IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v30y2021i12p2995-3015.html
   My bibliography  Save this article

Community‐level health programs and child labor: Evidence from Ethiopia

Author

Listed:
  • Alberto Posso
  • Udeni De Silva Perera
  • Ankita Mishra

Abstract

Many developing countries have adopted community‐based primary health‐care programs. A vital component of these programs is health literacy, which teaches households to avoid physical harm. Child labor can often result in physical harm through injury. Our hypothesis is that health literacy programs make households aware of previously unknown costs of child labor (i.e., risks of injury), resulting in a reallocation of labor away from children. Using Ethiopian data, we investigate if exposure to a community‐level health program delivered by Health Extension Workers (HEWs) lowers child labor. We use panel data comprising 5587 observations from 2255 children over four waves of the Young Lives Project. These data are combined with administrative regional‐level data on HEWs over the 2006–2016 period. Our identification strategy exploits variations in the deployment of HEWs across regions and time to investigate a plausibly exogenous effect on child labor. We provide evidence that supports our hypothesis. We posit that the mechanism behind our result is likely behavioral change, and rule out several other potential channels, including public safety net programs and the effect of HEWs on education. Our results point to the role that health programs can play in the fight against child labor.

Suggested Citation

  • Alberto Posso & Udeni De Silva Perera & Ankita Mishra, 2021. "Community‐level health programs and child labor: Evidence from Ethiopia," Health Economics, John Wiley & Sons, Ltd., vol. 30(12), pages 2995-3015, December.
  • Handle: RePEc:wly:hlthec:v:30:y:2021:i:12:p:2995-3015
    DOI: 10.1002/hec.4429
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.4429
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hec.4429?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Clément de Chaisemartin & Xavier D'Haultfœuille, 2020. "Two-Way Fixed Effects Estimators with Heterogeneous Treatment Effects," American Economic Review, American Economic Association, vol. 110(9), pages 2964-2996, September.
    2. Owen O'Donnell & Furio C. Rosati & Eddy van Doorslaer, 2005. "Health effects of child work: Evidence from rural Vietnam," Journal of Population Economics, Springer;European Society for Population Economics, vol. 18(3), pages 437-467, September.
    3. John Fitzgerald & Peter Gottschalk & Robert Moffitt, 1998. "An Analysis of Sample Attrition in Panel Data: The Michigan Panel Study of Income Dynamics," Journal of Human Resources, University of Wisconsin Press, vol. 33(2), pages 251-299.
    4. Netsanet Fetene & Erika Linnander & Binyam Fekadu & Hibret Alemu & Halima Omer & Maureen Canavan & Janna Smith & Peter Berman & Elizabeth Bradley, 2016. "The Ethiopian Health Extension Program and Variation in Health Systems Performance: What Matters?," PLOS ONE, Public Library of Science, vol. 11(5), pages 1-19, May.
    5. Huihui Wang & Roman Tesfaye & Gandham N.V. Ramana & Chala Tesfaye Chekagn, 2016. "Ethiopia Health Extension Program," World Bank Publications - Books, The World Bank Group, number 24119.
    6. C de Chaisemartin & X D’HaultfŒuille, 2018. "Fuzzy Differences-in-Differences," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 85(2), pages 999-1028.
    7. Basu, Kaushik & Van, Pham Hoang, 1998. "The Economics of Child Labor," American Economic Review, American Economic Association, vol. 88(3), pages 412-427, June.
    8. Helfand, Steven M. & Sielawa, Vilma H. & Singhania, Deepak, 2019. "A matter of time: An impact evaluation of the Brazilian National Land Credit Program," Journal of Development Economics, Elsevier, vol. 141(C).
    9. Zemzem Shigute & Christoph Strupat & Francesco Burchi & Getnet Alemu & Arjun S. Bedi, 2020. "Linking Social Protection Schemes: The Joint Effects of a Public Works and a Health Insurance Programme in Ethiopia," Journal of Development Studies, Taylor & Francis Journals, vol. 56(2), pages 431-448, February.
    10. Young, Alwyn, 2019. "Channeling Fisher: randomization tests and the statistical insignificance of seemingly significant experimental results," LSE Research Online Documents on Economics 101401, London School of Economics and Political Science, LSE Library.
    11. McGavock, Tamara, 2021. "Here waits the bride? The effect of Ethiopia's child marriage law," Journal of Development Economics, Elsevier, vol. 149(C).
    12. Wolff, François-Charles & Maliki, 2008. "Evidence on the impact of child labor on child health in Indonesia, 1993-2000," Economics & Human Biology, Elsevier, vol. 6(1), pages 143-169, March.
    13. Alberto Posso, 2019. "The health consequences of hazardous and nonhazardous child labor," Review of Development Economics, Wiley Blackwell, vol. 23(2), pages 619-639, May.
    14. Eric V. Edmonds & Nina Pavcnik, 2005. "Child Labor in the Global Economy," Journal of Economic Perspectives, American Economic Association, vol. 19(1), pages 199-220, Winter.
    15. Kathleen Beegle & Rajeev Dehejia & Roberta Gatti, 2009. "Why Should We Care About Child Labor?: The Education, Labor Market, and Health Consequences of Child Labor," Journal of Human Resources, University of Wisconsin Press, vol. 44(4).
    16. de Chaisemartin, Clement & D'Haultfoeuille, Xavier, 2014. "Fuzzy Changes-in Changes," CAGE Online Working Paper Series 184, Competitive Advantage in the Global Economy (CAGE).
    17. John Fitzgerald & Peter Gottschalk & Robert Moffitt, 1998. "An Analysis of the Impact of Sample Attrition on the Second Generation of Respondents in the Michigan Panel Study of Income Dynamics," Journal of Human Resources, University of Wisconsin Press, vol. 33(2), pages 300-344.
    18. Bai, Jie & Wang, Yukun, 2020. "Returns to work, child labor and schooling: The income vs. price effects," Journal of Development Economics, Elsevier, vol. 145(C).
    19. Roggero, P. & Mangiaterra, V. & Bustreo, F. & Rosati, F., 2007. "The health impact of child labor in developing countries: Evidence from cross-country data," American Journal of Public Health, American Public Health Association, vol. 97(2), pages 271-275.
    20. Justin Wolfers, 2006. "Did Unilateral Divorce Laws Raise Divorce Rates? A Reconciliation and New Results," American Economic Review, American Economic Association, vol. 96(5), pages 1802-1820, December.
    21. Ravallion, Martin & Wodon, Quentin, 2000. "Does Child Labour Displace Schooling? Evidence on Behavioural Responses to an Enrollment Subsidy," Economic Journal, Royal Economic Society, vol. 110(462), pages 158-175, March.
    22. Beuermann, Diether W. & Pecha, Camilo J., 2020. "The effect of eliminating health user fees on adult health and labor supply in Jamaica," Journal of Health Economics, Elsevier, vol. 73(C).
    23. Alwyn Young, 2019. "Channeling Fisher: Randomization Tests and the Statistical Insignificance of Seemingly Significant Experimental Results," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(2), pages 557-598.
    24. Abraha Woldemichael & Amirhossein Takian & Ali Akbari Sari & Alireza Olyaeemanesh, 2019. "Availability and inequality in accessibility of health centre-based primary healthcare in Ethiopia," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-16, March.
    25. Beegle, Kathleen & Dehejia, Rajeev H. & Gatti, Roberta, 2006. "Child labor and agricultural shocks," Journal of Development Economics, Elsevier, vol. 81(1), pages 80-96, October.
    26. Simon Feeny & Alberto Posso & Ahmed Skali & Amalendu Jyotishi & Shyam Nath & P. K. Viswanathan, 2021. "Child labor and psychosocial wellbeing: Findings from India," Health Economics, John Wiley & Sons, Ltd., vol. 30(4), pages 876-902, April.
    27. Alam, Shamma Adeeb, 2015. "Parental health shocks, child labor and educational outcomes: Evidence from Tanzania," Journal of Health Economics, Elsevier, vol. 44(C), pages 161-175.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Posso, Alberto, 2023. "Terrorism, banking, and informal savings: Evidence from Nigeria," Journal of Banking & Finance, Elsevier, vol. 150(C).
    2. Delphine BOUTIN & Marine JOUVIN, 2022. "Child Labour Consequences on Education and Health: A Review of Evidence and Knowledge Gaps," Bordeaux Economics Working Papers 2022-14, Bordeaux School of Economics (BSE).
    3. Edmonds, Eric V., 2008. "Child Labor," Handbook of Development Economics, in: T. Paul Schultz & John A. Strauss (ed.), Handbook of Development Economics, edition 1, volume 4, chapter 57, pages 3607-3709, Elsevier.
    4. Posso, Alberto, 2023. "Bilingual education and child labor: Lessons from Peru," Journal of Economic Behavior & Organization, Elsevier, vol. 212(C), pages 840-872.
    5. Delphine Boutin & Marine Jouvin, 2022. "Child Labour Consequences on Education and Health: A Review of Evidence and Knowledge Gaps," Working Papers hal-03896700, HAL.
    6. Trong‐Anh Trinh & Alberto Posso & Simon Feeny, 2020. "Child Labor and Rainfall Deviation: Panel Data Evidence from Rural Vietnam," The Developing Economies, Institute of Developing Economies, vol. 58(1), pages 63-76, March.
    7. Danusha Jayawardana & Nadezhda V. Baryshnikova & Terence C. Cheng, 2023. "The long shadow of child labour on adolescent mental health: a quantile approach," Empirical Economics, Springer, vol. 64(1), pages 77-97, January.
    8. Sim, Armand & Suryadarma, Daniel & Suryahadi, Asep, 2017. "The Consequences of Child Market Work on the Growth of Human Capital," World Development, Elsevier, vol. 91(C), pages 144-155.
    9. Meltem Dayioglu & Murat Guray Kirdar & Ismet Koc, 2021. "The Making of a Lost Generation: Child Labor among Syrian Refugees in Turkey," Koç University-TUSIAD Economic Research Forum Working Papers 2105, Koc University-TUSIAD Economic Research Forum.
    10. Connie Bayudan-Dacuycuy & Lawrence Dacuycuy, 2013. "Is schooling forever doomed with child labor around? An analysis using Philippine time use data," Economics Bulletin, AccessEcon, vol. 33(1), pages 138-151.
    11. Jinnat Ara & Dipanwita Sarkar & Jayanta Sarkar, 2021. "Like mother like daughter? Occupational mobility among children under asset transfer program in Bangladesh," QuBE Working Papers 061, QUT Business School.
    12. Meltem Dayıoğlu & Murat Güray Kırdar, 2022. "Keeping Kids in School and Out of Work: Compulsory Schooling and Child Labor in Turkey," Journal of Human Capital, University of Chicago Press, vol. 16(4), pages 526-555.
    13. Gianna Claudia Giannelli & Francesca Francavilla, 2007. "The Relation between Child Labour and Mothers’ Work: The Case of India," CHILD Working Papers wp22_07, CHILD - Centre for Household, Income, Labour and Demographic economics - ITALY.
    14. Krisztina Kis-Katos, 2012. "Gender differences in work-schooling decisions in rural North India," Review of Economics of the Household, Springer, vol. 10(4), pages 491-519, December.
    15. Kozhaya, Mireille & Martínez Flores, Fernanda, 2020. "Child Education and Work: Evidence from Mexico's Full-Time School Program," VfS Annual Conference 2020 (Virtual Conference): Gender Economics 224567, Verein für Socialpolitik / German Economic Association.
    16. Kozhaya, Mireille & Martinez Flores, Fernanda, 2020. "Schooling and child labor: Evidence from Mexico's full-time school program," Ruhr Economic Papers 851, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    17. Can Tang & Liqiu Zhao & Zhong Zhao, 2019. "Free Education Helps Combat Child Labor? The Effect of a Free Compulsory Education Reform in Rural China," Working Papers 2019-036, Human Capital and Economic Opportunity Working Group.
    18. Dammert, Ana C. & de Hoop, Jacobus & Mvukiyehe, Eric & Rosati, Furio C., 2018. "Effects of public policy on child labor: Current knowledge, gaps, and implications for program design," World Development, Elsevier, vol. 110(C), pages 104-123.
    19. Clément de Chaisemartin & Xavier D’Haultfœuille, 2023. "Two-way fixed effects and differences-in-differences with heterogeneous treatment effects: a survey," The Econometrics Journal, Royal Economic Society, vol. 26(3), pages 1-30.
    20. Ajefu, Joseph B. & Massacky, Falecia, 2023. "Mobile money, child labour and school enrolment," Telecommunications Policy, Elsevier, vol. 47(10).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:30:y:2021:i:12:p:2995-3015. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.