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Impact of national health insurance enrolment on farm investments in Sub-Saharan Africa: empirical evidence from Ghana

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  • Edward Asiedu
  • Dorcas Sowah
  • Amin Karimu

Abstract

Purpose - The study aims to explore the impact of National Health Insurance Scheme (NHIS) enrolment on farm investments in a developing country setting. We classify farm investments into (1) soil and land investments and (2) hired adult labour. Design/methodology/approach - This study used data on 5,883 farm households from the sixth round of the Ghana Living Standard Surveys (GLSS), which is nationally represented data at the household level. The data also includes a Labour Force Survey module. The sample frame was divided into a primary and secondary sampling unit, with interviews taking place in 1,200 enumeration areas (EAs). The estimation of impacts was carried out using ordinary least squares (OLS) estimations and addressed endogeneity concerns using propensity score matching (PSM) and instrumental variable (IV) estimators. Findings - The study finds a strong positive association between the NHIS enrolment status of farm households and investments in agricultural land and soil health improvement. Precisely, farm households who are enroled in the health insurance system tend to invest about 32% more in soil and land improvement activities and 30% more in hired farm labour than households who are not enroled in NHIS. Practical implications - The overall evidence from our study suggests that instead of high investments in fertilizer and other input subsidy programmes in Africa, sustainable smallholder agricultural investments can be achieved if concerns and issues of farmers’ health coverage are adequately addressed. Originality/value - This is one of the first papers that have explored the impact of NHIS in developing countries on farm investments.

Suggested Citation

  • Edward Asiedu & Dorcas Sowah & Amin Karimu, 2024. "Impact of national health insurance enrolment on farm investments in Sub-Saharan Africa: empirical evidence from Ghana," Agricultural Finance Review, Emerald Group Publishing Limited, vol. 84(4/5), pages 320-341, September.
    • Handle: RePEc:eme:afrpps:afr-03-2024-0041
    DOI: 10.1108/AFR-03-2024-0041
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    as
    1. Balana, Bedru B. & Mekonnen, Dawit & Haile, Beliyou & Hagos, Fitsum & Yimam, Seid & Ringler, Claudia, 2022. "Demand and supply constraints of credit in smallholder farming: Evidence from Ethiopia and Tanzania," World Development, Elsevier, vol. 159(C).
    2. Dean Karlan & Robert Osei & Isaac Osei-Akoto & Christopher Udry, 2014. "Agricultural Decisions after Relaxing Credit and Risk Constraints," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 129(2), pages 597-652.
    3. Carter, Michael R. & Cheng, Lan & Sarris, Alexandros, 2016. "Where and how index insurance can boost the adoption of improved agricultural technologies," Journal of Development Economics, Elsevier, vol. 118(C), pages 59-71.
    4. Takahashi, Kazushi & Ikegami, Munenobu & Sheahan, Megan & Barrett, Christopher B., 2016. "Experimental Evidence on the Drivers of Index-Based Livestock Insurance Demand in Southern Ethiopia," World Development, Elsevier, vol. 78(C), pages 324-340.
    5. Hans P. Binswanger-Mkhize, 2012. "Is There Too Much Hype about Index-based Agricultural Insurance?," Journal of Development Studies, Taylor & Francis Journals, vol. 48(2), pages 187-200, February.
    6. de Janvry, A. & Dequiedt, V. & Sadoulet, E., 2014. "The demand for insurance against common shocks," Journal of Development Economics, Elsevier, vol. 106(C), pages 227-238.
    7. Barbara Sianesi, 2004. "An Evaluation of the Swedish System of Active Labor Market Programs in the 1990s," The Review of Economics and Statistics, MIT Press, vol. 86(1), pages 133-155, February.
    8. Jing Cai & Alain De Janvry & Elisabeth Sadoulet, 2015. "Social Networks and the Decision to Insure," American Economic Journal: Applied Economics, American Economic Association, vol. 7(2), pages 81-108, April.
    9. Kwame Adjei-Mantey & Charles Yuji Horioka, 2023. "Determinants of health insurance enrollment and health expenditure in Ghana: an empirical analysis," Review of Economics of the Household, Springer, vol. 21(4), pages 1269-1288, December.
    10. Xavier Gine & Jessica Goldberg & Dean Yang, 2012. "Credit Market Consequences of Improved Personal Identification: Field Experimental Evidence from Malawi," American Economic Review, American Economic Association, vol. 102(6), pages 2923-2954, October.
    11. Berber Kramer & Peter Hazell & Harold Alderman & Francisco Ceballos & Neha Kumar & Anne G. Timu, 2022. "Is Agricultural Insurance Fulfilling Its Promise for the Developing World? A Review of Recent Evidence," Annual Review of Resource Economics, Annual Reviews, vol. 14(1), pages 291-311, October.
    12. Augurzky, Boris & Schmidt, Christoph M., 2001. "The Propensity Score: A Means to An End," IZA Discussion Papers 271, Institute of Labor Economics (IZA).
    13. Jennifer E Ifft & Todd Kuethe & Mitch Morehart, 2015. "Does federal crop insurance lead to higher farm debt use? Evidence from the Agricultural Resource Management Survey (ARMS)," Agricultural Finance Review, Emerald Group Publishing Limited, vol. 75(3), pages 349-367, September.
    14. Chima, Reginald Ikechukwu & Goodman, Catherine A. & Mills, Anne, 2003. "The economic impact of malaria in Africa: a critical review of the evidence," Health Policy, Elsevier, vol. 63(1), pages 17-36, January.
    15. Ifft, Jennifer & Kuethe, Todd & Morehart, Mitch, 2015. "Does Federal Crop Insurance lead to higher farm debt use? Evidence from the Agricultural Resource Management Survey," Working Papers 250011, Cornell University, Department of Applied Economics and Management.
    16. Landmann, Andreas & Frölich, Markus, 2015. "Can health-insurance help prevent child labor? An impact evaluation from Pakistan," Journal of Health Economics, Elsevier, vol. 39(C), pages 51-59.
    17. Daniel J. Clarke, 2016. "A Theory of Rational Demand for Index Insurance," American Economic Journal: Microeconomics, American Economic Association, vol. 8(1), pages 283-306, February.
    18. Sascha O. Becker & Andrea Ichino, 2002. "Estimation of average treatment effects based on propensity scores," Stata Journal, StataCorp LP, vol. 2(4), pages 358-377, November.
    19. Stein, Daniel, 2014. "Dynamics of demand for rainfall index insurance : evidence from a commercial product in India," Policy Research Working Paper Series 7035, The World Bank.
    20. Samuel Sekyi & Paul B. Domanban & Fauster Agbenyo, 2022. "Exploring heterogeneity of national health insurance scheme enrolment among persons in the informal sector," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(6), pages 3282-3296, November.
    21. Nathaniel D. Jensen & Christopher B. Barrett & Andrew G. Mude, 2016. "Index Insurance Quality and Basis Risk: Evidence from Northern Kenya," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 98(5), pages 1450-1469.
    22. Chantarat, Sommarat & Mude, Andrew G. & Barrett, Christopher B. & Turvey, Calum G., 2017. "Welfare Impacts of Index Insurance in the Presence of a Poverty Trap," World Development, Elsevier, vol. 94(C), pages 119-138.
    23. Shawn Cole & Daniel Stein & Jeremy Tobacman, 2014. "Dynamics of Demand for Index Insurance: Evidence from a Long-Run Field Experiment," American Economic Review, American Economic Association, vol. 104(5), pages 284-290, May.
    24. Banful, Afua Branoah, 2011. "Old Problems in the New Solutions? Politically Motivated Allocation of Program Benefits and the "New" Fertilizer Subsidies," World Development, Elsevier, vol. 39(7), pages 1166-1176, July.
    25. Mason-D'Croz, Daniel & Sulser, Timothy B. & Wiebe, Keith & Rosegrant, Mark W. & Lowder, Sarah K. & Nin-Pratt, Alejandro & Willenbockel, Dirk & Robinson, Sherman & Zhu, Tingju & Cenacchi, Nicola & Duns, 2019. "Agricultural investments and hunger in Africa modeling potential contributions to SDG2 – Zero Hunger," World Development, Elsevier, vol. 116(C), pages 38-53.
    26. Heckman, James J. & Lalonde, Robert J. & Smith, Jeffrey A., 1999. "The economics and econometrics of active labor market programs," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 3, chapter 31, pages 1865-2097, Elsevier.
    27. Barry J. Barnett & Olivier Mahul, 2007. "Weather Index Insurance for Agriculture and Rural Areas in Lower-Income Countries," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 89(5), pages 1241-1247.
    28. Hugh R. Waters, 1999. "Measuring the impact of health insurance with a correction for selection bias-a case study of Ecuador," Health Economics, John Wiley & Sons, Ltd., vol. 8(5), pages 473-483.
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