Publication: AERC-Cornell Symposium on 'Risk, Knowledge and Health in Africa': ARV Treatment and Time Allocation to Household Tasks: Evidence from Kenya
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Date
2009
ISSN
10176772
Published
2009
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Using 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.
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Publication AIDS Treatment and Intrahousehold Resource Allocation: Children's Nutrition and Schooling in Kenya(2009)The 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. 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Young boys in treated patients' households work significantly less after treatment initiation, while girls and adult household members do not change their labor supply.Publication The Effect of Absenteeism and Clinic Protocol on Health Outcomes : The Case of Mother-to-Child Transmission of HIV in Kenya(American Economic Association, 2013-04)We show that pregnant women whose first clinic visit coincides with the nurse's attendance are 58 percentage points more likely to test for HIV and 46 percent more likely to deliver in a hospital. Furthermore, women with high pretest expectations of being HIV positive, whose visit coincides with nurse attendance, are 25 and 7.4 percentage points more likely to deliver in a hospital and receive PMTCT medication, and 9 percentage points less likely to breast-feed than women whose visit coincides with nurse absence. 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The home-based HIV testing intervention resulted in community leaders reporting lower levels of stigma. However, stigma among community members reacted in mixed ways, and there is little evidence that the program affected beliefs about HIV prevalence and prevention.Publication Health as a Family Matter : Do Intra-household Education Externalities Matter for Maternal and Child Health?(2008)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. 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