Can health financing programmes reduce food insecurity in a developing country?

Despite the devastating effects of out-of-pocket healthcare expenditures on households' financial outlays, which potentially stifle household resources needed for food consumption, the health financing program-food insecurity nexus is yet to receive much needed attention in the literature. This study makes a significant contribution by investigating the effect of health financing program, conceptualised as membership of a National Health Insurance Scheme, on household food insecurity using the food insecurity experience scale (FIES) and several quasi-experimental methods. Using data from the seventh round of the Ghana Living Standards Survey, our endogeneity-corrected results indicate that membership of a health financing program can contribute to reduction in household food insecurity. The results are robust to alternative conceptualisations of food insecurity and different quasi-experimental methods. The effect of health financing programme membership on food insecurity is more pronounced among urban and female-headed households. Our findings further point to household savings as an important channel through which membership of health financing program reduces food insecurity.

Informal care and financial stress: Longitudinal evidence from Australia.

The number of people providing informal care has increased considerably in the last years while, at the same time, about one in four Australians have financial stress problems. This study uses rich longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA) survey to estimate the effect of informal care on financial stress. To establish causality, we exploit a fixed effect-instrumental variable approach to address omitted variable bias and reverse causality problems. Our findings show that informal caregiving increases financial stress between 9.9 and 14.5 percentage points. This finding is robust across a battery of quasi-experimental methods. The effect of informal caregiving on financial stress is more pronounced among males, rural residents and those living in low socioeconomic areas. Our analyses further show that financial fragility and social isolation are important channels through which informal caregiving affects financial stress.

Psychological profiles of South African smallholder farmers.

The present study examined smallholder farmer profiles based on key psychological variables associated with farm business performance in the South African context. A sample of 471 beef farmers (mean age = 54.15 years; SD = 14.46; men = 76%) and 426 poultry farmers (mean age = 47.28 years; SD = 13.53; women = 54.5%) provided data on a range of measures assessing attitudes, subjective norms, perceived behavioral control, personality characteristics, present and future time orientation, expected benefits of, and efficacy to perform the farm business tasks, and farm-related concerns. Latent profile analysis identified three distinct profile segments of smallholder beef and poultry farmers, respectively: Fatalists, Traditionalists, and Entrepreneurs. Our results suggested unique combinations of psychological characteristics in a sample of South African smallholder beef and poultry farmers and show a novel way of understanding enablers of, and barriers to, engaging in the farm business.

Effect of Financial Literacy on Poverty Reduction Across Kenya, Tanzania, and Uganda.

Financial literacy can be critical to reducing poverty, but limited evidence exists on the mechanisms of change. Guided by the financial capability framework, this study examines the direct effects of financial literacy on poverty and the indirect effect through financial inclusion and entrepreneurship, using data from wave 5 of the InterMedia Financial Inclusion Insights Program for Kenya, Tanzania, and Uganda. We also examined how the relationships differ by gender and locality. Overall, the endogeneity-corrected results suggest that an increase in financial literacy is associated with a 6.9% decrease in poverty. We found that entrepreneurship and financial inclusion act as mechanisms of change through which financial literacy decreases poverty, with the findings differing by gender and locality. These findings point to the poverty-reducing effect of financial literacy, mainly in Tanzania, followed by Kenya and Uganda. The results contribute to understanding how financial literacy and poverty interact and can inform contextually relevant interventions and policies.

Parental Time Poverty, Child Work and School Attendance in Ghana.

This study examines the relationship between parental time poverty, child work, and school attendance in Ghana using data from the sixth and seventh rounds of the Ghana Living Standard Survey (GLSS6 and GLSS7). Results of the analysis indicate an increasing decline in child enrolment in public schools (from 9% to 6%) among time poor household heads. In addition, parental time poverty increases children's walking hours to and from school and private school enrolment. We observed heterogeneity of parental time poverty on child work in relation to the location of households and gender disaggregation. Child work and school attendance-reducing effect of parental time poverty is mainly prevalent among male children but mixed for location. Our result is robust to the alternative estimation method of addressing endogeneity and further shows that household income is the primary channel through which time poverty influences child work and school attendance. Supplementary Information: The online version contains supplementary material available at 10.1007/s12187-022-09926-4 10.1007/s12187-022-09926-4.

Introducing the Disease Outbreak Resilience Index (DORI) Using the Demographic and Health Surveys Data from sub-Saharan Africa.

Although most studies on disease emergencies underscore the need for household readiness for shocks associated with disease outbreaks, no study to date has provided a holistic measure for profiling households based on their readiness toward disease outbreaks. This paper introduces a novel Disease Outbreak Resilience Index (DORI) using a multidimensional approach that draws on the Alkire-Foster methodology. DORI measures disease outbreak resilience in four dimensions: (a) water and hygiene, (b) physical distancing, (c) energy and communication, and (d) economic security and resilience. The paper details the development of DORI and its use by presenting findings from ten countries in sub-Saharan Africa using data from the Demographic and Health Surveys (DHS) program. In addition to serving as a resilience index, we illustrate how DORI can be used to produce a disease outbreak vulnerability index (DOVI). As a versatile index, the indicators under each dimension can be tailored to meet country- and region-specific contexts based on indicators appropriate to each context.

Effect of financial inclusion on out-of-pocket health expenditure: empirics from Ghana.

Empirical evidence on the link between financial inclusion and out-of-pocket health expenditure remains sparse while existing studies have mainly not used a multidimensional financial inclusion index. This study examines the link between financial inclusion and out-of-pocket health expenditure in Ghana using data from the seventh round of the Ghana Living Standards Survey. To ensure robustness in findings, the standard instrumental variable (with external instruments) and Lewbel's heteroskedasticity-based instrumental variable approaches are both applied. Our findings indicate that a standard deviation increase in financial inclusion is associated with an increase in households' out-of-pocket health expenditure between 0.1367 and 1.7608 standard deviations. This finding is more pronounced for female-headed and urban-located households. Financial inclusion has a bigger association with expenses on medical products/appliances than on outpatient services. Policymakers are encouraged to design and implement programs to scale up the level of financial inclusion which has the potential of facilitating demand for health, thereby leading to better health outcomes.