Community-level health programs and child labor: Evidence from Ethiopia.

Many developing countries have adopted community-based primary health-care programs. A vital component of these programs is health literacy, which teaches households to avoid physical harm. Child labor can often result in physical harm through injury. Our hypothesis is that health literacy programs make households aware of previously unknown costs of child labor (i.e., risks of injury), resulting in a reallocation of labor away from children. Using Ethiopian data, we investigate if exposure to a community-level health program delivered by Health Extension Workers (HEWs) lowers child labor. We use panel data comprising 5587 observations from 2255 children over four waves of the Young Lives Project. These data are combined with administrative regional-level data on HEWs over the 2006-2016 period. Our identification strategy exploits variations in the deployment of HEWs across regions and time to investigate a plausibly exogenous effect on child labor. We provide evidence that supports our hypothesis. We posit that the mechanism behind our result is likely behavioral change, and rule out several other potential channels, including public safety net programs and the effect of HEWs on education. Our results point to the role that health programs can play in the fight against child labor.

Child labor and psychosocial wellbeing: Findings from India.

Mental health is a neglected health issue in developing countries. We test if mental health issues are particularly likely to occur among some of the most vulnerable children in developing countries: those that work. Despite falling in recent decades, child labor still engages 168 million children across the world. While the negative impacts of child labor on physical health are well documented, the effect of child labor on a child's psychosocial wellbeing has been neglected. We investigate this issue with a new dataset of 947 children aged 12-18 years from 750 households in 20 villages across five districts of Tamil Nadu, India. Our purpose-built survey allows for a holistic approach to the analysis of child wellbeing by accounting for levels of happiness, hope, emotional wellbeing, self-efficacy, fear and stress. We use a variety of econometric approaches, some of which utilize household-level fixed effects and account for differences between working and nonworking siblings. We document a robust, large and negative association between child labor and most measures of psychosocial wellbeing. The results are robust to a battery of exercises, including tests for selection on unobservables, randomization inference, instrumental variable techniques, and falsification exercises.

Beyond monetary benefits of restoring sight in Vietnam: Evaluating well-being gains from cataract surgery.

A more holistic understanding of the benefits of sight-restoring cataract surgery requires a focus that goes beyond income and employment, to include a wider array of well-being measures. The objective of this study is to examine the monetary and non-monetary benefits of cataract surgery on both patients as well as their caregivers in Vietnam. Participants were randomly recruited from a Ho-Chi-Minh City Hospital. A total of 82 cataract patients and 83 caregivers participated in the survey conducted for this study. Paired t-tests, Wilcoxon Signed Rank tests, and regression analysis are used to detect any statistically significant differences in various measures of well-being for patients and caregivers before and after surgery. There are statistically significant improvements in monetary and non-monetary measures of well-being for both patients and caregivers approximately three months after undergoing cataract surgery, compared with baseline assessments collected prior to surgery. Non-monetary measures of well-being include self-assessments of overall health, mental health, hope, self-efficacy, happiness and life satisfaction. For patients, the benefits included statistically significant improvements in earnings, mobility, self-care, the ability to undertake daily activities, self-assessed health and mental health, life satisfaction, hope, and self-efficacy (p<0.01). For caregivers, attendance at work improved alongside overall health, mental health, hope, self-efficacy, happiness and life satisfaction, three months post-surgery (p<0.01). Restoring sight has positive impacts for those suffering from cataracts and their caregivers. Sometimes the benefits are almost equal in their magnitude. The study has also demonstrated that many of these impacts are non-monetary in nature. It is clear that estimates of the rate of return to restoring sight that focus only on financial gains will underestimate the true returns to society of restoring sight from cataract surgeries.