VIEW
PUBLICATIONS
BY:

→ COUNTRY/REGION

→ AUTHOR

→ PUBLICATION DATE

SAGA
B16 MVR Hall
Ithaca, NY 14853
(607) 255-8931
Fax (607) 255-0178
saga@cornell.edu

SAGA PUBLICATIONS Included here are Working Papers and Conference Papers. Publications on this page are organized by research themes: RETURN TO MAIN PUBLICATIONS BY RESEARCH THEME PAGE HEALTH AND NUTRITION The Relationship between Poverty and Maternal Morbidity and Mortality in Sub-Saharan Africa 2010 Meyerhoefer, Chad and David E. Sahn “Good maternal health is of fundamental importance to a country’s well-being and ability to prosper, and there are few times when maternal health is more at risk than in the period surrounding childbirth. Protecting the health of mothers during reproduction safeguards their future contributions to society and ensures the health and productivity of future generations. If either the health of mothers or their newborn offspring is compromised, there will be serious negative consequences for their families, communities, and the entire process of economic and social development. This is why the United Nations has set as one of its eight Millennium Development Goals (MDGs), the reduction of the maternal mortality ratio (MMR) by two-thirds in the developing world by the year 2015... ” Presented at the AERC/Hewlett Foundation Workshop, “Poverty and Economic Growth: The Impact of Population Dynamics and Reproductive Health Outcomes in Africa” in Brussels, Belgium, November 5-6, 2006 In Reproductive Health, Economic Growth and Poverty Reduction in Africa: Frameworks of Analysis, edited by Olu Ajakaiye and Germano Mwabu. University of Nairobi Press, 2010 Empirical Forecasting of Slow-Onset Disasters for Improved Emergency Response: An Application to Kenya’s Arid North August 2009 Mude, Andrew, Christopher B. Barrett, John G. McPeak, Robert Kaitho and Patti Kristjansen Mitigating the negative welfare consequences of crises such as droughts, floods, and disease outbreaks, is a major challenge in many areas of the world, especially in highly vulnerable areas insufficiently equipped to prevent food and livelihood security crisis in the face of adverse shocks. Given the finite resources allocated for emergency response, and the expected increase in incidences of humanitarian catastrophe due to changing climate patterns, there is a need for rigorous and efficient methods of early warning and emergency needs assessment. In this paper we develop an empirical model, based on a relatively parsimonious set of regularly measured variables from communities in Kenya’s arid north, that generates remarkably accurate forecasts of the likelihood of famine with at least three months lead time. Such a forecasting model is a potentially valuable tool for enhancing early warning capacity. Presented at Policy Research Conference on “Pastoralism and Poverty Reduction in East Africa,” held in Nairobi, Kenya, June 27-28, 2006 In Food Policy 34(4): 329-339, August, 2009 Measuring Intra-Household Inequality: Explorations Using the Body Mass Index April 2009 Sahn, David E. and Stephen D. Younger This paper examines the relationship between level of well-being and inequality at inter-country and intra-household levels, using individuals’ body mass index (BMI) rather than income as the indicator of well-being. BMI is useful for these purposes because (1) it is measured at the individual rather than household level; (2) it reflects command over food, but also non-food resources that affect health status like sanitary conditions and labour-saving technologies; (3) it accounts for caloric consumption relative to needs; (4) it is easily measured; and (5) any measurement error is likely to be random. We do not find any evidence to support the idea of an intra-household or inter-country Kuznets curve. We study the correlations between average household well-being, still measured by BMI, and differences in the BMIs of males and females, parents and children. Here, we find a tendency to protect the BMI of young children when living standards are very low. We find no clear patterns by gender. Perhaps the most striking finding in the paper is that about half of total BMI inequality at the country level is within households. Thus, standard measures of inequality that use household-level data may drastically understate true inequality. Presented at the WIDER Conference on Advancing Health Equity, Helsinki, Finland, September 29-30, 2006, and the CIRPÉE Conference on Health Economics, Université Laval, March 30, 2007 In Health Economics 18(S1): S13-S36, April, 2009 (UNU-WIDER Special Issue on Health and Development) Determinants of HIV Knowledge and Condom Use among Women in Madagascar: An Analysis Using Matched Household and Community Data April 2009 Glick, Peter, Josée Randriamamonjy, and David E. Sahn We estimate the determinants of HIV/AIDS knowledge and related behavior (use of condoms) among women in Madagascar, a country where prevalence remains low but conditions are ripe for a rapid increase in infections. In both rural and urban areas, more educated and wealthier women are more likely to know about means of preventing infection, less likely to have misconceptions about transmission, and more likely to use condoms. Community factors such as availability of health centers and access to roads also are associated with greater HIV knowledge. However, most of the large rural-urban difference in mean knowledge is due not to location per se but to differences in schooling and wealth; rather than simply being geographically targeted, AIDS education efforts must be designed to target and be understood by uneducated and poor subpopulations. In African Development Review 21(1): 147-179, April, 2009 Do Free Goods Stick to Poor Households? Experimental Evidence on Insecticide Treated Bednets March 2009 Hoffmann, Vivian, Christopher B. Barrett, and David R. Just If the market allocates goods to those willing and able to pay the most for them, efforts to target durable health goods such as insecticide-treated bednets (ITNs) to poor populations may prove ineffective, with the poor reselling donated goods to the non-poor who value them more highly. However, low market demand may be due to liquidity constraints rather than low valuation of nets. The endowment effect also militates against the resale of in-kind transfers. We quantify these two effects through a field experiment in Uganda. Our results indicate that very few nets will be resold by recipient households. In World Development 37(3):607-617, March, 2009 Improving Food Aid’s Impact: What Reforms Would Yield The Highest Payoff? July 2008 Lentz, Erin C. and Christopher B. Barrett Developing an integrated model of the food aid distribution chain, from donor appropriations through operational agency programming decisions to household consumption choices we simulate alternative policies and sensitivity analysis to establish how varying underlying conditions — e.g., delivery costs, the political additionality of food, targeting efficacy — affect the optimal policy for improving the well-being of food insecure households. We find that improved targeting by operational agencies is crucial to advancing food security objectives. At the donor level, the key policy variable under most model parameterizations is ocean freight costs associated with cargo preference restrictions on US food aid. In World Development 36(7): 1152-1172, July, 2008 Agricultural Technology, Productivity, and Poverty in Madagascar May 2008 Minten, Bart and Christopher B. Barrett This paper uses a unique, spatially-explicit dataset to study the link between agricultural performance and rural poverty in Madagascar. We show that, controlling for geographical and physical characteristics, communes that have higher rates of adoption of improved agricultural technologies and, consequently, higher crop yields enjoy lower food prices, higher real wages for unskilled workers, and better welfare indicators. The empirical evidence strongly favors support for improved agricultural production as an important part of any strategy to reduce the high poverty and food insecurity rates currently prevalent in rural Madagascar. In World Development 36(5): 797-822 Food Systems and the Escape from Poverty and Ill-Health Traps in Sub-Saharan Africa May 2008 Barrett, Christopher Millienium Development Goal #1 is to halve extreme poverty ($1/day per person) and hunger. Progress toward this goal has been excellent at global level, led by China and India, but woefully insufficient in sub-Saharan Africa. In Africa, a disproportionate share of the extreme poor are “ultra-poor”, surviving on less than $0.50/day per person, a condition that appears both stubbornly persistent and closely associated with widespread severe malnutrition – “ultra hunger” – and ill health. Indeed, ill health, malnutrition and ultra-poverty are mutually reinforcing states that add to the challenge of addressing any one of them on its own and make integrated strategies essential. Food systems are a natural locus for such a strategy because agriculture is the primary employment sector for the ultra-poor and because food consumes a very large share of the expenditures of the ultra-poor. The causal mechanisms underpinning the poverty trap in which ultra-poor, unhealthy and undernourished rural Africans too often find themselves remain only partially understood, but is clearly rooted in the food system that guides their production, exchange, consumption and investment behaviors. Four key principles to guide interventions in improving food systems emerge clearly. But there remains only limited empirical evidence to guide detailed design and implementation of strategies to develop African food systems so as to break the lock of poverty and ill-health traps. This paper was prepared for the Cornell University and United Nations University Symposium on The African Food System and its Interactions with Health and Nutrition, held at the United Nations, New York City, November 13, and at Cornell University, November 15, 2007. Are Africans Practicing Safer Sex: Evidence from Demographic and Health Surveys for Eight Countries January 2008 Glick, Peter and David E. Sahn We use repeated rounds of Demographic and Health Survey data from eight African countries to examine changes in and determinants of three HIV risk behaviors: age at first intercourse; number of current sexual partners, and use of condoms. As a prelude, we assess the within- country comparability of DHS surveys over time. We find some evidence of changes in sample composition, which is easily handled in a multivariate framework, and find evidence as well of changes in how people respond to questions about HIV behavior. Because of the latter, which likely represents an increase in social desirability bias over time, our estimates of risk reduction may be upper bounds on the true effects. Overall the picture is one of reductions in risk behaviors over recent 4-6 year intervals, especially with respect to condom use; in some cases the changes seem large given the short time periods involved. With some exceptions, however, the extent and pervasiveness of these changes seems inadequate in relation to the urgency of the public health crisis represented by AIDS. With respect to the determinants of behaviors, schooling and wealth have contradictory impacts on risk behavior: they both tend to increase the likelihood of using condoms while (for men) also increasing the demand for additional sexual partners. Presented at the International Union for the Scientific Study of Population (IUSSP) Seminar on “Interactions between Poverty and HIV/AIDS,” Cape Town, South Africa, December 2005. Alternate version in Economic Development and Cultural Change 56(2):397-439, January, 2008 Are Client Satisfaction Surveys Useful? Evidence from Matched Facility and Household Data in Madagascar September 2007 Glick, Peter Client satisfaction surveys in developing countries are increasingly being promoted as a means of understanding health care quality and the demand for these services. However, concerns have been raised about the reliability of responses in such surveys: for example, ‘courtesy bias’ may lead clients, especially if interviewed upon exiting clinics, to provide misleadingly favorable responses. This study uses unique data from Madagascar to investigate these and other issues. Identical questions about satisfaction with local health care centers were asked in user exit surveys and in a population based household survey; the latter would be less contaminated by courtesy bias as well as changes in provider behavior in response to being observed. We find strong evidence that reported satisfaction is biased upward in exit surveys for subjective questions regarding (for example) treatment by staff and consultation quality, but is not biased for relatively objective questions about facility condition and supplies. The surveys do provide useful information on the determinants of consumer satisfaction with various dimensions of provider quality. Still, to obtain reliable estimates of consumer perceptions of health service quality, household based sampling appears to be far superior to the simpler exit survey method. Presented at the Regional Conference on “Education in West Africa: Constraints and Opportunities” in Dakar, Senegal, November 1-2, 2005 This is an expanded version of a paper published in Social Science and Medicine. Inequality and Poverty in Africa in an Era of Globalization: Looking Beyond Income to Health and Education August 2007 Sahn, David E. and Stephen D. Younger This paper describes changes over the past 15-20 years in non-income measures of well- being – education and health – in Africa. We expected to find, as we did in Latin America, that progress in the provision of public services and the focus of public spending in the social sector would contribute to declining poverty and inequality in health and education, even in an environment of stagnant or worsening levels of income poverty. Unfortunately, our results indicate that in the area of health, little progress is being made in terms of reducing pre-school age stunting, a clear manifestation of poor overall health. Likewise, our health inequality measure showed that while there were a few instances of reduced inequality along this dimension, there was, on balance, little evidence of success in improving equality of outcomes. Similar results were found in our examination of underweight women as an indicator of general current health status of adults. With regard to education, the story is somewhat more positive. However, the overall picture gives little cause for complacency or optimism that Africa has, or will soon reap the potential benefits of the process of globalization. Presented at the UNU-WIDER Conference on “The Impact of Globalization on the Poor in Africa,” Johannesburg, South Africa, 1-2 December, 2005 Living Standards in Africa August 2007 Sahn, David E. and Stephen D. Younger This paper substantiates two claims — that Africa is poor compared to the rest of the world and that poverty in Africa is not declining consistently or significantly, in contrast to other regions of the world. We consider poverty in the dimensions of health and education, in addition to income, stressing the inherent conceptual and measurement issues that commend such a broader perspective. We note a lack of consistency in the movement of the poverty measures. During similar periods, we often find them moving in opposite directions. We therefore discuss the need go beyond examining each poverty measure individually, and present an approach to evaluating poverty reduction in multiple dimensions jointly. The results of the multidimensional poverty comparisons reinforce the importance of considering deprivation beyond the material standard of living and provide insight into how to reconcile differing stories that arise from examining each indicator separately. Forthcoming in Sudhir Anand, Paul Segal, and Joseph E. Stiglitz, Debates in the Measurement of Global Inequality, Oxford University Press, 2008. Reproductive Health and Behavior, HIV/AIDS, and Poverty in Africa May 2007 Glick, Peter This paper examines the complex linkages of poverty, reproductive/sexual health and behavior, and HIV/AIDS in Africa. It addresses the following questions: (1) what have we learned to date about these links and what are the gaps in knowledge to be addressed by further research; (2) what is known about the effectiveness for HIV prevention of reproductive health and HIV/AIDS interventions and policies in Africa; and (3) what are the appropriate methodological approaches to research on these questions. With regard to what has been learned so far, the paper pays considerable attention in particular to the evidence regarding the impacts of a range of HIV interventions on risk behaviors and HIV incidence. Other sections review the extensive microeconomic literature on the impacts of AIDS on households and children in Africa and the effects of the epidemic on sexual risk behavior and fertility decisions. With regard to methodology, the paper assesses the approaches used in the literature to deal with, among other things, the problem of self-selection and non- randomness in the placement of HIV and reproductive health programs. Data requirements for different research questions are discussed, and an effort is made to assess what researchers can learn from existing sources such as Demographic and Health Surveys. Presented at the AERC/Hewlett Foundation Workshop, “Poverty and Economic Growth: The Impact of Population Dynamics and Reproductive Health Outcomes in Africa” in Brussels, Belgium, November 5-6, 2006 Forthcoming in edited volume published by the African Economic Research Consortium, Nairobi, Kenya HIV/AIDS and Rural Livelihoods in Zambia: A Test of the New Variant Famine Hypothesis May 2007 Mason, Nicole M., Antony Chapoto, Thomas S. Jayne and Robert J. Myers The ‘new variant famine’ (NVF) hypothesis postulates that the HIV/AIDS pandemic is eroding rural livelihoods and making rural households more vulnerable to drought and other transitory shocks. Despite limited empirical evidence, the NVF hypothesis has become an important part of the conventional wisdom surrounding the relationship between HIV/AIDS and food crises in southern Africa. This study provides a new empirical test of the NVF hypothesis via econometric estimation of the relationship between AIDS-related morbidity and mortality and indicators of rural livelihoods. District longitudinal data from smallholder farmers in Zambia surveyed annually between 1991 and 2003 are used to estimate several econometric models in order to: (1) understand the effects of HIV/AIDS on rural farm production; (2) measure whether HIV/AIDS exacerbates the impacts of drought and other factors affecting rural farm production; and (3) determine whether these results are consistent with the predictions of the NVF hypothesis. We find little evidence of a systematic decline in rural livelihoods at the national or provincial level as measured by mean household agricultural production, area cultivated, or the value of production per unit of land. Furthermore, contrary to a priori expectations, we do not find evidence of a robust negative direct effect of HIV/AIDS on any of these three agricultural production outcomes. We do find some evidence that HIV/AIDS may have negative indirect effects on rural farm production by exacerbating the impacts of drought, gender inequalities and agricultural sector policy changes related to structural adjustment. This final finding is consistent with the predictions of the NVF hypothesis. Prepared for the AERC-Cornell Conference on “Bottom-Up Interventions and Economic Growth in Sub-Saharan Africa,” May 31-June 1, 2007, Nairobi, Kenya The Economic Impact of AIDS Treatment: Labor Supply in Western Kenya February 2007 Thirumurthy, Harsha, Joshua Graff Zivin, and Markus Goldstein Using longitudinal survey data collected in collaboration with a treatment program, this paper is the first to estimate the economic impacts of antiretroviral treatment in Africa. The responses in two important outcomes are studied: (1) labor supply of adult AIDS patients receiving treatment; and (2) labor supply of children and adults living in the patients’ households. We find that within six months after the initiation of treatment, 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. These results indicate that the labor supply response to treatment is both rapid and large. Since patient health would continue to decline without treatment, these labor supply responses are underestimates of the impact of treatment on the treated. The upper bound of the treatment impact, which is based on plausible assumptions about the counterfactual, is considerably larger and also implies that the wage benefit from treatment is roughly equal to the costs of treatment provision. The responses in the labor supply of patients’ household members are heterogeneous. Young boys work considerably less after initiation of treatment, while girls and other adults in the household do not change their labor supply. In multiple-patient households, only the labor supply of girls remains unaffected. The effects on child labor are particularly important since they suggest significant spillover effects from individual treatment. Prepared for the AERC-Cornell Conference on “Bottom-Up Interventions and Economic Growth in Sub-Saharan Africa,” May 31-June 1, 2007, Nairobi, Kenya Malaria in Rural Nigeria: Implications for the Millennium Development Goals May 2007 Alaba, Olufunke A. and Olumuyiwa B. Alaba In recent years, there has been increase in human and financial commitments to malaria control, nationally and internationally, partly due to the need to meet the development targets set in the millennium development goals (MDGs). However, these efforts have not translated into significant decrease in the disease incidence and its impact in Nigeria. Using the cost of illness analysis, the paper found that an estimate of about 10% of gross domestic output of Oyo state is lost annually to malaria attack. This has serious implications for the achievement of development blueprint in the National Economic Empowerment and Development Strategies (NEEDS) and the MDG target. Effective control of malaria is capable of reducing household poverty, inequality, welfare and aggregate national development. Prepared for the AERC-Cornell Conference on “Bottom-Up Interventions and Economic Growth in Sub-Saharan Africa,” May 31-June 1, 2007, Nairobi, Kenya Changes in HIV/AIDS Knowledge and Testing Behavior in Africa: How Much and for Whom? April 2007 Glick, Peter and David E. Sahn Demographic and Health Survey data from six African countries indicate that HIV prevention knowledge is improving and that more Africans are getting tested. Still, in many cases fewer than half of adult respondents can identify specific prevention behaviors; knowledge appears particularly inadequate in countries not yet fully gripped by the epidemic. Schooling and wealth impacts on prevention knowledge generally have either not changed or have increased, meaning that initial disparities in knowledge by education and wealth levels have persisted or widened. HIV messages therefore need to be made more accessible to and/or better understood by the poor and less educated. Paper prepared for the conference “African Development and Poverty Reduction: The Macro-Micro Linkage” Cape Town, South Africa October 2004 In Journal of Population Economics 20(2):383-422, April, 2007 Sex Work as a Response to Risk in Western Kenya March 2007 Robinson, Jonathan and Ethan Yeh Formal and informal commercial sex work is a way of life for many poor women in developing countries. Though sex workers have long been identified as crucial in affecting the spread of HIV/AIDS, particularly in sub-Saharan Africa, the nature of sex-for-money transactions remains poorly understood. This paper investigates sex worker behavior using daily self-reported data on sexual behavior, income shocks, expenditures, and labor supply for a sample of 237 women in Western Kenya. We find significant day-to-day fluctuations in sex worker decisions, and that women engage in sex-for-money transactions in part to deal with unexpected non-labor income shocks. Riskier sex is better compensated in Western Kenya, and we find that women increase their supply of riskier, better compensated sex on days in which a household member falls ill. In particular, women are 23.6% more likely to have unprotected sex, 16.8% more likely to have anal sex, and increase the number of unprotected sexual acts by 21.7% on such days. These increases in risky sexual behavior have important health consequences for these women and on the spread of HIV/AIDS. While not denying the need for interventions that encourage women to leave the commercial sex industry, our research suggests that important opportunities exist to reduce the health risks of sex work within sex work beyond HIV education and condom distribution. Prepared for the AERC-Cornell Conference on “Bottom-Up Interventions and Economic Growth in Sub-Saharan Africa,” May 31-June 1, 2007, Nairobi, Kenya Nutrition, Health and Productivity in Urban Ethiopia: Panel Evidence using Instrumental Variables (IV) Quantile Regression Framework March 2007 Kedir, Abbi M. Using the panel data (1994-2000) on individuals who reported their wages in urban Ethiopia, we have estimated a relationship between health measures (i.e. height and BMI) and wages (which proxies productivity). Our preliminary findings from the IV quantile regression estimates (which controls for the endogeneity) indicates that productivity of individuals is significantly and positively affected by both human capital measures. The returns to BMI or current bodily strength is important at the lower end of the wage distribution. The return to height (a measure of long term nutrition investment) also falls starting from the 75th wage quintile. Our estimates are robust to specification. The substantive content of the results (i.e. the high-nutrition and high-productivity equilibrium story) does not change even if we did not control for endogeneity of schooling. Non-parametric evidence also supports the strong and positive relationship between productivity and the two key indicators of human capital. There are surprising findings such as the lack of statistically significant link between schooling and wage. This will further be investigated along with other empirical issues such as outliers. Prepared for the AERC-Cornell Conference on “Bottom-Up Interventions and Economic Growth in Sub-Saharan Africa,” May 31-June 1, 2007, Nairobi, Kenya Can Information Campaigns Eradicate AIDS? The Effect of HIV Knowledge and Risk Behavior on HIV Status: The Case of Three Sub-Saharan Countries February 2007 Frölich, Markus and Rosalia Vazquez-Alvarez AIDS continues to have a devastating effect on many developing economies, par- ticularly in Sub-Saharan Africa. Given the lack of a vaccine to stop HIV transmission and the very expensive medical treatment, most public policy emphasis has been placed on edu- cation and particular information campaigns. In this paper, we examine the impact of AIDS education from two sides. First, we examine to what extent information campaigns have been successful in reducing HIV prevalence and incidence. Second, we examine the impact of actual AIDS knowledge on HIV rates. The basic policy issue can be expressed as follows: Suppose that everyone knew and understood the basic facts about AIDS, would this reduce HIV rates to (almost) zero? If so, public policy should target groups with incomplete knowledge. If not, information campaigns alone are bound to fail and much stronger interventions are required to eradicate AIDS. Using rich data sets from three Sub-Saharan economies (Kenya, Tanzania and Ethiopia) we investigate the effect of observed HIV related knowledge on the probability of catching the virus using data on individuals. Our analysis controls for detailed individual specific characteristics including variables reflecting innate risk behaviour that may drive the risk of becoming HIV positive irrespective of HIV related health knowledge. We examine fur- ther how these effects differ between different groups, thereby identifying target groups that public information campaigns should direct more attention to. Results so far are preliminary. Prepared for the AERC-Cornell Conference on “Bottom-Up Interventions and Economic Growth in Sub-Saharan Africa,” May 31-June 1, 2007, Nairobi, Kenya Labor Market Activities and Fertility December 2006 Younger, Stephen D. “This paper focuses on one aspect of the demographic transition, women’s labor market activity, and how it relates to the basic variables of fertility and poverty. Just as there are differences in fertility and mortality in rich and poor countries, there are differences in women’s time use. In rich countries, women tend to work outside the home, usually in wage employment on a fixed hourly schedule. In poor countries, women tend to work at home or, especially in Africa, on their family’s farm or at own- account activities where time use is more flexible. Understanding the relationship between the demographic transition and these differences in time use is our main theme...” Presented at the AERC/Hewlett Foundation Workshop, “Poverty and Economic Growth: The Impact of Population Dynamics and Reproductive Health Outcomes in Africa” in Brussels, Belgium, November 5-6, 2006 An Assessment of Changes in Infant and under-Five Mortality in Demographic and Health Survey Data for Madagascar September 2006 Glick, Peter, Stephen D. Younger, and David E. Sahn Repeated rounds of nationally representative surveys are an important source of information on changes in the welfare of the population. In particular, policymakers and donors in many developing countries rely heavily on the Demographic and Health Surveys (DHS) to provide information on levels and trends in indicators of the health status of the population, including child survival. The reliability of observed trends, however, depends strongly on the comparability across survey rounds of the sampling strategy and of the format of questions and how interviews ask them. In Madagascar, the most recent (2003/4) DHS indicated very sharp declines in rates of infant and under-five mortality compared with the previous survey from 1997. However, retrospective under-one and under-five mortality data in 1997 and 2003/4 for the same calendar years also show large differences, suggesting that this trend may be spurious. We employ a range of descriptive and multivariate approaches to investigate the issue. Despite evidence of significant interviewer recording errors (with respect to date of birth and age at death) in 2003/4, the most likely source of problems is that the two samples differ: comparisons of time-invariant characteristics of households and of women suggests that the later DHS sampled a somewhat wealthier (hence lower mortality) population. Corrections to the data using hazard survival model estimates are discussed. These suggest a much more modest reduction in infant and under-five mortality than indicated by the raw data for the two surveys. Is Settling Good for Pastoralists? The Effects of Pastoral Sedentarization on Children’s Nutrition, Growth, and Health Among Rendille and Ariaal of Marsabit District, Northern Kenya June 2006 Fratkin, Elliot, Martha A. Nathan, and Eric A. Roth The settling of formerly mobile pastoral populations is occurring rapidly throughout East Africa. Pastoral sedentarization has been encouraged by international development agencies and national governments to alleviate problems of food insecurity, health care delivery, and national integration. However, it has not been demonstrated that abandoning the pastoral way of life, and particularly access to livestock products, has been beneficial to the health and well-being of pastoral populations. This paper reports the results of a three-year study of pastoral and settled Rendille and Ariaal (mixed Samburu/Rendille) communities in Marsabit District northern Kenya, which compares levels of child malnutrition and illness between five different Rendille communities, ranging from purely pastoral to agricultural and urban communities. Analysis of bimonthly dietary recalls, anthropometric measurements, morbidity data, and economic differentiation and specialization among 202 mothers and their 488 children under age 9 reveals large differences in the growth patterns and morbidity of nomadic vs. settled children. In particular, age-specific height and weight measurements for the nomadic pastoral community are significantly higher than same-aged measurements of children from the sedentary villages. Furthermore, women and especially pregnant women showed higher levels of malnutrition in the settled communities. Both women and children showed higher rates of respiratory and diarrheal morbidity in settled versus nomadic communities, although malaria rates were uniformly higher in lowland communities than in the highlands. Differences in child growth are attributed mainly to better nutrition, and particularly access to camel’s milk within the nomadic communities. The striking decrease in diarrheal and respiratory diseases for the nomadic children vs. settled children coupled with the findings of a relative decrease in malnutrition and stunting indicate an unexpected edge for health and growth of nomadic Rendille children. The policy implications of our findings are significant. Although pastoralism is not an option for everyone living in dry regions like northern Kenya, the decrease in diarrheal and respiratory illness and for pastoralist children, and the higher levels of stunting in settled children from pastoral populations, should be part of decisions affecting social, economic, and health policy for pastoral regions. Presented at the Policy Research Conference on “Pastoralism and Poverty Reduction in East Africa,” held in Nairobi, Kenya, June 27-28, 2006. Influencing and Developing Good Policy in Early Childhood Development (ECD) amongst Pastoralist Communities in East Africa: The Case of Samburu in Kenya June 2006 van de Linde, Tanja What do we mean by a good ECD policy and are there special elements that are particularly relevant to children from pastoralist societies? Let’s start by a quick deconstruction of ECD: early childhood and development. By early childhood we mean the period of a child’s life, starting at conception and including the first years of primary school usually up to age eight. We look at child development holistically, meaning physical, social, intellectual, language, cultural and emotional development. A working definition of “good” or “quality” ECD is “one that meets the developmental and cultural needs of young children and their families in ways that enable them to thrive”. (Bernard van Leer Foundation). It can also be defined as that program which does not alienate the developing young generation but prepares them to fit into their society. Presented at the Policy Research Conference on “Pastoralism and Poverty Reduction in East Africa,” held in Nairobi, Kenya, June 27-28, 2006. Robust Multidimensional Spatial Poverty Comparisons in Ghana, Madagascar, and Uganda April 2006 Duclos, Jean-Yves, David E. Sahn, and Stephen D. Younger We investigate spatial poverty comparisons in three African countries using multidimensional indicators of well-being. The work is analogous to the univariate stochastic dominance literature in that we seek poverty orderings that are robust to the choice of multidimensional poverty lines and indices. In addition, we wish to ensure that our comparisons are robust to aggregation procedures for multiple welfare variables. In contrast to earlier work, our methodology applies equally well to what can be defined as "union", "intersection," or "intermediate" approaches to dealing with multidimensional indicators of well-being. Further, unlike much of the stochastic dominance literature, we compute the sampling distributions of our poverty estimators in order to perform statistical tests of the difference in poverty measures. We apply our methods to two measures of well-being, the log of household expenditures per capita and children’s height-for-age z-scores, using data from the 1988 Ghana Living Standards Survey, the 1993 Enquête Permanente auprès des Ménages in Madagascar, and the 1999 National Household Survey in Uganda. Bivariate poverty comparisons are at odds with univariate comparisons in several interesting ways. Most importantly, we cannot always conclude that poverty is lower in urban areas from one region compared to rural areas in another, even though univariate comparisons based on household expenditures per capita almost always lead to that conclusion. In World Bank Economic Review 20(1):91-113 Escaping Poverty and Becoming Poor in 36 Villages of Central and Western Uganda February 2006 Krishna, Anirudh, Daniel Lumonya, Milissa Markiewicz, Firminus Mugumya, Agatha Kafuko, Jonah Wegoye Twenty-four per cent of households in 36 village communities of Central and Western Uganda have escaped from poverty over the past 25 years, but another 15 per cent have simultaneously fallen into poverty. A roughly equal number of households escaped from poverty in the first period (ten to 25 years ago) as in the second period (the last ten years) examined here. However, almost twice as many households fell into poverty during the second period as in the first period. Progress in poverty reduction has slowed down as a result. Multiple causes are associated with descent into poverty and these causes vary significantly between villages in the two different regions. For nearly two-thirds of all households in both regions, however, ill health and health-related costs were a principal reason for descent into poverty. Escaping poverty is also associated with diverse causes, which vary across the two regions. Compared to increases in urban employment, however, land-related reasons have been more important for escaping poverty in both regions. In Journal of Development Studies 42(2): 346-370, 2006 In Understanding and Reducing Persistent Poverty in Africa, Christopher Barrett, Peter Little, Michael Carter (eds.), Routledge, 2007. Do Mothers’s Educational Levels Matter in Child Malnutrition and Health Outcomes in Gambia and Niger? November 2005 Oyekale, A. S. and T. O. Oyekale Despite past policy interventions and supports, malnutrition remains one of the major problems confronting children in Sub-Sahara Africa (SSA). This study analyzed the effect of mothers’ educational levels on child malnutrition. Data from the 2000 End-Decade Multiple Indicator Cluster Survey by the United Nations International Children Emergency Funds (UNICEF) for Gambia and Niger were used. Data were analyzed with Foster-Greer-Thorbeck approach and Probit regression. Results show stunting, wasting and underweight head counts are higher in Niger rural and urban areas, while stunting, wasting and underweight head count, depth and severity are higher among children whose mothers had no secondary education for all the countries. The Probit analysis reveals that attainment of secondary education by the mothers, urbanization, presence of pipe water, presence of mother and father at home, polio vaccination, ever breast fed and access to radio and television significantly reduce the probability of stunting, wasting and underweight, while infection with diarrhea, fever and age at first polio vaccine significantly increase it. It was recommended that to reduce malnutrition and achieve the Millennium Development Goals (MDGs) in Gambia and Niger, institutional arrangements for catering for secondary education of girls and ensuring consistency in child health programs must be strengthened, among others. Paper prepared for the Regional Conference on “Education in West Africa: Constraints and Opportunities” in Dakar, Senegal, November 1-2, 2005. Improvements in Children’s Health: Does Inequality Matter? August 2005 Sahn, David E. and Stephen D. Younger The literature on the contributions to poverty reduction of average improvements in living standards vs. distributional changes uses only one measure of well-being – income or expenditure. Given that poverty is defined by deprivation over different dimensions, we explore the role of average improvements and distributional changes in children’s health and nutrition using the height of young children as our measure of well-being. Similar to the income literature, we find that shifts in the mean level of heights, not changes in distribution, account for most improvements in heights. Unlike the literature on income inequality, however, there is a positive association between improvements in average heights and reduced dispersion of those heights. In The Journal of Economic Inequality 3(2):125-143, 2005. Scaling up HIV Voluntary Counseling and Testing in Africa: What Can Evaluation Studies Tell Us About Potential Prevention Impacts? August 2005 Glick, Peter Although there is a widespread belief that scaling up HIV voluntary testing and counseling (VCT) programs in Africa will have large prevention benefits through reductions in risk behaviors, these claims are difficult to establish from existing evaluations of VCT. Considerations from behavioral models and the available data suggest that as VCT coverage expands marginal program effects are likely to decline due to changes in the degree of client selectivity, and that potential uptake among those at highest risk is uncertain. The paper also assesses two other common perceptions about VCT in Africa: that a policy of promoting couples-oriented VCT would be more successful than one emphasizing individual testing, and that VCT demand and prevention impacts will be enhanced where scaling up is accompanied by the provision of anti-retroviral drugs. In Evaluation Review 29(4): 331-357, August 2005 Children’s Health Status in Uganda July 2005 Bahiigwa, Godfrey and Stephen D. Younger This paper studies trends and determinants of children's standardized heights, a good overall measure of children's health status, in Uganda over the 1990s. During this period, Uganda made impressive strides in economic growth and poverty reduction (Appleton, 2001). However, there is concern that improvements in other dimensions of well-being, especially health, has been much weaker. We find that several policy variables are important determinants of children's heights. Most importantly, a broad package of basic health care services has a large statistically significant effect. Provision of some of these services, especially vaccinations, appears to have faltered in the late 1990s, which may help to explain the lackluster performance on stunting during that period. We also find that civil conflict, a persistent problem in some areas of the country, has an important (negative) impact on children's heights. Better educated mothers have taller children, but the only substantial impact is for children of mothers who have completed secondary school. Finally, we find that households that rely more on own-production sources of income tend to have more malnourished children, even after controlling for their overall level of income and a host of other factors. This latter conclusion is supportive of the Plan for Modernization of Agriculture, which aims to shift farmers from subsistence to commercial agriculture or other more productive activities. Public Expenditure and Human Capital in Nigeria: An Autoregressive Model July 2005 Michael Adebayo Adebiyi In this study, we set out to empirically investigate the direction of causality between human capital (i.e. education and health) expenditures and defence spending including debt service obligations in Nigeria, using annual time series data from 1970 to 2000. Some statistical tools are employed to explore the relationship among these variables. The study examines stochastic characteristics of each time series by testing their stationarity using Augmented Dickey Fuller (ADF) and Phillip Perron (PP) tests. Then, the effects of stochastic shocks of each of the endogenous variables are explored, using vector autoregressive (VAR) model. The evidence from the Granger causality tests shows that, in Nigeria, debt service obligations determine human capital expenditure such as education. Also, from impulse response analysis, the result shows that unanticipated effect of debt service obligations or defence spending on human capital expenditure is ambiguous in Nigeria. Presented at the International Conference on "Shared Growth in Africa," July 21-22, 2005, Accra, Ghana Poverty Traps and Safety Nets April 2005 Barrett, Christopher B. and John G. McPeak This paper uses data from northern Kenya to argue that the concept of poverty traps needs to be taken seriously, and that if poverty traps indeed exist, then safety nets become all the more important. However, as presently practiced, safety nets based on food aid appear to be failing in northern Kenya. In Poverty, Inequality and Development: Essays in Honor of Erik Thorbecke, Alain de Janvry and Ravi Kanbur, eds., Norwell, MA: Kluwer Academic Publishers, 2005 Infant Mortality in Uganda: Determinants, Trends, and the Millennium Development Goals January 2005 Ssewanyana, Sarah and Stephen D. Younger Unusually for an African economy, Uganda’s growth has been rapid and sustained for an extended period of time. Further, this growth has clearly translated into substantial declines in poverty for all socio-economic groups and in all regions of the country. Despite this, there is concern in the country that other indicators of well-being are not improving at the same rate as incomes. This paper studies one such indicator, infant mortality. We use three rounds of the Uganda Demographic and Health Surveys to construct a national time series for infant mortality over a long period of time, 1974-1999. We also use these survey data to model the determinants of infant mortality and, based on those results, to examine the likelihood that Uganda will meet the Millennium Development Goal of halving infant mortality by 2015. Presented at the DPRU-TIPS-Cornell University Forum on "African Development and Poverty Reduction: The Macro-Micro Linkage," October 13-15, 2004, Cape Town, South Africa Alternate version in Journal of African Economies 17(1):34-61, 2008 Pareto’s Revenge January 2005 Kanbur, Ravi Consider a project or a policy reform. In general, this change will create winners and losers. Some people will be better off, others will be worse off. Making an overall judgment on social welfare depends on weighing up the gains and losses across individuals. How can we make these comparisons? In the 1930s, a strong school of economic thought led by Lionel Robbins held that economists qua economists have no business making such judgments. They only have a basis for declaring an improvement when no such interpersonal comparisons of gains and losses are involved. Only a change which makes nobody worse off and at least one person better off, can be declared an improvement. Such a change is called a Pareto Improvement (PI). If no such changes are possible, the state of affairs is described as being Pareto Efficient (PE), a Pareto Optimum, or Pareto Optimal (PO). Named after Vilfredo Pareto, PI and PE are central to post 1945 high economic theory. After all, PE makes an appearance in the two fundamental theorems of Welfare Economics. These are that every competitive equilibrium (CE) is PE, and every PE allocation can be achieved as a CE, under certain conditions. Through these theorems, the post second world war economic theory of Kenneth Arrow and Gerard Debreu links back to Lionel Robbins and Vilfredo Pareto, and thence to Adam Smith’s Invisible Hand of competitive markets. From there the links come full circle back to stances taken in current policy debates on the role of markets and government. In Journal of Social and Economic Development 7(1): 1-11, 2005 Are wealthier nations healthier nations? A panel data approach to the determination of human development in Africa October 2004 Issidor Noumba Many authors did not expect a bright future for the sub-Saharan African countries at the outset of independence in the 1960s. Today, when we look at the African economic, social, and political indicators, we notice that these authors were right. African countries continue to tail the list of developing countries as far as human development is concerned. Poverty is endemic in the region, HIV/AIDS and traditional infectious diseases constitute a serious threat to African health status. Life expectancy at birth is very low and HIV/AIDS prevalence very high. Assuming that health status indicators are good proxies of human development, this paper intends to answer the following queries: (i) What is the extent of health disparities in Africa? (ii) Are wealthier African nations healthier nations? (iii) What are the main determinants of the health status in Africa. The incipient renewal of concern for poverty and equity in health leads us also to ask ourselves whether income inequality and inequality in health status are significant determinants of health outcomes. A simple descriptive statistics analysis show that health status seems to vary not only across countries, but also according to the level of economic development. The paradox story is that wealthier African nations are not necessarily healthier nations. We use the econometrics of panel data to estimate one version of the traditional production function of the health services. The results of our estimates show that GNP per capita is an important determinant of health outcome. Wealthier nations are not always healthier nations, but wealth (income) matters for health. Income inequality and inequality in health status are also strongly correlated with the health status indicators. At the end of the day, the study show that income and inequalities are important determinants of human development in Africa. Presented at the DPRU-TIPS-Cornell University Forum on "African Development and Poverty Reduction: The Macro-Micro Linkage," October 13-15, 2004, Cape Town, South Africa Impact of HIV/AIDS on saving behaviour in South Africa October 2004 Sandra Freire The models measuring the macroeconomic impact of HIV/AIDS are heterogeneous : each one relies on a specific theoretical background. Nevertheless, there are, at least, three main common limits to those approaches : the authors concentrate on the impact on the labour market ; they neglect the potential implications on the capital market ; and they do not model some essential microeconomic impacts such as the change in the agents’ economic behaviour. More specifically, the analysis of the impact of HIV/AIDS on savings takes into account direct costs such as health expenditures, seldom indirect costs like the anticipation of funeral costs and they do not model differed indirect costs. The paper proposes an analysis of this last kind of implications through the impact of the epidemic on the saving behaviour. This paper focuses on the uncertainty of life expectancy and is based on two frameworks: the Galí (1990) model which considers the life cycle theory with a finite horizon at the aggregate level and the Moresi (1999) model which specifies a peculiar consumption utility function through uncertain lifetime. The calibration and simulations of our model reveal a significant drop in the future saving rate in South Africa under the hypothesis of a virus evolution similar to the one given by the UN Population Division : the saving rate in 2015, under those hypothesis, should be at least 5 percentage points inferior to the estimated saving rate that would then prevail in the absence of the epidemic. Presented at the DPRU-TIPS-Cornell University Forum on "African Development and Poverty Reduction: The Macro-Micro Linkage," October 13-15, 2004, Cape Town, South Africa The Demand for Education for Orphans in Zimbabwe October 2004 Craig Gundersen, Thomas Kelly and Kyle Jemison We examine the effect of orphan status on school enrolment in Zimbabwe, a country strongly impacted by the HIV/AIDS pandemic with a rapidly growing population of orphans. Using data from 2003, after controlling for other determinants of enrolment we find that orphans are less likely to attend school than non-orphans. The result is robust to our correction for selection bias. Two additional results have implications for targeting: we find that the effect of being an orphan is especially large for older children and that, after controlling for previous education, the effect of being an orphan on school enrolment is sharply diminished. Presented at the DPRU-TIPS-Cornell University Forum on "African Development and Poverty Reduction: The Macro-Micro Linkage," October 13-15, 2004, Cape Town, South Africa Implications of Genetically Modified Food Technology Policies for Sub-Saharan Africa October 2004 Kym Anderson and Lee Ann Jackson The first generation of genetically modified (GM) crop varieties sought to increase farmer profitability through cost reductions or higher yields. The next generation of GM food research is focusing also on breeding for attributes of interest to consumers, beginning with ‘golden rice’, which has been genetically engineered to contain a higher level of vitamin A and thereby boost the health of unskilled laborers in developing countries. This paper analyzes empirically the potential economic effects of adopting both types of innovation in Sub-Saharan Africa (SSA). It does so using the global economy-wide computable general equilibrium model known as GTAP. The results suggest that the welfare gains are potentially very large, especially from nutritionally enhanced GM rice and wheat, and that – contrary to the claims of numerous interests – those estimated benefits are diminished only slightly by the presence of the European Union’s current barriers to imports of GM foods. In particular, if SSA countries impose bans on GM crop imports in an attempt to maintain access to EU markets for non-GM products, the loss to domestic consumers due to that protectionism boost to SSA farmers is far more than the small economic gain for those farmers from greater market access to the EU. Presented at the DPRU-TIPS-Cornell University Forum on "African Development and Poverty Reduction: The Macro-Micro Linkage," October 13-15, 2004, Cape Town, South Africa Foreign aid and population growth: evidence from Africa October 2004 Leonid Azarnert This paper investigates the relationship between foreign aid and population growth in Sub-Saharan Africa. Using a panel of African countries over the last four decades, it demonstrates the positive effect of foreign aid on fertility and population growth in this region. Presented at the DPRU-TIPS-Cornell University Forum on "African Development and Poverty Reduction: The Macro-Micro Linkage," October 13-15, 2004, Cape Town, South Africa Policy Dynamics, Trends in Domestic Fish Production & Implications for Food Security in Ghana July 2004 A. Wayo Seini, V. K. Nyanteng and A. Asantewah Ahene The fishing industry in Ghana started as an artisanal fishery with very simple and low efficient gears and methods operating in very near coastal waters, lagoons, estuaries and rivers. Through government and private efforts to promote production, the fishing industry continued to improve over the years with the development of new gears and methods that had been more efficient than the previous ones. Through government schemes, the use of outboard motors on canoes, introduced in 1959, was very successful and went a long way to create a modern sub-sector of the canoe fisheries. These schemes, particularly the charter party scheme (a hire purchase scheme), also encouraged fishermen to purchase larger fishing boats and gear which they paid for over a period of four years at very low interest rates (Lawson and Kwei, 1974). This paper examines major policy regimes since Ghana’s independence and relates them to trends in domestic fish production. Domestic production is then linked to the implications for food security. There is no doubt that fish is an important commodity in the country’s food security, particularly when the latter is defined beyond availability and accessibility to encompass the nutritional content of a meal that is required to provide a balanced diet and to ensure a minimum daily intake of 2,300 calories. Where food consumption is not balanced from the standpoint of nutrition, some diseases and improper physical developments emerge, such as stunting, underweight and wasting in children, particularly, under-5 years of age. Fish is consumed by many households and among all income groups everywhere in Ghana, largely to supply protein requirements in the diet. Presented at the ISSER-University of Ghana-Cornell University International Conference on "Ghana at the Half Century," July 18-20, 2004, Accra, Ghana Mitigating the Impact of HIV II July 2004 John K. Anarfi and Ernest N. Appiah Since the first clinical evidence of HIV/AIDS was reported in 1981, the epidemic continues to escalate at an alarming rate and has now become a full-blown developmental crisis in the world. Africa is the most affected continent and at the end of the year 2002 she had 28.1 million of the world’s estimated 42 million people living with HIV. Since the beginning of the epidemic and by the end of 2001 a cumulative 19 million Africans had already died of AIDS. Although just 10% of the world’s youth live in Sub-Saharan Africa, the region contained almost three-quarters of all youth living with HIV/AIDS in 2001 – a total of 8.6 million. That is certainly a threat to the future generation of Africa and calls for refocusing of efforts on strategies that have the potential of registering a strong impact in efforts at reducing further spread of the disease. This paper identifies education as a strategy that can be used to mitigate the impact of HIV/AIDS in Ghana. It focuses on both formal school education and general education on HIV/AIDS. Presented at the ISSER-University of Ghana-Cornell University International Conference on "Ghana at the Half Century," July 18-20, 2004, Accra, Ghana Food Aid Targeting, Shocks and Private Transfers Among East African Pastoralists July 2005 Lentz, Erin and Christopher B. Barrett Public transfers of food aid are intended largely to support vulnerable populations in times of stress. We use high frequency panel data among Ethiopian and Kenyan pastoralists to test the efficacy of food aid targeting under three different targeting modalities, food aid’s responsiveness to different types of covariate shocks, and its relationship to private transfers. We find that, in this region, self-targeting food-for-work or indicatortargeted free food distribution more effectively reach the poor than do food aid distributed according to community-based targeting. Food aid flows do not respond significantly to either covariate, community-level income or asset shocks. Rather, food aid flows appear to respond mainly to more readily observable rainfall measures. Finally, food aid does not appear to affect private transfers in any meaningful way, either by crowding out private gifts to recipient households nor by stimulating increased gifts by food aid recipients. Healthcare Provision and Self Medication in Ghana October 2004 G. J. M. van den Boom, N. N. N. Nsowah-Nuamah and G. B. Overbosch Self-medication is predominant in Ghana, where one out of four lives outside a 15 km radius of a doctor. The cost of visiting a doctor is almost $10, one third of monthly per capita expense, as compared to $1.5 for self-medication. Simulated utilization patterns indicate that higher densities (doctors within 15 km) and more insurance (flat rate tax covering half of the health expense) could raise demand for doctors by 15-20%. The poor though continue to rely on self-medication. Medicines that are affordable and of certified quality could thus play a key supplementary role in health sector development. In Ernest Aryeetey and Ravi Kanbur (editors), The Economy of Ghana: Analytical Perspectives on Stability, Growth and Poverty, James Currey, 2008. Presented at the ISSER-University of Ghana-Cornell University International Conference on "Ghana at the Half Century," July 18-20, 2004, Accra, Ghana Maternal Literacy and Numeracy Skills and Child Health in Ghana May 2005 Niels-Hugo Blunch This paper examines the impact of maternal literacy and numeracy skills and schooling on the production of children’s health in Ghana. The analysis considers child health inputs, including pre- and post-natal care and vaccinations, and child health outputs, including illnesses and mortality. Previous studies of the determinants of child health have mostly been limited to investigating the impact of maternal schooling only and, as a consequence, largely have not considered skills, including literacy and numeracy skills and health knowledge, and also have ignored alternative routes to acquiring skills, such as adult literacy programs. Analyzing a recent household survey for Ghana, this paper addresses both of these issues. Preliminary results for a specification where all regressors are treated as predetermined indicate that skills are largely not important once education is controlled for but at the same time also indicate a positive association between adult literacy course participation and child health. The latter points towards the potentially important role of adult literacy programs in promoting child health by the acquisition of health knowledge by participants in these programs, which is something that has previously received little to no attention in the economics literature. In Ernest Aryeetey and Ravi Kanbur (editors), The Economy of Ghana: Analytical Perspectives on Stability, Growth and Poverty, James Currey, 2008. Presented at the ISSER-University of Ghana-Cornell University International Conference on "Ghana at the Half Century," July 18-20, 2004, Accra, Ghana Public Service Provision, User Fees, and Political Turmoil January 2004 Fafchamps, Marcel and Bart Minten Following an electoral dispute, the central highlands of the island of Madagascar were subjected to an economic blockade during the first half of 2002. After the blockade ended in June 2002, user fees for health services and school fees were progressively eliminated. This paper examines the provision of schooling and health services to rural areas of Madagascar before, during, and after the blockade. We find that public services were more resilient to the blockade than initially anticipated, but that health services were more affected than schools. The removal of user fees had a large significant effect on public services that is distinct from the end of the blockade and the increase in school book provision. Growth and Poverty Reduction in Uganda, 1992-1999: A Multidimensional Analysis of Changes in Living Standards October 2003 Younger, Stephen D. This paper examines Uganda’s progress on poverty reduction when poverty is measured in multiple dimensions. In particular, I consider poverty measures that are defined across household expenditures per capita or household assets, children’s health status, and in some cases, mother’s literacy. The comparisons are robust to the choice of poverty line, poverty measure, and sampling error. In general, I find that multidimensional poverty declined significantly in Uganda during the 1990s, although results for the latter half of the decade are more ambiguous. While there was clear progress in the dimension of expenditures and assets, improvement in children’s height-for-age z-scores is less certain for the 1995-2000 period. I also make poverty comparisons for individual regions and urban and rural areas in the country. Rather surprisingly, progress on multivariate poverty reduction is less clear in Central region and in urban areas. Urban-Rural Inequality in Africa July 2003 Sahn, David E. and David C. Stifel In this paper we examine the relative importance of rural versus urban areas in terms of monetary poverty and seven other related living standards indicators. We present the levels of urban-rural differences for several African countries for which we have data and find that living standards in rural areas lag far behind those in urban areas. Then we examine the relative and absolute rates of change for urban and rural areas, and find no overall evidence of declining differences in the gaps between urban and rural living standards. Finally, we conduct urban-rural decompositions of inequality, examining the within versus between (urban and rural) group inequality for asset inequality, education inequality, and health (height) inequality. In Journal of African Economies 12(4):564-597, 2003 Presented at WIDER (World Institute for Development Economics Research) Conference on Spatial Inequality in Africa, University of Oxford, September 21-22, 2002. Water Pricing, the New Water Law, and the Poor: An Estimation of Demand for Improved Water Services in Madagascar December 2002 Minten, Bart, Rami Razafindralambo, Zaza Randriamiarana, and Bruce Larson Generalized cost recovery is one of the basic principles of the new Water Law that has recently been adopted by the Malagasy government. However, the effect of this change in policy is still poorly understood. Based on contingent valuation surveys in an urban and a rural area in southern Madagascar, this study analyzes the effect of changes in prices for water services. The results suggest that a minimum size of 90 households in a village is necessary to reach full cost recovery for well construction. Given that this is significantly above the current size of villages in the survey area, full cost recovery seems therefore impossible and subsidies are necessary to increase access to improved water services. Cost recovery for maintenance is relatively easier to achieve. In urban areas, water use practices and willingness to pay for water services depend highly on household income. To better serve the poor, it is therefore suggested that rich households, who rely on private taps, cross-subsidize poor households as a significant number of households is unwilling or unable to pay for water from a public tap. Given that public taps make up a small part of the total consumption of the national water company JIRAMA, lower income from public taps are shown to have only a marginal effect on its total income. However, as experiences in other countries as well as in Madagascar have shown, a fee on public taps is necessary as water for free leads to spoilage, does not give any incentive for the distributor to expand networks, and might therefore be a bad policy for the poor overall. The Distribution of Social Services in Madagascar, 1993-99 December 2002 Glick, Peter and Mamisoa Razakamanantsoa While a number of benefit incidence studies of public expenditures have been carried out for African countries, there are very few studies that look at how the incidence of such expenditures has been changing over time. We use three rounds of nation-wide household surveys to analyze the distribution of public expenditures on education and health services in Madagascar over the decade of the 90s, a period of little economic growth but significant changes in social sector organization and budgets. Education and health services for the most part are found to be distributed more equally than household expenditures: therefore they serve to redistribute welfare from the rich to the poor. By stricter standards of progressivity, however, public services do poorly. Few services other than primary schooling accrue disproportionately to the poor in absolute terms. When we further adjust for differences in the numbers of potential beneficiaries in different expenditure quintiles (e.g., school-age children in the case of education), none of the education or health benefits considered appear to target the poor while several target the non-poor. We also find significant disparities in the use of services between rural and urban areas, and by province. On the other hand, for both education and health services, no notable gender differences exist in coverage. With regard to changes over the decade, primary enrollments rose sharply and also become significantly more progressive; since the country experienced little or no growth in household incomes during the period, this apparently reflects supply rather than demand side factors. The improvement in equity in public schooling occurred in part because the enrollment growth was in effect regionally targeted: it occurred only in rural areas, which are poorer. Also see, "The Distribution of Education and Health Services in Madagascar over the 1990s: Increasing Progressivity in an Era of Low Growth," in Journal of African Economies (October, 2005). RETURN TO MAIN PUBLICATIONS BY RESEARCH THEME PAGE

HOME | RESEARCH | PUBLICATIONS | TECHNICAL ASSISTANCE | CONFERENCES | GRANTS | PARTNERS | PROJECT PERSONNEL | PROGRESS REPORTS | LINKS | CONTACT US | SEARCH