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PublicationTransactional Sex as a Response to Risk in Western Kenya(2011) Robinson, Jonathan; Yeh, EthanThough formal and informal sex work has long been identified as crucial for the spread of HIV/AIDS, the nature of the sex-for-money market remains poorly understood. Using a unique panel dataset constructed from 192 self-reported diaries, we find that women who engage in transactional sex substantially increase their supply of risky, better compensated sex to cope with unexpected health shocks, particularly the illness of another household member. These behavioral responses entail significant health risks for these women and their partners, and suggest that these women are unable to cope with risk through other consumption smoothing mechanisms. PublicationInside Informality : The Links between Poverty, Microenterprises, and Living Conditions in Nairobi's Slums(2010) Gulyani, Sumila; Talukdar, DebabrataUsing households rather than enterprises as the analytical unit, this study of 1,755 households in Nairobi's slums reveals that informal household microenterprises are indeed helping offset poverty. Microenterprises are helping households that are, a priori, more likely to be poor. Better microenterprise performance is associated with certain "business-related" factors, such as sales area, time in, and sector of operation. But "living conditions"--residential tenure and infrastructure access--also strongly influence both creation and success of microenterprises. Interventions that improve infrastructure and reduce tenure insecurity and rent-induced pressures to move may be crucial for incubating microenterprises and reinforcing their contribution to poverty alleviation in Nairobi's slums. PublicationThe Living Conditions Diamond: An Analytical and Theoretical Framework for Understanding Slums(2010) Gulyani, Sumila; Bassett, Ellen M.What constitutes a 'slum' is much debated in the urban poverty and affordable housing literature. We argue that a focus on living conditions can help clarify this and present a framework, the living conditions diamond, for detailing living conditions and determining how the settlements we deem 'slums' compare with each other and with nonslum settlements. The diamond distills living conditions into four dimensions: (i) tenure, (ii) infrastructure, (iii) unit quality, and (iv) neighbourhood and location. This framework depicts conditions in graphic terms enabling comparison of conditions within and across cities. The diamond moves us beyond the notion that slums are homogeneously poor in quality, and facilitates analyses that can reveal why they differ. Settlements in Nairobi, Kenya and Dakar, Senegal are compared. PublicationWomen's Use of Private and Government Health Facilities for Childbirth in Nairobi's Informal Settlements(2009) Bazant, Eva S.; Koenig, Michael A.; Fotso, Jean-Christophe; Mills, SamuelThe private sector's role in increasing the use of maternal health care for the poor in developing countries has received increasing attention, yet few data exist for urban slums. Using household-survey data from 1,926 mothers in two informal settlements in Nairobi, Kenya, collected in 2006, we describe and examine the factors associated with women's use of private and government health facilities for childbirth. More women gave birth at private facilities located in the settlements than at government facilities, and one-third of the women gave birth at home or with the assistance of a traditional birth attendant. In multivariate models, women's education, ethnic group, and household wealth were associated with institutional deliveries, especially in government hospitals. Residents in the more disadvantaged settlement were more likely than those in the better-off settlement to give birth in private facilities. In urban areas, maternal health services in both the government and private sectors should be strengthened, and efforts made to reach out to women who give birth at home. PublicationAERC-Cornell Symposium on 'Risk, Knowledge and Health in Africa': ARV Treatment and Time Allocation to Household Tasks: Evidence from Kenya(2009) d'Adda, Giovanna; Goldstein, Markus; Graff Zivin, Joshua; Nangami, Mabel; Thirumurthy, HarshaUsing longitudinal survey data collected over a period of two years, this paper examines the impact of antiretroviral (ARV) treatment on the time allocated to various household tasks by treated HIV-positive patients and their household members. We study outcomes such as time devoted to housework, firewood and water collection, as well as care-giving and care-seeking. As treatment improves the health and productivity of patients, we find that female patients in particular are able to increase the amount of time they devote to water and firewood collection. This increased productivity of patients coupled with large decreases in the amount of time they spend seeking medical care leads to a reduced burden on children and other household members. We find evidence that boys and girls in treated patients' households devote less time to housework and other chores. These results suggest that the provision of ARV treatment generates a wide variety of benefits to households in resource-poor settings. PublicationChanges in Wage Distributions, Wage Gaps and Wage Inequality by Gender in Kenya(2009) Agesa, Richard U.; Agesa, Jacqueline; Dabalen, AndrewUsing data from Kenya, the determinants of gender differences in the overall distribution of earnings are estimated as part of explaining the positive association between the return to measured and unmeasured human capital attributes as formalised by human capital theory (Mincer in 'Schooling Experience, and Earnings', New York: National Bureau of Economic Research, Columbia University Press, 1974). The Kenyan data allows us to demonstrate that males possess relatively more human capital, and once gender differences in measured and unmeasured skills are accounted for, males receive relatively higher returns to both their measured and unmeasured human capital attributes. These findings support the notion that gender differences in the return to human capital trigger male and female earnings differences in Kenya. PublicationAIDS Treatment and Intrahousehold Resource Allocation: Children's Nutrition and Schooling in Kenya(2009) Zivin, Joshua Graff; Thirumurthy, Harsha; Goldstein, MarkusThe provision of antiretroviral medications is a central component of the response to HIV/AIDS and consumes substantial public resources from around the world, but little is known about this intervention's impact on the welfare of children in treated persons' households. Using longitudinal survey data from Kenya, we examine the relationship between the provision of treatment to adults and the schooling and nutrition outcomes of children in their households. Weekly hours of school attendance increase by over 20% within 6 months after treatment is initiated for the adult patient. We find some weak evidence that young children's short-term nutritional status also improves. These results suggest how intrahousehold allocations of time and resources may be altered in response to health improvements of adults. PublicationThe Economic Impact of AIDS Treatment : Labor Supply in Western Kenya(2008) Thirumurthy, Harsha; Graff Zivin, Joshua; Goldstein, MarkusUsing longitudinal survey data collected in collaboration with a treatment program, this paper estimates the economic impacts of antiretroviral treatment. The responses in two outcomes are studied: (1) labor supply of treated adult AIDS patients; and (2) labor supply of individuals in patients' households. Within six months after treatment initiation, there is a 20 percent increase in the likelihood of the patient participating in the labor force and a 35 percent increase in weekly hours worked. Young boys in treated patients' households work significantly less after treatment initiation, while girls and adult household members do not change their labor supply. PublicationSlum Real Estate: The Low-Quality High-Price Puzzle in Nairobi's Slum Rental Market and Its Implications for Theory and Practice(2008) Gulyani, Sumila; Talukdar, DebabrataThis study of 1,755 households in Nairobi's slums challenges the conventional belief that slums offer low-quality, low-cost shelter to a population that cannot afford better standards. In Nairobi, slums provide low-quality but high-cost shelter. Although slum residents pay millions of dollars in rents annually, and better quality units command higher rents, very little is being re-invested to upgrade quality. To resolve the challenge that the Nairobi puzzle poses for theory and practice, we develop a new analytical framework for understanding quality of living conditions. Improving conditions in Nairobi's slums requires, we argue, two simultaneous interventions: alteration of the tenure mix to enhance owner occupancy and infrastructure investment.