Child-headed households in South Africa: What we know and what we don't

Household structures in many countries in Africa have been drastically changed by the HIV/AIDS epidemic. Traditionally, orphans were absorbed by members of the extended family but today this safety net no longer works so well and many children are left to fend for themselves. The South African Government recognises the problem, but views differ on the effectiveness of the programmes for assisting these children. This article looks at what is known and what needs further research. It is known that child-headed households do exist in South Africa and that children living in these households are vulnerable. What is not known is the prevalence of these households and how to deal with the children's psycho-social problems. The article argues that the definition of child-headed households needs to be refined if we are to understand the extent of the problem. This will facilitate assessment of the programmes established for these children.     

Poverty,HIV/AIDS and the old age pension in Bhambayi,Kwazulu-Natal,South Africa

To date the international community has tended to direct HIV prevention programmes, treatment, care and supportive services to young adults and children, with little concern about the impact on older people. Since empirical evidence on the socioeconomic impact of HIV/AIDS on households with older persons is lacking, this paper attempts to fill this gap, using data from a household-based survey conducted in Bhambayi, a mixed formal and informal settlement north of eThekwini, KwaZulu-Natal. The findings highlight the links between the uptake of the South African old age pension, poverty and HIV/AIDS in households with older persons. The paper makes recommendations for both government and non-governmental organisations in respect of community-based support systems for such households affected by HIV/AIDS.     

Regression analysis on the variation in efficiency frontiers for prevention stage of HIV/AIDS

Abstract

Objectives:

To investigate how the cost effectiveness of preventing HIV/AIDS varies across possible efficiency frontiers (EFs) by taking into account potentially relevant external factors, such as prevention stage, and how the EFs can be characterized using regression analysis given uncertainty of the QALY-cost estimates.

Methods:

We reviewed cost-effectiveness estimates for the prevention and treatment of HIV/AIDS published from 2002–2007 and catalogued in the Tufts Medical Center Cost-Effectiveness Analysis (CEA) Registry. We constructed efficiency frontier (EF) curves by plotting QALYs against costs, using methods used by the Institute for Quality and Efficiency in Health Care (IQWiG) in Germany. We stratified the QALY-cost ratios by prevention stage, country of study, and payer perspective, and estimated EF equations using log and square-root models.

Results:

A total of 53 QALY-cost ratios were identified for HIV/AIDS in the Tufts CEA Registry. Plotted ratios stratified by prevention stage were visually grouped into a cluster consisting of primary/secondary prevention measures and a cluster consisting of tertiary measures. Correlation coefficients for each cluster were statistically significant. For each cluster, we derived two EF equations – one based on the log model, and one based on the square-root model.

Discussion:

Our findings indicate that stratification of HIV/AIDS interventions by prevention stage can yield distinct EFs, and that the correlation and regression analyses are useful for parametrically characterizing EF equations. Our study has certain limitations, such as the small number of included articles and the potential for study populations to be non-representative of countries of interest. Nonetheless, our approach could help develop a deeper appreciation of cost effectiveness beyond the deterministic approach developed by IQWiG.     

河南艾滋病村驻村调查笔记

通过对艾滋病村和受艾滋病影响群体状况的直接观察和解释,揭示艾滋病疫情对当地社会经济发展、人民生活和社会稳定所造成的负面影响。政策建议:(1)为了避免更大的灾难,政府应当把遏止艾滋病作为“科学发展观”和“人口与发展战略”的一个组成部分,以便进一步动员各方面资源参与艾滋病的防治工作。(2)国家人口和计划生育系统应当全面介入国家的艾滋病预防。     

Invariance, price indices and estimation in almost ideal demand systems

Two issues are addressed in this paper. First, we explore the issue of price index invariance in the linearized Almost Ideal demand system. We establish that the Stone index, which lacks invariance, and the recently proposed invariant Laspeyres, Paasche and Tornqvist indices all generate biased and inconsistent estimators. Monte Carlo evidence shows that invariance does not necessarily lead to better estimates of price and income elasticities insofar as the Stone and Paasche indices are unambiguously inferior to the Laspeyres and Tornqvist indices, especially if prices are not strongly positively correlated. Second, we examine the merits of the widely used conditional ML estimator of the non-linear Almost Ideal system in which a prior value is chosen for the “subsistence” parameter. We find that the bias and trace mean square error increases induced by conditional estimation are modest. The choice between the linearized and the non-linear models favors the latter although in some cases linear methods are as good as non-linear. First Version Received: January 1999 / Final Version Received: March 2000     

HIV/AIDS AND POVERTY IN SOUTH AFRICA: A BAYESIAN ESTIMATION OF SELECTION MODELS WITH CORRELATED FIXED‐EFFECTS

In this paper, we estimate the causal impact of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) on monetary poverty using a panel database from South Africa. We treat endogeneity and selection problems associated with HIV/AIDS by a selection model that includes correlated fixed effects both in the level and in the participation equations, which are estimated simultaneously via original Bayesian methods. We model the consequences of the illness on both labour income and income transfers, and disentangle between urban and rural households. While no significant impact of HIV/AIDS on labour income is found because of households' recomposition, we find a substantial fall in received transfers among rural population and a dramatic increase in chronic poverty.     

Food Demand in Mexico: An Application of the Amemiya-Tobin Approach to the Estimation of a Censored Food System

The modeling of micro-level food demand patterns requires not only allowing for household heterogeneity, but also addressing the problem of censoring. In this article, we present a variation of the Amemiya-Tobin framework for estimating a censored demand system that allows for household heterogeneity. The unique aspect of our approach is the use of a procedure that ensures the adding up of both latent and observed expenditure shares and also imposes expenditure share nonnegativity. This system is applied to an analysis of food demand based on a random sample of urban Mexican households.     

我国葡萄酒进口需求及产品异质性的实证研究

我国是葡萄酒净进口国,随着我国居民收入水平的不断提高,进口规模逐渐扩大,需要把握进口变化的动因,判断我国葡萄酒进口贸易的发展方向,从而促进我国葡萄酒贸易的健康发展。运用进口需求模型定量分析葡萄酒进口变化的主要决定因素,进而针对不同来源地产品之间的关系,用近似理想需求系统模型进行分析。结果表明,随着消费者收入的提高和进口关税的降低,我国葡萄酒进口贸易仍有很大发展空间;进口葡萄酒和国产葡萄酒存在差异化竞争,进口葡萄酒占据了我国高端市场;在我国的葡萄酒进口市场上,法国与智利和澳大利亚的产品具有异质性,智利与澳大利亚的产品表现为同质性。我国葡萄酒进口规模将逐渐扩大,国产高端产品需要一定的保护和培育。     

Intellectual Property and the Pharmaceutical Industry: A Moral Crossroads Between Health and Property

The moral justification of intellectual property is often called into question when placed in the context of pharmaceutical patents and global health concerns. The theoretical accounts of both John Rawls and Robert Nozick provide an excellent ethical framework from which such questions can be clarified. While Nozick upholds an individuals right to intellectual property, based upon its conformation with Lockean notions of property and Nozicks ideas of just acquisition and transfer, Rawls emphasizes the importance of basic liberties, such as an individuals right to health, superceding such secondary rights as intellectual property rights. From a policy perspective, patent protection for pharmaceutical products necessarily entails the balancing of corporate intellectual property interests and public interests in healthcare. The moral dilemma that occurs when these two interests clash is not easily resolved. Aside from corporate and public interests, the state maintains an interest in creating and preserving policies that regulate the moral dilemma itself. This paper analyzes the economic and ethical factors surrounding the production and distribution of the anti-HIV medication, AZT. Potential policy implications and recommendations are also discussed.     

Adult Mortality,AIDS, and Fertility in Rural Malawi

The future course of fertility is a major determinant of economic development in many sub‐Saharan countries, so understanding how HIV/AIDS affects childbearing is of great interest. We show that fertility responds negatively to female mortality and positively to male mortality and that the overall fertility response is small. The negative effect of female mortality is in line with earlier studies that only focus on women and their infection and mortality risks, while the finding of a positive effect of adult‐male mortality is novel. One interpretation of this finding is that women who perceive a high risk of their husbands' or grown‐up sons' deaths are likely to want to have more children to ensure future support.