Heterogeneous effects of emigration on labor market activity and investment decisions in Punjab, Pakistan.

We investigate the impacts of emigration on the labor market and investment decisions of migrant-sending households in Pakistan by constructing a large individual-level dataset, using several rounds of the Multiple Indicator Cluster Survey conducted between 2003 and 2014. We add to the literature by introducing a new time-varying instrumental variable to control for endogenous migration decisions, constructed as a composite of three variables that represent opportunities to work abroad: (i) the household's number of adult males, (ii) historic diaspora rates, and (iii) deviations of nighttime light intensity from its trend in migrant-receiving countries. We find a significant shift in domestic labor market activity from lower-status employment categories (not working at all, unpaid family work and manual labor) toward higher-status activities and entrepreneurship such as self-employment and becoming an employer within migrant-sending households. We also find higher investment in property, bank deposits, agricultural land, livestock, poultry and fisheries by individuals in migrant-sending households. The results are stronger for vulnerable groups, implying that migration can be a force for good for rural development, the welfare of women, and less-educated individuals.

Impact of prenatal exposure to Ramadan on disability in Pakistan among adults age 18-64.

Purpose: Temporary disruptions to eating and sleeping patterns due to exposure to Ramadan during pregnancy have been shown to increase the probability of disability and chronic health problems later in life. This study aims to analyze the intent-to-treat effect of prenatal exposure to Ramadan (the Islamic month of fasting) on individual disabilities for individuals age 18 to 64 across three provinces encompassing 94% of Pakistan's population. Subjects and methods: The study uses observational data from 2017 to 2019 by the UN-supported Multiple Indicator Cluster Survey (MICS) on 187,265 adults in Punjab, 71,895 adults in Sindh, and 91,283 in Khyber Pakhtunkhwa, Pakistan. Excluding data on those age > 64 and observations with incomplete data, multivariate regression analysis was conducted on the data of around 277,000 individuals to assess the risk of disability due to pregnancy coinciding with Ramadan. Results: Considering exposure to Ramadan by calendar month prior to birth, women exposed in particular months have lower rates of disability related to sight (-0.3 percentage point, p < 0.1), memory (-0.3 pp., p < 0.05), and mobility (-0.6 pp., p < 0.05) but a higher chance of hearing problems (0.2 pp., p < 0.1) as compared to women who were not exposed in utero, while men exposed in particular months have a higher likelihood of a disability in sight (0.5 pp., p < 0.05), hearing (0.4 pp., p < 0.05), communication (0.5 pp., p < 0.01), memory (0.5 pp., p < 0.05), or mobility (0.9 pp., p < 0.01) as compared to men who were not exposed to Ramadan and women who were similarly exposed. Considering the provinces separately, the results were dominated by Punjab where overlap of pregnancy with Ramadan increased the likelihood of men experiencing a severe disability in hearing, communication, memory, or mobility. Men in Sindh were more likely to experience a memory or mobility disability, and men in Khyber Pakhtunkhwa were less likely to experience a communication or memory disability. Conclusions: Pregnant women should be counseled regarding the alterations in eating, nutrition, and sleep patterns that may occur during Ramadan, as exposure to Ramadan during pregnancy increases rates of sight, hearing, memory, communication, and mobility disabilities in men.

The Impact of Prenatal Exposure to Ramadan on Child Anthropomorphic Outcomes in Pakistan.

OBJECTIVES: This study analyzes the intent-to-treat effect of prenatal exposure to Ramadan (the Islamic month of fasting) on outcomes including stunting and underweight for children under age 5 years in Pakistan born between 2003 and 2018. METHODS: The study uses observational data from four rounds of the UN-supported Multiple Indicator Cluster Survey (MICS) data collected on 204,186 children under-5 from Punjab, Pakistan in 2007-2008, 2010-2011, 2013-2014, and 2017-2018. Excluding data on outliers and observations with incomplete data, multivariate logistic regression analysis was conducted on the appended cross-sectional data of 179,943 children under-5 to assess the risk of stunting or underweight according to the month of gestation coinciding with Ramadan. RESULTS: We observe a significant increase in the risk of stunting and underweight associated with exposure to Ramadan following an inverted-U pattern. The peak impact of Ramadan exposure on a child being underweight occurs in the third month of pregnancy, where the probability of being underweight is 20 percent higher as compared to children whose gestation did not coincide with Ramadan. The peak impact of Ramadan exposure on stunting occurs in the fourth month of pregnancy, where the probability of stunting is 22 percent higher as compared to children whose gestation did not coincide with Ramadan. These results vary little by gender. In contrast, exposure to Ramadan in the ninth month of gestation is associated with a reduction in the risk of stunting for boys and underweight for both boys and girls. CONCLUSIONS FOR PRACTICE: Our analysis indicates that prenatal exposure to Ramadan during the first two trimesters have negative implications for children's growth. The study highlights the critical role of maternal habits during early pregnancy, especially nutritional intake, for the long-term physical development of children.

Effects of birth order and son preference on utilization of pre- and post-natal health inputs in Punjab.

The study planned to determine the roles of birth order and son preference on receiving prenatal, delivery care, and postnatal child health inputs, using cross-sectional data collected by the Multiple Cluster Indicators Study Punjab related to year 2011 from all districts of the Punjab province of Pakistan. Prenatal inputs, safe delivery care, and total child health inputs fall with higher birth order of the child, though these trends are diminished when household socioeconomic controls are added. Prenatal inputs increase with maternal education, household head education, and household wealth. Postnatal inputs have a weaker relationship with both birth order and maternal education. Safe delivery care and total health inputs are higher for families without a prior-born son, demonstrating son-biased fertility stopping behaviours by families.