Child Schooling,Child Health,and Rainfall Shocks: Evidence from Rural Vietnam

Abstract

We study the effect of rainfall shocks on child schooling outcomes and on standardised height for age (a measure of child health) in rural Vietnam. We find that adverse rainfall shocks during pregnancy adversely affect children’s school entry delay and progress through school. Adverse rainfall shocks in the third year of life adversely affect both schooling and child health. These effects differ by region, as a result of constraints that reflect regional economic heterogeneity. We predict that policies that help rural families smooth income shocks will result in increases in human capital and in substantial cumulative returns over a worker’s working life.     

Resource Management under Climatic Risk: A Case Study from Niger

In this article, we develop an empirical model of an agro-pastoral system subject to high climatic risk in order to test the impact of rainfall variability on livestock densities, land allocation patterns and herd mobility observed at the community level. Also, because grazing land is a common-pool resource, we determine the impact of cooperation on these decision variables. To capture different abilities of communities to cooperate in managing these externalities, we construct indices comprised of factors considered to affect the costliness of achieving successful cooperation. We then test hypotheses regarding the impact of rainfall variability and cooperation, using data collected in a semi-arid region of Niger. Results indicate that rainfall variability initially leads to higher densities, but the impact becomes negative as variability increases still further. This result indicates that the benefits of accumulating large herds in variable environments are eventually offset by the increasing probability of large losses. Mobility in the current period is strongly related to current rainfall, and is also positively related to long-term rainfall variability. Communities with characteristics hypothesised to favour cooperation have lower stock densities and greater herd mobility. Neither cooperation nor rainfall variability has a significant impact on the proportion of land allocated to crops or common pastures.     

Effects of Insurance on Child Labour: Ex-Ante and Ex-Post Behavioural Changes

In this paper we analyse possible effects of insurance on child labour. First, we develop a theoretical model that separates effects of insurance with and without a shock taking place. We then empirically test the hypotheses derived from the model by analysing the extension of a health insurance product in urban Hyderabad in Pakistan. Consistent with the theoretical model we develop in this paper, the reduction in child labour caused by the extension is largely due to an ex-ante feeling of protection as opposed to an ex-post shock-mitigation effect.     

Educated Mothers,Well-Fed and Healthy Children? Assessing the Impact of the 1980 School Reform on Dietary Diversity and Nutrition Outcomes of Zimbabwean Children

We scrutinise the causal influence of schooling on child dietary diversity and nutrition in Zimbabwe using the exogenous variability in schooling prompted by the 1980 education policy, a natural trial fitting a fuzzy regression discontinuity design. We established that a one-year of learning promotes dietary diversity and nutrition even after accounting for plausible mediating factors. Also, education is more liable to impact dietary practices and nutrition through improvements in health knowledge, literacy, wealth and prenatal care utilisation. These findings suggest that promoting schooling access to girls in resource-poor nations might have far-reaching implications on feeding practices and consequently child nutrition.     

The Political Economy of Child Mortality Decline in Tanzania and Uganda, 1995–2007

This article identifies political economy factors that help explain dramatic differences in the pace of child mortality reduction between Tanzania and Uganda from 1995 to 2007. The existing literature largely explains divergence in basic health outcomes with reference to economic variables such as GDP per capita. However, these factors cannot explain recent divergence across African countries with similar levels of GDP per capita, rates of economic growth, and levels of health funding. I argue that institutional and governance divergences between Tanzania and Uganda can be linked directly to differing coverage levels of key child health interventions (especially related to malaria control), and thus to differing child health outcomes. These institutional differences can be explained in part by historical factors, but more relevant causes can be found in recent political events. In Tanzania, there was an unusually effective project of institution building in the health sector, while in Uganda, by contrast, there was a negative political shock to the health system. This was driven by the repatrimonialization of the Ugandan state after President Yoweri Museveni??s decision to eliminate term limits in the 2001?C2006 period. This repatrimonialization process reversed previous health sector institutional gains and had particularly negative effects on child health service delivery in Uganda over the period in question.     

Child Income Appropriations as a Disease-Coping Mechanism: Consequences for the Health-Education Relationship

This paper analyses the relationships between HIV/AIDS and education taking into account the appropriative nature of child income. Using a theoretical model, we show that considering remittances from one’s child as an insurance asset can reverse the usual negative relationship between disease prevalence and educational investment. This prediction confirms the results of an empirical study conducted on data compiled from the Demographic and Health Survey (DHS) database for 12 sub-Sahara African countries for children aged between 7 and 22-years-old. Using regional HIV prevalence as a measure of health risk, we find that the ‘sign of the slope’ between health risk and the enrolment of children is not constant. Splitting the data based on expected remittance patterns (for example rural versus urban), we obtain that the effect is most likely driven by household characteristics related to child income appropriation.     

Piped Water Access,Child Health and the Complementary Role of Education: Panel Data Evidence from South Africa

This study establishes the causal impact of piped water access on child health in rural South Africa (2008–2015) through the use of a panel dataset and a quasi-experimental sample space. By employing an ordinal measure of child health as the dependent variable within linear fixed effects, logit, ordinal probit, and propensity-score matched linear as well as non-linear Difference-in-Difference, it is demonstrated that positive health benefits for children with access to piped water are observed if and only if the minimum level of educational attainment of the primary-caregiver is equal to or greater than seven years. This finding of complementarity is demonstrated to be a function of an individual’s (in)capacity to evaluate water quality: people below this threshold suffer from a piped water bias, place insufficient weight on the observable characteristics of water when determining water quality, and are subsequently less likely to treat piped water preceding consumption.     

The Impact of Resource Inflows on Child Health: Evidence from Kwazulu-Natal,South Africa, 1993–98

This paper investigates changes to the health status of young children (aged 0–5 years) in the Kwazulu-Natal province of South Africa during 1993–98. In our estimation we explicitly take into account the potential endogeneity of household resources in affecting child health. In particular, we examine whether the effect of resources is differentiated by the source, the age and the sex of the recipient. Finally, we also take into account the panel structure of the data and conduct (household level) fixed effects estimation of the determinants of child health. The estimation results show that the state of child health has experienced marked improvement following the dismantling of apartheid. Our results point to the role of household resources and health infrastructure availability in improving the health status of children.     

Does Health Aid Reduce Infant and Child Mortality from Diarrhoea in Sub-Saharan Africa?

Achieving sustained improvements in health outcomes remains a challenge for sub-Saharan Africa, where diarrhoea remains a leading cause of death in children under the age of five. This paper examines the impact of foreign aid to the health sector on diarrhoea mortality in children under five in 47 sub-Saharan African countries, using panel data on the sectoral allocation of official development assistance in conjunction with country-level data on health outcomes. After controlling for fixed effects and the potential endogeneity of health aid, we find that increased health aid and increased public health expenditure are associated with lower diarrhoea mortality in children under five. In addition, health aid increases government spending on health, suggesting that the overall impact of health aid on diarrheal death rates could exceed the direct effect. Furthermore, increased access to improved sources of water and sanitation are important in reducing child mortality from diarrhoea.     

Rangeland Degradation in North China Revisited? A Preliminary Statistical Analysis to Validate Non-Equilibrium Range Ecology

Over the past decades, the concepts of carrying capacity and Clementsian vegetation succession have come under attack from the theory of Non-Equilibrium Range Ecology. The new theory hypothesises that in arid regions with high rainfall variability the ecology is mainly determined by climatic and not biotic factors, such as animal grazing. The argument carried further implies that 'rangeland degradation' or 'desertification' are not caused by overgrazing but are part of a natural process of vegetation decline and growth in response to rainfall, which ruminant numbers merely follow. Few empirical studies involving time-series data have been executed to substantiate Non-Equilibrium Range Ecology. This article, hopes to make a contribution to the current debate with a statistical validation of one of its main postulates: the correlation between ruminant numbers and rainfall. The analysis is conducted with figures from the People's Republic of China: a state in which rangeland policy is an outstanding example of management on the basis of carrying capacities and Clementsian succession theory.     

Agricultural Production,Dietary Diversity and Climate Variability

Abstract

Nonseparable household modelsoutline the interlinkage between agricultural production and household consumption, yet empirical extensions to investigate the effect of production on dietary diversity and diet composition are limited. While a significant literature has investigated the calorie-income elasticity abstracting from production, this paper provides an empirical application of the nonseparable household model linking the effect of exogenous variation in planting season production decisions via climate variability on household dietary diversity. Using degree days, rainfall and agricultural capital stocks as instruments, the effect of production on household dietary diversity at harvest is estimated. The empirical specifications estimate production effects on dietary diversity using both agricultural revenue and crop production diversity. Significant effects of both agricultural revenue and crop production diversity on dietary diversity are estimated. The dietary diversity-production elasticities imply that a 10 per cent increase in agricultural revenue or crop diversity result in a 1.8 per cent or 2.4 per cent increase in dietary diversity respectively. These results illustrate that agricultural income growth or increased crop diversity may not be sufficient to ensure improved dietary diversity. Increases in agricultural revenue do change diet composition. Estimates of the effect of agricultural income on share of calories by food groups indicate relatively large changes in diet composition. On average, a 10 per cent increase in agricultural revenue makes households 7.2 per cent more likely to consume vegetables, 3.5 per cent more likely to consume fish, and increases the share of tubers consumed by 5.2 per cent.     

For Health,Strength, and Daily Food: The Dual Impact of Remittances and Public Health Expenditure on Household Health Spending and Child Health Outcomes

Abstract

Child and infant mortality in developing countries decreased 33.5 per cent and 30.9 per cent, respectively, during 1995–2009, while remittances and public health spending more than doubled. I examine how remittances and government health spending improve these child health outcomes. Neither government health spending nor remittances causally affect household health spending. Public health spending has an insignificant negative impact on mortality. The increase in remittances causally accounts for 32 per cent and 37 per cent of the decline in child and infant mortality, respectively. Remittances reduce mortality through improved living standards from the relaxation of households’ budget constraints.     

Infant and child mortality in developing countries: Analysing the data for Robust determinants

Is development best achieved by going for growth, or does specific attention need to be paid to directly improving human welfare? In contrast to the Human Development Reports of the UNDP, the World Bank has stressed the growth approach. Recent work has reinforced this position by arguing that health spending is extremely ineffective in reducing infant or child mortality, which is mainly explained by a country's income per capita. This article contests this position through testing the robustness of determinants of infant and child mortality. We have estimated over 420,000 equations which show that, while income per capita is a robust determinant of infant and child mortality, so are indicators of health, education and gender inequality. Some health spending, such as immunisation, is thus shown to be cost effective way of saving lives. Our results are consistent with the view that much health spending in developing countries may be poorly targeted or otherwise ineffective, but do not support the position that public health strategies should not be given too great a role in pursuing improvements in human welfare.     

Health care benefits in the public sector: An examination of availability,size, and managerial effects among north carolina municipalities

This study focuses on the extent to which health care benefits are used in North Carolina municipal governments. As such, it not only maps out the existence of these practices, but also the conditions and circumstances in which they occur. Health care practices (Basic dental and medical coverage, employee assistance programs, and child care provisions) are examined.

Since group health coverage is nearly universal (albeit the type and extent of coverage varies), it was not examined in this survey. With the exception of pre-paid dental insurance (41 percent) and unpaid maternity leave (31 percent), limited use is made of the various health care programs surveyed.

Population and workforce size effects are marginal.The presence of a city manager or town administrator, on the other hand, results in two or three fold the use as occurs in mayor-council cities.     

How Economic Empowerment Reduces Women’s Reproductive Health Vulnerability in Tanzania

This article uses data from Northern Tanzania to analyse how economic empowerment helps women reduce their reproductive health (RH) vulnerability. It analyses the effect of women’s employment and economic contribution to their household on health care use at three phases in the reproductive cycle: before pregnancy, during pregnancy and at child birth. Economic empowerment shows a positive effect on health seeking behaviour during pregnancy and at child birth, which remains robust after controlling for bargaining power and selection bias. This indicates that any policy that increases women’s economic empowerment can have a direct positive impact on women’s RH.     

The Impact of Indoor Air Pollution on the Incidence of Life Threatening Respiratory Illnesses: Evidence from Young Children in Peru

This article analyses the impact of indoor air pollution on boys' and girls' health, and the validity of various mitigation strategies using a panel of Peruvian children younger than six years old. It controls for unobserved child heterogeneity and important confounding variables established in the literature, but seldom available in surveys. The analysis finds a negative, statistically significant and considerable impact of indoor air pollution on child respiratory health. This impact is stronger and only significant for boys. To discard a spurious correlation the article shows diarrhoea, a priori not related to pollution, is not affected by cooking fuel choice.     

Seasonality and Trends in Child Malnutrition: Time-Series Analysis of Health Clinic Data from the Dowa District of Malawi

This article investigates the factors most affecting year-to-year trends and month-to-month fluctuations in underweight among children under five years of age in the Dowa District of Malawi from 2004 to 2012, including both the ability of households to obtain and utilise food and to child-related policy interventions. Time series regressions reveal strong hungry-season effects associated with both food availability and disease transmission, in addition to trends in household health. These findings reveal the complex nature of child malnutrition in the Dowa District and the importance of a food and nutritional security approach in understanding and addressing this phenomenon.     

Books received

This paper is concerned with the role of education as a determinant of health care choices. The central premise of the paper is that utilisation of health services is determined not solely by an individual's own education, but rather by a notion of effective education, which incorporates the educational attainment of other household members. The paper sets out a general framework for representing intra-household education externalities, and proposes a number of specific hypotheses concerning the way in which the education of different household members affects health care choices. These hypotheses are tested on data from Mozambique, focusing on maternity services, child immunisations, and child malnutrition. We draw four major conclusions from the analysis. First, while maternal education seems to be the education variable of primary importance for the health service and malnutrition variables under consideration, the education of other household members does have a significant and sometimes large effect. This is true not only for the spouse, but also the education of other individuals residing in the household. Second, the analysis suggests that while the education of the person (non-spouse) in the household with the highest level of education is important, the level of education of additional household members does not, as a rule, affect the use of services or child health outcomes. Third, the data provide no evidence of a gender difference in education externalities. Fourth, we examine the merits of two alternative representations of the education externality, but are unable to conclude unambiguously in favour of one specification over the other.     

Aid,Remittances, Medical Brain Drain and Child Mortality: Evidence Using Inter and Intra-Country Data

This article analyses the respective impact of aid, remittances and medical brain drain (MBD) on child mortality using panel and cross-country quintile-level data on respectively 84 and 46 developing countries. Our results show that remittances reduce child mortality while MBD increases it. Health aid also significantly reduces child mortality but its impact is less robust than the impact of remittances. Remittances seem to be more effective in reducing mortality for children belonging to households from the upper classes, whereas neither a pro-poor nor anti-poor effect is found for health aid.     

The joint demand for health care,leisure, and commodities: Implications for health care finance and access in Vietnam

This paper explores linkages between the demand for health care providers and the consumption of food, non-food goods, and leisure in Vietnam, using a mixed continuous/discrete dependent variable model. Cross-price elasticities calculated from the model suggest there are strong substitution effects between health care, leisure, and certain commodities. The model allows us to explore the implications of replacing user fees with alternative forms of health care finance, such as commodity taxes. In particular, the results suggest financing public health care services with a non-food sales tax rather than user fees would be more progressive and would improve access to care.