School of Economics and Finance (ETDs)

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End date: 2024Subject: search.filters.subject.SDG-3: Good health and well-being

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Now showing 1 - 6 of 6
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    The effect of parental education on child and adult health in Zambia: A regression discontinuity analysis
    (University of the Witwatersrand, Johannesburg, 2024) Daka, Lincoln; Booysen, Frederik
    This thesis expands upon and enhances existing research in the field of health economics. The thesis consists of three separate yet interrelated chapters that examine the effect of education on key demographic variables: child health, fertility and HIV/AIDS in Zambia, three key factors affecting the progress of development in Africa. The endogeneity problem is present in all of the three empirical papers examined. To circumvent this endogeneity problem and establish a credible causal effect, we explore the impact of Zambia’s 2002 Universal Free Primary Education (UFPE) policy which created an exogenous source of variation in education as a quasi – experiment. The three substantial empirical studies, employ the same econometric methodology, a Regression Discontinuity Design (RDD), whose appealing feature is local randomisation. This characteristic has distinguished the method from other evaluation methods in terms of estimating unbiased treatment effects. Another advantage of the fuzzy Regression Discontinuity design is that it can account for the endogeneity of the treatment variable. The utilisation of the fuzzy Regression Discontinuity design is a valuable contribution in all of the research. Furthermore, every chapter makes a unique contribution within its respective sector. We outline Zambia’s Universal Free Primary Education (UFPE) Policy and also present the Regression Discontinuity Design methodology framework. We find significant causal impacts of maternal education on child health measured by height-for-age, weight-for-height and Weight-for- age. The findings also indicate that maternal education is associated with a reduction in the prevalence of stunting and underweight and no effect wasting contrary to other research. We present evidence of the several mechanisms by which maternal education impacts child health. The results of our study indicate that a greater level of maternal education exerts a beneficial influence on child health through the postponement of marriage, the reduction in total fertility, and the delay in the age of first childbirth and sexual debut. Additionally, we have discovered indications of positive assortative mating. Furthermore, education empowers moms by facilitating their access to information via television and newspapers, equipping them with knowledge about the ovulation time, and helping them to make well-informed decisions regarding contraceptive techniques. Conventional wisdom posits that decreased fertility may indicate the presence of “superior quality” children and increased rates of survival for both mother and child. Can education serve as a catalyst for decreasing fertility rates in developing nations? We find that female education reduces iv | P a g e the number of children ever born. We present evidence of the reduction in total fertility as a result of female education. We also show that female schooling reduces the preferred number of children and increases the age at first birth. We find that female schooling affects fertility through age at first sex and marriage, literacy, assortative mating and the knowledge effect. There is no evidence to suggest that female schooling has a major impact labour market participation. We present evidence of the heterogeneous impacts of a mother’s education based on “poor versus wealthy” criterion, whether rural/urban status, region and religion. We also present evidence of the effect of female education on the HIV seroprevalence status, number of sexual partners and knowledge of HIV transmission mechanisms. We show that female education lowers HIV seroprevalence status, decreases the number of sexual partners and increases HIV knowledge. Our research suggests that educated women are more likely to have a deep and detailed understanding of HIV. Lastly, we present evidence of the heterogeneous effects of female education by household status on HIV related outcomes.
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    The price effects of a hospital merger: a case study of the Mediclinic Southern Africa (Pty) Limited (Mediclinic) and Matlosana Medical Health Services (Pty) Limited (MMHS) merger
    (University of the Witwatersrand, Johannesburg, 2024) Laurence, Marcelle; Mncube, Liberty
    This study evaluates the assessment conducted in the prohibited Mediclinic Southern Africa (Pty) Ltd and Matlosana Medical Health Services (Pty) Ltd (MMHS) proposed merger. The study employs a qualitative approach, centred on a case study methodology, to assess the theories of harm discussed. It aims to provide insights into the adequacy and outcome of the competition authorities’ assessment drawing comparisons to international literature and policy implications. It uses economic theory to analyse and show the significance of robust and nuanced regulatory frameworks in healthcare merger evaluation.
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    Caregiver capabilities and socio-economic disparities in children’s health-related quality of life
    (University of the Witwatersrand, Johannesburg, 2024) Turner, Georgia
    This study investigates the relationship between children’s health-related quality of life and the associated contextual factors. Furthermore, this study analyses the socio-economic disparities that exist amongst children and what particular social determinants of health are influencing their health and wellbeing. Using an OLS regression as well as the Blinder-Oaxaca decomposition, the results show how children with a lower socio-economic status experience a lower HRQOL as opposed to those with a higher socio-economic status. Furthermore, this paper reports new research on the association of caregiver’s capabilities and children’s HRQOL which represents an important explanation for children’s health-related quality of life. Caregivers’ capabilities are a set of tools that enables parents to manage work, life and parenting effectively. The results provide evidence how important these capabilities are as it contributes to a better health related quality of life in their children. The findings show how a higher socio-economic status is associated with better caregiver capabilities. This is an important finding in the South African context, as exorbitant social inequalities exist, and hence, improving adult capabilities could potentially result in not only aiding to narrow the socio-economic disparity gap, but also improving the overall quality and health of children. This also leads to the premise of a bi-directional association whereby improving caregivers’ socio-economic status may likely also improve their capabilities.
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    Associations between economic preferences and behavioural health intentions among young adults living in an informal settlement
    (University of the Witwatersrand, Johannesburg, 2023-03) Andrady, Wayne Jude; Booysen, Frikkie
    The emergence of non-communicable diseases in South Africa, most notably among the urban poor, is resulting in an increased burden of diseases. Since NCDs can develop in distinct periods of the life course, post-adolescence-intentions to engage in health behaviours need to be investigated. Furthermore, there is consistent evidence that health behaviours are associated with economic preferences. Yet, it is unclear whether economic preferences are also associated with behavioural health intentions. Objectives: The study aims to examine how risk-taking and patience are associated with behavioural health intentions among young adults in a poor informal urban settlement in South Africa. The study also explores whether there are gender differences in behavioural health intentions and whether these economic preferences contribute to gender gaps in behavioural health intentions. Data and Methods: The study utilized secondary survey data collected from a sample of 240 young adults using a structured questionnaire. The study collected data on behavioural intentions for seven health- protective and health-harming behaviours. Risk-taking and patience are measured using qualitative, quantitative and combined measures from the Global Preference Survey. Ordered probit and seemingly unrelated regression models were estimated and t-tests were employed to quantify gender gaps, followed by the Blinder-Oaxaca decomposition analysis. Findings The study reveals that economic preferences have a moderate association with behavioural health intentions among young adults. However, these results seem contradictory to priori expectations and further research is required. Our findings emphasize the importance of recognizing and addressing the limitations associated with imperfect measures of economic preferences when investigating their association with health behavioural intentions
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    The technical efficiency of country responses to the COVID-19 pandemic
    (niversity of the Witwatersrand, Johannesburg, 2023-02) Desjardins, Armand; Booysen, Frederik
    The COVID-19 pandemic saw the most comprehensive implementation in history of pharmaceutical and non-pharmaceutical interventions by governments around the world. A better understanding of how efficient these interventions are, especially given their high economic costs to society is pivotal in designing similar policy for future outbreaks of this nature. This research estimates the technical efficiency of country responses to the COVID-19 pandemic using a Stochastic Frontier Analysis model and panel dataset combining indicators from the Our World in Data (OWID), Google Movement Index and World Bank Economic Indicators databases. The SFA regression also corrects for endogeneity in the input variables, as policy stringency tends to be influenced by the number of cases in each country. To do so, the OWID stringency index is used as an instrumental variable for each of the policy inputs to correct for the endogenous relationship between the input and output variables. The study found that the correction of technical efficiency estimates for endogeneity using the xtsfkk routine in Stata was an appropriate estimation strategy. The exogenously and endogenously estimated efficiency scores furthermore differed statistically significantly, with exogenously estimated scores representing overestimates of technical efficiency. Vaccination policies proved to be the most technically efficient channel of prevention followed by stay-at-home restrictions. A second stage OLS regression was used to estimate the effects of selected drivers on the technical efficiency scores computed in the Stage 1 SFA model. Health expenditure as a % of GDP, hospital beds per 1,000 population, and physicians per 1,000 population were all positively related to technical efficiency. Countries with reactive and flexible policy approaches, able to increase policy intensity levels based on COVID-19 waves, were found to obtain higher technical efficiency scores than wealthy countries. Improvements in the level of detail on the drivers of technical efficiency and the adoption of machine learning techniques to estimate efficiency scores are recommended to extend research in this area past its current scope
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    Loss of household income and self- reported health during the covid-19 lockdown in South Africa
    (© University of the Witswatersrand, Johannesburg, 2023) Pillay, Cayla
    The COVID-19 pandemic struck the world unexpectedly and caused a detrimental economic and health crisis worldwide. Globally, lockdown protocols were implemented to ease the pandemic's initial effects, and South Africa was no exception. This paper provides evidence of the relationship between loss of household income and self-reported health. This study uses a fixed-effects Linear Probability Model (LPM), and the results present a negative relationship between loss of household income and self-reported health. The changes in lockdown levels have no significant effect on loss of income. The outcomes suggest that when income is lost, the health of individuals tends to deteriorate.