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Parental health shocks and schooling: The impact of mutual health insurance in Rwanda

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  • Woode, Maame Esi

Abstract

The goal of this study was to look at the educational spill-over effects of health insurance on schooling with a focus on the Rwandan Community Based Health Insurance Programme, the Mutual Health Insurance scheme. Using a two-person general equilibrium overlapping generations model, this paper theoretically analyses the possible effect of health insurance on the relationship between parental health shocks and child schooling. Individuals choose whether or not they want to incur a medical cost by seeking care in order to reduce the effect of health shocks on their labour market availability and productivity. The theoretical results show that, health shocks negatively affect schooling irrespective of insurance status. However, if the health shock is severe (incapacitating) or sudden in nature, there is a discernible mitigating effect of health insurance on the negative impact of parental ill health on child schooling. The results are tested empirically using secondary data from the third Integrated Household Living Conditions Survey (EICV) for Rwanda, collected in 2011. A total of 2401 children between the ages of 13 and 18 are used for the analysis. This age group is selected due to the age of compulsory education in Rwanda. Based on average treatment effect on treated we find a statistically significant difference in attendance between children with MHI affiliated parents and those with uninsured parents of about 0.044. The negative effect of a father being severely ill is significant only for uninsured household. For the case of the mother, this effect is felt by female children with uninsured parents only when the illness is sudden. The observed effects are more pronounced for older children. While the father's ill health (sever or sudden) significantly and negatively affects their working hours, health insurance plays appears to increase their working hours. The effects of health insurance extend beyond health outcomes.

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  • Woode, Maame Esi, 2017. "Parental health shocks and schooling: The impact of mutual health insurance in Rwanda," Social Science & Medicine, Elsevier, vol. 173(C), pages 35-47.
    • Handle: RePEc:eee:socmed:v:173:y:2017:i:c:p:35-47
    DOI: 10.1016/j.socscimed.2016.11.023
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    2. Sowmya Dhanaraj & Christy Mariya Paul & Smit Gade, 2019. "Household income dynamics and investment in children: Evidence from India," Education Economics, Taylor & Francis Journals, vol. 27(5), pages 507-520, September.
    3. Lee, Ines, 2024. "Co-benefits from health and health systems to education," Health Policy, Elsevier, vol. 142(C).
    4. Sasiwooth Wongmonta, 2023. "The Impact of Parental Health Shocks on Child Schooling and Labor: Evidence from Thailand," PIER Discussion Papers 209, Puey Ungphakorn Institute for Economic Research.
    5. Guanfu Fang & Xin Li & Tianyu Tang, 2024. "Growing up without health insurance: Evidence from rural China," Health Economics, John Wiley & Sons, Ltd., vol. 33(2), pages 363-390, February.
    6. Silvia Mendolia & Nga Nguyen & Oleg Yerokhin, 2019. "The impact of parental illness on children’s schooling and labour force participation: evidence from Vietnam," Review of Economics of the Household, Springer, vol. 17(2), pages 469-492, June.
    7. Emmanuel Nshakira-Rukundo & Essa Chanie Mussa & Nathan Nshakira & Nicolas Gerber & Joachim von Braun, 2021. "Impact of community-based health insurance on utilisation of preventive health services in rural Uganda: a propensity score matching approach," International Journal of Health Economics and Management, Springer, vol. 21(2), pages 203-227, June.
    8. Pu Liao & Zhihong Dou & Xingxing Guo, 2021. "The Effect of Health Shock and Basic Medical Insurance on Family Educational Investment for Children in China," IJERPH, MDPI, vol. 18(10), pages 1-16, May.
    9. Cristian Bortes & Mattias Strandh & Karina Nilsson, 2020. "Parental Illness and Young People’s Education," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 13(6), pages 2069-2091, December.
    10. Lim, Sung Soo, 2020. "Parental chronic illness and child education: Evidence from children in Indonesia," International Journal of Educational Development, Elsevier, vol. 73(C).

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    More about this item

    Keywords

    Rwanda; Human capital; Economic impact; Health shocks; Schooling; Overlapping generations model; Propensity scores;
    All these keywords.

    JEL classification:

    • E21 - Macroeconomics and Monetary Economics - - Consumption, Saving, Production, Employment, and Investment - - - Consumption; Saving; Wealth
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I25 - Health, Education, and Welfare - - Education - - - Education and Economic Development
    • J22 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Time Allocation and Labor Supply
    • J24 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Human Capital; Skills; Occupational Choice; Labor Productivity

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