Published by Tegemeo Institute for Agricultural Policy and Developmentfood security, food policy, Kenya, prime-age adult mortality, Health Economics and Policy, Q18,

Jayne, Thomas S.

Yamano, Takashi

English

Research Papers in Economics

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TEGEMEO INSTITUTE FOR AGRICULTURAL  DEVELOPMENT AND POLICY
No. 2           (Downloadable at:  http://www.aec.msu.edu/agecon/fs2/kenya/index.htm)         February 2003
MEASURING THE EFFECTS OF PRIME-AGE ADULT MORTALITY IN KENYA
T. Yamano and T.S. Jayne
BACKGROUND:   The starting point for the design
of effective programs to mitigate the impacts of AIDS-
related adult mortality is accurate information on how
households are affected by, and respond to, premature
death.  This note presents key findings from the study,
Measuring the Effects of Prime-Age Adult Death on
Rural Households in Kenya. The full report is
downloadable from the web address above.  While this
is an initial exploration, the study is designed to help
in the formulation of programs to mitigate the spread
and effects of the disease.
OBJECTIVES:  This paper estimates the impact of
prime-age adult mortality on household composition,
crop production, asset holdings, and non-farm income
using nationwide household survey data in rural
Kenya. Life expectancy has declined by 10 years due
in Kenya due to HIV/AIDS.  Linking detailed
nationwide household survey data on agricultural
production, off-farm  incomes, assets, and
mortality/morbidity, this work goes beyond village
case studies that have limited earlier work on the topic.
METHODS: The study is based on a two-year panel
of 1,422  households surveyed in 1997 and 2000.
First, the paper uses adult mortality rates from an HIV-
negative sample from neighboring Tanzania to predict
the number of deaths in the Kenya sample that might
have been expected in the absence of HIV, and
compares this to the number of deaths actually
recorded over the survey interval.  Based on this
procedure, only a quarter of the prime-age female
deaths in the 25-34 age range and about half of the
male deaths in the 35-44 year age range age range
could have been predicted on the basis of the HIV-
negative Tanzanian adult mortality rates. In Nyanza
Province, the discrepancies were even larger.  This
strongly indicates that AIDS accounts for a large
proportion of the recorded deaths for these age/sex
categories, particularly in the Nyanza area.  Next,
using  household fixed-effects models that control for
time-varying effects, we estimate changes in outcomes
between households afflicted by adult mortality vs.
those not afflicted over the three-year survey period.
FINDINGS:  The study highlights six major findings:
         First, there are important gender differences
in the prevalence of adult death. Half of the
deceased prime-age men were in the highest per capita
income quartile in the 1997 survey and they are likely
to be household heads.  This is consistent with findings
from earlier studies showing a positive correlation
between male HIV infection and socioeconomic status.
Deceased prime-age women were distributed more
evenly through all income quartiles and are most likely
to be daughters in their households.  While most NGO
AIDS education campaigns are targeted toward low-
income workers, such as agricultural laborers on
commercial farms, these findings indicate the need to
target relatively high-income men as well.
Second, the gender and status of the deceased
person affects how household size and composition
adjusts.  Households suffering the death of a head-of-
household or spouse incurred a greater-than-one
person decline in the number of household members.
Male head-of-household mortality significantly
increased the likelihood that older daughters would
leave the household, often to get married. These
households also  significantly increased their cattle
assets between 1997 and 2000.  However, these
households incur major losses in their supply of adult
labor.
Female head/spouse mortality is associated with
a 60% probability in the departure from the premises
of a young boy as well as a young girl.  This conforms
to the conventional wisdom that women are the main
caregivers and that new widowers may seek to relocate
their young children to the homes of relatives while
they focus on earning a livelihood to support them.  
By contrast, the death of other prime-age family
members is partially offset by the entry or return of
other adult members.  We detect few statistically
significant effects on household size, crop production,
off-farm income, and asset levels when the mortality
incurred is a member other than the household head or
spouse.  However, these are very partial measures of
welfare.
Third, the effects of adult death on farm
production are sensitive to the gender, position, and
age of deceased members.  For example, the death of
a male household head between 16 and 59 years old is
associated with a 47-68 percent reduction in the value
of the household’s crop production (net of cash input
costs), with the results being sensitive to the definitionTEGEMEO POLICY BRIEF No.2
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of “prime age”.  Effects are less dramatic for other
prime-age family members.  The gender of the
deceased adult affects the type of crop suffering a
shortfall, with grain crops being adversely affected in
the case of female adult mortality and “cash crops”
such as sugar and coffee being most adversely affected
in the case of male prime-age mortality.  Our finding
that male household heads’ death has the most
dramatic effect on crop production, may reflect two
adjustments: (a) the shift in crop output from relatively
high-value to low-value crops, which may result from
the fact that it is primarily men who acquire the
specialized crop husbandry and marketing knowledge
to grow these crops under outgrower and cooperative
arrangements, and (b) the frequent loss of labor from
the departure of older daughters from the household in
addition to the loss of the male head.
Fourth, households seem to cope with prime-
age adult death by selling particular types of assets,
mainly small animals. Prime-age male head mortality
is also associated with a reduction in the value of farm
equipment, which contributes to the observed decline
in farm production and exacerbates households’
longer-term ability to restore former production levels.
Fifth, households incurring the loss of a prime-
age male head-of-household suffer a  significant
loss of off-farm income (-$193 per year compared
to un-afflicted households).
Sixth, there is little indication that households
are able to recover quickly from the effects of adult
mortality.  The inclusion of categorical variables
representing deaths occurring in 1999 or 2000 were
not significant in any of the models, providing little
evidence of recovery over the three-year survey
interval.
IMPLICATIONS:  The findings point to the need for
special attention to widows (and their dependents)
incurring the recent death of their prime-age spouse.
The loss of income from cultivation of cash crops such
as tea, sugarcane, and horticulture was a major source
of hardship for these households, resulting from the
loss of family labor as well as a loss in crop husbandry
and marketing knowledge for such crops.  By
overcoming gender barriers and nurturing women
farmers’ participation  in extension programs,
cooperatives, and outgrower crop schemes, the shocks
to agricultural income faced by widows’ households
could be mitigated.  Government and outgrower
companies can organize field sessions in which
experienced farmers are recruited to help teach women
about husbandry and marketing techniques for
particular crops. However, such programs also require
complementary campaigns to legitimize these activities
within local communities, especially among men,
many of whom feel that such training upsets traditional
norms as to the gender-related division of labor
activities.
NGOs providing targeted assistance to relatives of
AIDS victims might prioritize households incurring the
recent death of a prime-age male household head,
which may reduce widows’ needs to sell off
productive assets or resort to dangerous activities like
bartering casual sex – all activities that trade off long-
run welfare in order to meet immediate survival needs.
  Some longstanding traditions that formerly
played a important social function, such as “widow
inheritance,” may spread the transmission of AIDS and
appear to have become dysfunctional since the advent
of HIV/AIDS. Strategies targeted to widows and their
dependents may reduce the need for widow inheritance
or even riskier behaviors such as the selling of sex.
How should rising prime-age mortality affect
agricultural research priority setting?  It has often been
asserted that greater attention is now needed on labor-
saving and low-input cropping systems.  Yet prime-
age death may affect households’ access to productive
assets in different ways; and their initial resource
endowments also matter.  In densely populated areas
where many households farm less than a hectare, land
and capital may be the most binding constraints even
after a death in the family.  Moreover, some crop
technologies provide relatively high returns to land and
labor in a given area but require substantial labor input
per unit of land to achieve these returns. This leaves
open the possibility that returns are higher from
intensive cultivation of small fields rather than less
intensive cultivation of larger fields. More research is
needed on how crop technologies should be adapted
for household afflicted by prime-age death before
conclusions are reached on the need for low-labor or
low-input technologies.  Moreover, better-functioning
labor and land rental markets will expand options for
afflicted households. Market development and
economic development may be the most important
ways of enabling households to withstand the shocks
caused by prime-age death, yet these long term growth
processes will depend on minimizing the growth-
retarding effects that AIDS creates through well-
targeted assistance programs.
The Tegemeo Institute of Agricultural Development and Policy is
attached to Egerton University, and collaborates formally with
Michigan State University under the Tegemeo Agricultural
Monitoring and Policy Analysis Project (TAMPA II), under which
this study was conducted.  Funding for this study was provided by
USAID/Kenya.  Please direct all inquiries to the Director, Tegemeo
Institute, P.O. Box 20498, Nairobi Kenya, tel:254-2-2717818; fax
254-2-2717819, or email:  egerton@tegemeo.org.

Measuring the Effects of Prime-age Adult Mortality in Kenya

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