Natascha Wagner

Child health, its dynamic interaction with nutrition and health memory--evidence from Senegal.

Child malnutrition is pervasive in developing countries and anthropometric measures such as weight-for-height and height-for-age have proven reliable indicators of short term malnutrition and stunting. Rather than studying these indicators separately, we look at their interaction and carve out child health dynamics. Considering height-for-age a childs health stock and weight-for-lagged height a proxy for nutritional inputs, we develop a child health production function that features self-productivity of past health stocks and contemporaneous nutritional inputs. We test the model on a Senegalese panel of 271 children between 0 and 5 years employing dynamic panel methods to control for endogeneity in the production function. In line with previous evidence, we find that children can partially catch-up from malnutrition spells. Yet, child health stocks also deplete quickly and need constant updating in the form of nutrition. This demonstrates the importance of health memory and that malnutrition cannot be fought with snapshot interventions. Consequently, sustainable nutrition interventions have to be long term and yield higher returns the earlier they reach children.

Polygyny and Child Growth: Evidence From Twenty-Six African Countries

ABSTRACT Using household data from twenty-six African countries, this study examines the correlation between four measures of polygyny and child growth. External validity is added to existing small-sample evidence by investigating this correlation across many countries and by controlling for, as well as exploring, sources of heterogeneity at the regional, country, household, and maternal level. Household fixed-effects models indicate that the children of monogamous mothers have significantly greater height-for-age z-scores than children of polygynous mothers. Also, a low ranking in the hierarchy of mothers and the ratio of married women to men are negatively correlated with child height. The correlation varies widely across countries and is strongest for multigenerational polygynous households.

Resource Dependence and Armed Violence: Impact on Sustainability in Developing Countries

The dependence on oil, gas, and mineral exports arguably has a negative impact on economic growth in resource-rich, developing countries. This article looks at the impact of resource dependence on adjusted net savings (ANS) as an indicator of weak sustainability. Our results, based on a panel of 104 developing countries during the recent commodity price boom, confirm a negative relationship between resource extraction and sustainable development as measured by ANS. We further look at the specific role of armed conflict and armed violence as captured by the homicide rate. Armed conflict, which is positively associated with resource dependence, negatively affects ANS per capita according to both our OLS and instrumental variables (IV) estimates. Similarly, armed violence has a detrimental effect on sustainable development. Our IV estimate suggests that a one-point increase in the homicide rate decreases ANS per capita by

Female Genital Cutting and Long-Term Health Consequences - Nationally Representative Estimates across 13 Countries

60. Since education expenditures are a critical ANS component, we further examine the impact of resource dependence and violence on human capital. Consistent with previous findings, resource-dependent countries underinvest in education but armed conflict and violence do not affect the instantaneous share of education expenditures, hinting at a detrimental effect working through physical and social capital rather than education.

Universal health coverage at the macro level: Synthetic control evidence from Thailand

Abstract Using cross-sectional data from 13 African countries, I compare long-term health outcomes across cut and uncut women. This study is the first to use nationally representative data. Consistent with medical research, no evidence of general health impairments or decreased fertility induced by female genital cutting (FGC) is found; rather cut women have more children. The most pronounced long-term health impairments are a 24 per cent increase in the odds of contracting sexually transmitted infections and a 15 per cent increase in genital problems. Concomitantly, the odds that a cut woman will marry before an uncut woman are 13 per cent.

Misfortunes never come singly: Structural change, multiple shocks and child malnutrition in rural Senegal

As more and more countries are moving towards Universal Health Coverage (UHC), it is important to understand the macro level or aggregate impacts of such a policy. We use synthetic control methods to study the impact of UHC, introduced in Thailand in 2001, on various macroeconomic and health outcomes. Thailand is compared to a weighted average of control countries in terms of aggregate health financing indicators, aggregate health outcomes and economic performance, over the period 1995 to 2012. Our results suggest that UHC helps alleviate the financial consequences of illnesses. The estimated treatment effect of UHC on out-of-pocket payments as a percentage of overall health expenditures is negative 13 percentage points and its effect on annual government per capita health spending is US

HIV/AIDS sensitisation and peer mentoring: evidence from a randomised experiment in Senegal

79. We detect a smaller effect of US

How Much Should We Trust Micro-data? A Comparison of the Socio-demographic Profile of Malawian Households Using Census, LSMS and DHS data

60.8 on total health spending per capita which appears with a lag. We document positive health effects as captured by reductions in infant and child mortality. We do not find any effect on GDP and the share of the government budget devoted to health. Overall, our results complement micro evidence based on within country variation. The counterfactual design implemented here may be used to inform other countries on the macro level repercussions of UHC.

Polygyny and child health revisited

This study considers the two most pronounced shocks Senegalese subsistence farmers struggle with, namely increasing purchase prices and droughts. We assess the relationship of these self-reported shocks with child health in a multi-shock approach to account for concomitance of adverse events from the natural, biological, economic and health sphere. We employ a unique farming household panel dataset containing information on children living in poor, rural households in eight regions of Senegal in 2009 and 2011 and account for structural changes occurring between survey periods due to the large scale, national Nutrition Enhancement Program. By zooming in to the micro level we demonstrate that Senegal as a Sahelian country, mainly reliant on subsistence agriculture, is very vulnerable to climate variability and international price developments: According to our conservative estimates, the occurrence of a drought explains 25% of the pooled weight-for-age standard deviation, income losses 31%. Our multi-shock analysis reveals that the shocks are perceived as more severe in 2011 with droughts explaining up to 44% of the standard deviation of child health, increased prices up to 21%. Yet, the concomitance of droughts and increased prices after the structural change, i.e. the Nutrition Enhancement Program, indicates that the health of children experiencing both shocks in 2011 has improved. We argue that these results are driven by the increase in rural household income as theoretically outlined in the agricultural household model. Thus, adequate policy responses to shocks do not only depend on the nature but also on the concomitance of hazardous events.

Protocol for a Randomized Controlled Trial Evaluating Mobile Text Messaging to Promote Retention and Adherence to Antiretroviral Therapy for People Living With HIV in Burkina Faso

Using a simple experimental design, count data models and routinely collected administrative data from Senegalese health districts, this study examines whether funding community-based organisations can be an effective method of increasing voluntary counselling and testing. Two treatment groups are identified: a newly introduced peer-mentoring mechanism and traditional social mobilisation. Findings indicate that funded peer mentoring roughly doubles the number of individuals who get tested, who follow pretest counselling and who collect their test results, whereas funded traditional social mobilisation appears to be slightly less effective. Moreover, the study demonstrates that inexpensive administrative data can be used for impact evaluation.