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The Impact of the AIDS Pandemic on Health Services in Africa: Evidence from Demographic and Health Surveys

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  • Anne Case
  • Christina Paxson

Abstract

We document the impact of the AIDS crisis on non-AIDS related health services in fourteen sub-Saharan African countries. Using multiple waves of Demographic and Health Surveys (DHS) for each country, we examine antenatal care, birth deliveries, and rates of immunization for children born between 1988 and 2005. We find deterioration in nearly all of these dimensions of health care over this period. The most recent DHS survey for each country collected data on HIV prevalence, which allows us to examine the association between HIV burden and health care. We find that erosion of health services is highly correlated with increases in AIDS prevalence. Regions of countries that have light AIDS burdens have witnessed small or no declines in health care, using the measures noted above, while those regions currently shouldering the heaviest burdens have seen the largest erosion in treatment for pregnant women and children. Using semi-parametric techniques, we can date the beginning of the divergence in health services between high and low HIV regions to the mid-1990s.

Suggested Citation

  • Anne Case & Christina Paxson, 2009. "The Impact of the AIDS Pandemic on Health Services in Africa: Evidence from Demographic and Health Surveys," NBER Working Papers 15000, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:15000
    Note: AG CH EH
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    References listed on IDEAS

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    1. Oster Emily, 2010. "Estimating HIV Prevalence and Incidence in Africa from Mortality Data," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 10(1), pages 1-46, September.
    2. McIntyre, Diane & Thiede, Michael & Dahlgren, Göran & Whitehead, Margaret, 2006. "What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts?," Social Science & Medicine, Elsevier, vol. 62(4), pages 858-865, February.
    3. World Bank, 2009. "Improving Effectiveness and Outcomes for the Poor in Health, Nutrition, and Population," World Bank Publications - Reports 10573, The World Bank Group.
    4. William Easterly, 2009. "Can the West Save Africa?," Journal of Economic Literature, American Economic Association, vol. 47(2), pages 373-447, June.
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    Cited by:

    1. van Dalen, H.P. & Micevska Scharf, M., 2011. "Reproductive Health Aid : A Delicate Balancing Act," Other publications TiSEM 0af5adbf-3e57-42ac-b9b0-6, Tilburg University, School of Economics and Management.
    2. Guven, Cahit & Sotirakopoulos, Panagiotis & Ulker, Aydogan, 2020. "Short-term Labour Market Effects of COVID-19 and the Associated National Lockdown in Australia: Evidence from Longitudinal Labour Force Survey," GLO Discussion Paper Series 635, Global Labor Organization (GLO).
    3. Ariel BenYishay & Keith Kranker, 2015. "All-Cause Mortality Reductions from Measles Catchup Campaigns in Africa," Journal of Human Resources, University of Wisconsin Press, vol. 50(2), pages 516-547.
    4. Ruben Castro & Jere Behrman & Hans-Peter Kohler, 2015. "Perception of HIV risk and the quantity and quality of children: the case of rural Malawi," Journal of Population Economics, Springer;European Society for Population Economics, vol. 28(1), pages 113-132, January.
    5. Nicholas Wilson, 2011. "Fertility Responses to Prevention of Mother-to-Child Transmission of HIV," Center for Development Economics 2011-08, Department of Economics, Williams College, revised Sep 2011.
    6. William W. Olney, 2015. "Remittances and the Wage Impact of Immigration," Journal of Human Resources, University of Wisconsin Press, vol. 50(3), pages 694-727.
    7. Alsan, Marcella M. & Cutler, David M., 2013. "Girls’ education and HIV risk: Evidence from Uganda," Journal of Health Economics, Elsevier, vol. 32(5), pages 863-872.
    8. Nicholas Wilson, 2015. "Can Disease-Specific Funding Harm Health? in the Shadow of HIV/AIDS Service Expansion," Demography, Springer;Population Association of America (PAA), vol. 52(5), pages 1671-1700, October.
    9. Marcella M. Alsan & David M. Cutler, 2010. "Why did HIV decline in Uganda?," NBER Working Papers 16171, National Bureau of Economic Research, Inc.
    10. Maureen Lewis & Marijn Verhoeven, 2010. "Financial Crises and Social Spending : The Impact of the 2008-2009 Crisis," World Bank Publications - Reports 12965, The World Bank Group.
    11. Mark McGovern & David Canning & Till Bärnighausen, 2018. "Accounting for Non-Response Bias using Participation Incentives and Survey Design," CHaRMS Working Papers 18-02, Centre for HeAlth Research at the Management School (CHaRMS).

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    More about this item

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development
    • O55 - Economic Development, Innovation, Technological Change, and Growth - - Economywide Country Studies - - - Africa

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