AIDS Treatment and Intrahousehold Resource Allocations: Children's Nutrition and Schooling in Kenya

The provision of life-saving antiretroviral (ARV) treatment has emerged as a key component of the global response to HIV/AIDS, but very little is known about the impact of this intervention on the welfare of children in the households of treated persons. We estimate the impact of ARV treatment on children’s schooling and nutrition outcomes using longitudinal household survey data collected in collaboration with a treatment program in western Kenya. We find that children’s weekly hours of school attendance increase by over 20 percent within six months after treatment is initiated for the adult household member. For boys in treatment households, these increases closely follow their reduced market labor supply. Similarly, young children’s short-term nutritional status—as measured by their weight-for-height Z-score—also improves dramatically. We also present evidence that the impact of treatment is considerably larger when compared to the counterfactual scenario of no ARV treatment. The results illustrate how intrahousehold allocations of time and resources are altered in response to significant health improvements. Since the improvements in children’s schooling and nutrition at these critical early ages will affect their socio-economic outcomes and wellbeing in adulthood, the widespread provision of ARV treatment is likely to generate significant long-run welfare benefits.antiretroviral drugs, ARVs, HIV/AIDS, Kenya, children school attendance, children nutrition,

An evaluation of the impact of PROGRESA on pre-school child height

One of the major components of the PROGRESA program has been directed toward improving the nutritional status of small children in poor rural communities in Mexico. Results suggest that PROGRESA may be having fairly substantial effects on lifetime productivities and earnings of currently small children in poor households.Nutrition. ,

No 'free ride' for African women:a comparison of head-loading versus back-loading among Xhosa women

Although contrasting evidence exists in the literature as to the economy of head-loading, there is a notion that head-loading is an extremely economical method of load carriage. This has become known as the ‘free ride’ hypothesis and, although untested, it is widely accepted. The purpose of this study was to test the ‘free ride’ hypothesis for head-load carriage among African women by comparing the relative economy of head-loading and back-loading. Twenty-four Xhosa women walked on a level treadmill, attempting to carry loads of between 10% and 70% of their body mass (BM) using both a backpack and a head basket. All 24 women carried at least 25% of their BM in both conditions. The relative economy of load carriage was calculated for loads of 10% to 25% of BM. Results indicated that the ‘free ride’ was not a generalisable phenomenon, with both methods realising economy scores close to unity (1.04 ± 0.19 and 0.97 ± 0.15 for head-loading and back-loading, respectively). The results did, however, reveal significant individual differences in economy scores and it is suggested that analysis of such individual differences in future may well be instructive in understanding mechanisms associated with greater economy in load carriage

Access to water, women's work and child outcomes

Poor rural women in the developing world spend considerable time collecting water. How then do they respond to improved access to water infrastructure? Does it increase their participation in income earning market-based activities? Does it improve the health and education outcomes of their children? To help address these questions, a new approach for dealing with the endogeneity of infrastructure placement in cross-sectional surveysis proposed and implemented using data for nine developing countries. The paper does not find that access to water comes with greater off-farm work for women, although in countries where substantial gender gaps in schooling exist, both boys'and girls'enrollments improve with better access to water. There are also some signs of impacts on child health as measured by anthropometric z-scores.Gender, Water Supply and Sanitation,Rural Labor Markets,Rural Water Supply and Sanitation,Access&Equity in Basic Education,Early Child and Children's Health

AIDS Treatment and Intrahousehold Resource Allocations: Children's Nutrition and Schooling in Kenya

The provision of life-saving antiretroviral (ARV) treatment has emerged as a key component of the global response to HIV/AIDS, but very little is known about the impact of this intervention on the welfare of children in the households of treated persons. We estimate the impact of ARV treatment on children’s schooling and nutrition outcomes using longitudinal household survey data collected in collaboration with a treatment program in western Kenya. We find that children’s weekly hours of school attendance increase by over 20 percent within six months after treatment is initiated for the adult household member. For boys in treatment households, these increases closely follow their reduced market labor supply. Similarly, young children’s short-term nutritional status—as measured by their weight-for-height Z-score—also improves dramatically. We argue that these treatment effects will be considerably larger when compared to the counterfactual scenario of no ARV treatment. The results provide evidence on how intrahousehold resource allocation is altered in response to significant health improvements. Since the improvements in children’s schooling and nutrition at these critical early ages will affect their socio-economic outcomes in adulthood, the widespread provision of ARV treatment is likely to generate significant long-run macroeconomic benefits.

Food Insecurity, Family Structure and Agricultural Productivity: the role of Social Capital in Nigeria.

Replaced with revised version of paper 07/21/10.Food Security and Poverty,

Bariatric surgery and brain health: A longitudinal observational study investigating the effect of surgery on cognitive function and gray matter volume

Dietary modifications leading to weight loss have been suggested as a means to improve brain health. In morbid obesity, bariatric surgery (BARS)—including different procedures, such as vertical sleeve gastrectomy (VSG), gastric banding (GB), or Roux-en-Y gastric bypass (RYGB) surgery—is performed to induce rapid weight loss. Combining reduced food intake and malabsorption of nutrients, RYGB might be most effective, but requires life-long follow-up treatment. Here, we tested 40 patients before and six months after surgery (BARS group) using a neuropsychological test battery and compared them with a waiting list control group. Subsamples of both groups underwent structural MRI and were examined for differences between surgical procedures. No substantial differences between BARS and control group emerged with regard to cognition. However, larger gray matter volume in fronto-temporal brain areas accompanied by smaller volume in the ventral striatum was seen in the BARS group compared to controls. RYGB patients compared to patients with restrictive treatment alone (VSG/GB) had higher weight loss, but did not benefit more in cognitive outcomes. In sum, the data of our study suggest that BARS might lead to brain structure reorganization at long-term follow-up, while the type of surgical procedure does not differentially modulate cognitive performance

A Multilevel Approach to Explain Child Mortality and Undernutrition in South Asia and Sub-Saharan Africa

While undernutrition among children is very pervasive both in Sub- Saharan Africa and South Asia, child mortality is rather low in South Asia. In contrast to that Sub-Saharan African countries suffer by far the worst from high rates of child mortality. This different pattern of child mortality and undernutrition in both regions is well known, but approaches using aggregated macro data have not been able to explain it appropriately. In this paper we analyze the determinants of child mortality as well as child undernutrition based on DHS data sets for a sample of six developing countries in South Asia and Sub-Saharan Africa. We investigate the effects of individual, household and cluster socioeconomic characteristics using a multilevel model approach and examine their respective influences on both phenomena. We find that the determinants of child mortality and undernutrition differ significantly from each other. Access to health infrastructure is more important for child mortality, whereas the individual characteristics like wealth and educational and nutritional characteristics of mothers play a larger role for anthropometric shortfalls. Although very similar patterns in the determinants of each phenomenon are discernable, there are large differences in the magnitude of the coefficients. Besides regressions using a combined data set of all six countries show, that there are still significant differences between the two regions although taking account of a large set of covariates.Child mortality,child undernutrition,multilevel modelling