We use three years of household panel data to analyze the effects of ill-health on household economic outcomes in rural Ethiopia. We examine the immediate effects of various ill-health measures on... Show moreWe use three years of household panel data to analyze the effects of ill-health on household economic outcomes in rural Ethiopia. We examine the immediate effects of various ill-health measures on health expenditure and labor supply, the subsequent coping responses, and finally the effect on income and consumption. We find evidence of substantial economic risk in terms of increased health expenditure and reduced agricultural productivity. Households are able to smooth consumption by resorting to intra-household labor substitution, borrowing and depleting assets. However, maintaining current consumption through borrowing and depletion of assets is unlikely to be sustainable and displays the need for health financing reforms and safety nets that reduce the financial consequences of ill-health. Show less
In 2011, in an attempt to increase access to health care and reduce household vulnerability to out-of-pocket health expenditure, the Government of Ethiopia launched a Community-Based Health... Show moreIn 2011, in an attempt to increase access to health care and reduce household vulnerability to out-of-pocket health expenditure, the Government of Ethiopia launched a Community-Based Health Insurance Scheme (CBHI). This paper uses three rounds of household survey data, collected before and after the introduction of the CBHI pilot, to assess the impact of the scheme on household consumption, income, indebtedness, and livestock holdings. We find that enrollment leads to a 5 percentage point-or 13%-decline in the probability of borrowing and is associated with an increase in household income. There is no evidence that enrolling in the scheme affects consumption or livestock holdings. Our results show that the scheme reduces reliance on potentially harmful coping responses such as borrowing. This paper adds to the relatively small body of work that rigorously evaluates the impact of CBHI schemes on economic welfare. Show less
Based on household survey data and event history interviews undertaken in a highly shock prone country, this paper investigates which shocks trigger which coping responses and why? We find clear... Show moreBased on household survey data and event history interviews undertaken in a highly shock prone country, this paper investigates which shocks trigger which coping responses and why? We find clear differences in terms of coping strategies across shock types. The two relatively covariate shocks, that is, economic and natural shocks are more likely to trigger reductions in savings and in food consumption while the sale of assets and borrowing is less common. Coping with relatively idiosyncratic health shocks is met by reductions in savings, asset sales and especially a far greater reliance on borrowing as compared to other shocks. Reductions in food consumption, a prominent response in the case of natural and economic shocks is notably absent in the case of health shocks. Across all shock types, households do not rely on gifts from family and friends or on enhancing their labour supply as coping approaches. The relative insensitivity of food consumption to health shocks based on the shocks-coping analysis presented here is consistent with existing work which examines consumption insurance. However, our analysis leads to a different interpretation. We argue that this insensitivity should not be viewed as insurability of food consumption against health shocks but rather as an indication that a reduction in food consumption is not a viable coping response to a health shock as it does not provide cash to meet health care needs. Show less
Health and healing in Africa have increasingly become subject to monetization and commodification, in short, the market. Based on fieldwork in nine countries, this volume offers different... Show moreHealth and healing in Africa have increasingly become subject to monetization and commodification, in short, the market. Based on fieldwork in nine countries, this volume offers different perspectives on these emerging markets and the way medical staff, patients, households and institutions navigate them in their quest for well-being. Contributions: Introduction: Economic ethnographies of the marketization of health and healing in Africa (Rijk van Dijk and Marleen Dekker); Milking the sick: medical pluralism and the commoditization of healthcare in contemporary Nigeria (Akinyinka Akinyoade and Bukola Adeyemi Oyeniyi); Organizing monies: the reality and creativity of nursing on a hospital ward in Ghana (Christine Böhmig); Market forces threatening school feeding: the case for school farming in Nakuru town, Kenya (Dick Foeken et al.); Dashed hopes and missed opportunities: malaria control policies in Kenya (1896-2009) (Kenneth Ombongi and Marcel Rutten); The market for healing and the elasticity of belief: medical pluralism in Mpumalanga, South Africa (Robert Thornton); Medical knowledge and healing practices among the Kapsiki/Higi of northern Cameroon and northeastern Nigeria (Walter E.A. van Beek); The commodification of misery: markets for healing, markets for sickness (Zanzibar) (Nadine Beckmann); Individual or shared responsibility: the financing of medical treatment in rural Ethiopian households (Marleen Dekker); Can't buy me health: financial constraints and health-seeking behaviour in rural households in central Togo (Andr‚ Leliveld et al.); Marriage, commodification and the romantic ethic in Botswana (Rijk van Dijk). [ASC Leiden abstract] Show less
