Essays on Health and Health Care in Developing Economies

Abstract

This collection of essays investigates the effects of disease and disease-specific interventions on human capital investment. I focus on the experiences of sub-Saharan Africa and India around the turn of the 21st century. In Chapters 1 and 2, I examine the impact of scaling up treatment for Acquired Immune Deficiency Syndrome (AIDS) on maternal and child health care and on child schooling in sub-Saharan Africa. I propose a new method to identify the degree to which, after widespread implementation of treatment programs took off in 2004, treatment became accessible across sub-national regions. Employing this empirical strategy, I find suggestive evidence of positive effects on prenatal blood testing and birth deliveries in health facilities but negative effects on child immunizations. Whereas maternal and child health services are the outcomes of interest in Chapter 1, Chapter 2 evaluates whether treatment scale-up affected school attendance and timely progression through school among children 7 to 14 years old. The results indicate that children, orphans and non-orphans alike, from regions with more successful AIDS treatment scale-up were indeed more likely to be in school and less far behind grade-for-age. Shifting our attention to India, Chapter 3 addresses a puzzle in household economics: although wealthier households consume more calories per person at a given point in time, calorie consumption -- a key measure of health and poverty in development policy -- has fallen over time with rising incomes. My co-author, Dean Spears, and I test the hypothesis that an improving disease environment allows people to more effectively utilize calories consumed and thereby decreases caloric needs. Our study is the first to document a robust relationship between disease externalities and calorie consumption, and this mechanism can explain one-fifth or more of India's calorie consumption puzzle.