquired literacy practices of adults. Results that are robust to different specifications are reported.     

INTRA-HOUSEHOLD ALLOCATIONS IN RURAL ETHIOPIA: A DEMAND SYSTEMS APPROACH

This article examines the effects of price, income and demographic changes on intra-household allocations by integrating the outlay equivalent method into the Quadratic Almost Ideal Demand System (QUAIDS). Tests for separability in preferences and demographic separability are conducted. Longitudinal data to control for household heterogeneity are used. Results indicate that Ethiopian rural households respond to price, income and demographic changes in a more complicated manner than usually presumed; price, income and demographic changes do not have similar effects on all household members. Income changes affect men and boys more than women and girls, but variations in prices affect women and boys more than men and girls. Even though outlay equivalent ratios on average indicate discrimination against girls, girls are more protected from fluctuations in income and prices compared to boys. The results highlight limitations of previous studies that ignore direct income and price effects.     

Real-world incidence and burden of adverse events among non-metastatic prostate cancer patients treated with secondary hormonal therapies following androgen deprivation therapy

Abstract

Aims: To describe the incidence and identify prognostic factors of central nervous system (CNS) adverse events (AEs) and any AEs (CNS, skin rash, or fracture) and evaluate the healthcare resource utilization (HCRU), direct medical costs, and therapy discontinuation associated with these AEs among non-metastatic prostate cancer (nmPC) patients who received secondary hormone therapies.

Methods and results: nmPC patients who had initiated secondary hormonal therapy with enzalutamide, bicalutamide, or abiraterone ≥1?year after androgen deprivation therapy (ADT) were identified in the MarketScan database. Survival analyses were used to describe the incidence of CNS or any AEs. Annual HCRU and costs were compared across patient groups (CNS AE vs no CNS AE; any AE vs no AE) using propensity score weighted generalized linear models. Multivariate Cox proportional hazards models were used to identify AE predictors and compare risks of discontinuation.

Results: The analysis included 532 patients who initiated secondary hormonal therapies, among whom 201 (38%) and 244 (46%) experienced a CNS AE and any AE, respectively. Median times to CNS AE and any AE from therapy initiation were 17.90 and 11.00?months, respectively. Predictors of any AE were any AE in the baseline period (≤6?months before starting therapy), Charlson Comorbidity Index (CCI) score (1 vs 0), surgical castration, and older age. Predictors of CNS AEs were CNS AE in the baseline period and CCI score (1 vs 0). CNS and any AEs were associated with significantly higher HCRU. CNS AEs were associated with significantly higher incremental total medical costs ($18,522). CNS AEs and any AEs significantly increased therapy discontinuation risk by 48% and 38%, respectively.

Conclusions: AEs increase the economic burden and therapy discontinuation among nmPC patients receiving secondary hormonal therapies subsequent to ADTs. These patients should be carefully evaluated for AEs to reduce therapy discontinuation, HCRU, and direct medical costs.     

Intrahousehold Welfare in Rural Ethiopia*

We examine the relationship between bargaining power and intrahousehold welfare in rural Ethiopia. The relative nutrition of spouses is associated with differences in cognitive ability, independent income and asset devolution upon divorce. Female empowerment benefits child nutrition and education. Spouses’ health, leisure and consumption of assignable goods show no association with differences in bargaining power. The relative nutrition and health of spouses varies across villages, but not in ways predicted by anthropological accounts of female empowerment. Bargaining variables may be weakly associated with intrahousehold welfare because surveyed households are poor and have little room for disagreement over consumption.