Essays On Health In The Senegambia Region

Abstract

This thesis focuses on health in the Senegambia region, the countries of Senegal and The Gambia. Both countries can be found in the western part of West Africa. Both countries are ranked as under developed countries. I have chosen to look at both countries due to their similarities both in terms of proximity, climate and more importantly ethnic composition. Both countries have the exact same ethnic groups but in different proportions. Both countries, also exhibit the same weather conditions and are exposed to the same shocks as will be seen in this thesis. Although I look at both countries in this thesis, I focus on one country in each chapter. Although not shown, the results obtained for one country translate to the other; particularly in Chapters 2 and 3.Chapter 2 asks whether, by being exposed to a drought in utero, a mother can transfer resistance of in utero exposure to drought to her offspring. The Chapter does this in a novel way by identifying two drought events that took place in Senegal (in 1983/4 and 2011) and take advantage of a DHS survey that took place shortly after the second drought. Using a difference-in-differences model, I show that resistance transfer from mother to child took place, with double exposed children having better weight-for age and weight-for height measures than children whose mothers were not exposed to the first drought in utero. In addition to the above, the Chapter also shows that by using a difference-in-difference model and identifying two shocks, the effect of in utero drought on child health and the intergenerational transfer of in utero shocks from mother to child can also be estimated within the same model. Chapter 3 tests the Thrifty Phenotype Hypothesis by looking at whether children exposed to a drought would have better health measures when exposed to a drought in utero, in later stages of childhood, than their peers who were not exposed in utero. This Chapter does this in a novel way, by focusing on two drought events that occurred in Senegal, 2007 and 2011, and taking advantage of three DHS surveys (2005, 2010 and 2013). Children under 5 are put into one of four groups; control, exposed in utero, exposed as children and exposed twice. Results of a mother fixed effects model show that children who were exposed to a drought in utero have an advantage when exposed to another drought during childhood, although the advantage is not strong enough to wipe out the negative cumulative effect of the two droughts. By using a mother fixed effects model, we can be confident that the results are driven more by genetic factors than by the child’s environment. Chapter 4 studies the effect of hotel establishments, and by extensions tourists, can have on the behaviors of the local population. In this Chapter, I use a novel approach to answer the question quantitatively, being the first to estimate such an effect. By using the GPS locations of households in The Gambia collected in the Integrated Household Survey of 2015, and the GPS locations of hotels that were in existence in The Gambia between 1965 and 1999. I use these and the year a hotel opened to estimate a family fixed effects model. The results of the family FE model show that living closer to a hotel during the critical ages, 10 to 15, can lead to a person being more likely to smoke in adulthood, spend more years in school and be less likely to be unemployed.