Living Standards Measurement Research Articles

Spatiotemporal analysis of having been sick or injured and having sought health consultation by district in Punjab province of Pakistan - 2010-2015.

To analyse the geospatial and temporal distribution of disease and injury burden and factors that influence health care seeking behaviour in thirty-six districts of Punjab in Pakistan. Utilizing the district level-Pakistan Social and Living Standards Measurement survey data for 2010-2015 from the Pakistan Bureau of Statistics and Human Development Index (HDI) data for the years 2011-2015 from the United Nations Development Programme; choropleth maps were created based on the district level proportions of population reporting having been sick or injured and having sought health consultations for all three waves of PSLM surveys and based on HDI for the years 2011, 2013 and 2015 for the Punjab districts. Spatial cluster analysis of having been sick or injured and having sought health consultations for three waves of PSLM was conducted. For the years (2010-11), (2012-13) and (2014-15) respectively; the mean proportions of population that reported being sick or injured were (7.36±2.23), (6.99±2.33), and (5.70±1.72). The corresponding mean proportions that sought health consultation were (96.11±2.92), (96.05±2.26) and (96.82±2.15) respectively. Having sought health consultation in years (2010-11) and (2012-13), having been sick/injured in (2010-11), and human development index of 2013 as well as 2015 were statistically significant determinants of having sought consultation in the last wave of (2014-15) (p<0.05). Findings show a decline in the reported disease and injury burden between 2010 and 2015 but constant rates of seeking health care. HDI and having sought care previously are the major determinants of subsequent health consultation in Punjab. Future studies need to focus on how these results can be utilized to health inequalities in Pakistan.

Telescoping Error in Recalled Food Consumption: Evidence from a Survey Experiment in Ethiopia

AbstractTelescoping errors occur if survey respondents misdate events from outside the reference period and include them in their recall. Concern about telescoping influenced the design of early Living Standards Measurement Study (LSMS) surveys, which used a two-visit interview format to bound food consumption recall. This design fell out of favor although not for evidence-based reasons. To measure the extent of telescoping bias on food consumption measures, a survey experiment was conducted in Addis Ababa, Ethiopia, randomly assigning households to either a two-visit bounded recall or a single visit unbounded recall. The average value of reported food consumption is 16 percent higher (95 percent CI: 7.4–25.9) in the unbounded single visit recall relative to the two-visit bounded recall. Most of the error is explained by difference in reported spending on less frequently consumed, protein-rich foods, so apparent food security indicators based on household diet diversity are likely overstated with unbounded recall.

Measuring the Changes in Income Distribution of Pakistan

A continuous rise in income inequality is a highly debated theme as many changes in the structure of income distribution have happened in Pakistan. This study explores the changes in income distribution during 1998-2018 in Pakistan. The study has used PIHS 1998-99 Pakistan Social and Living Standard Measurement survey data for 2007-08, and 2018-19, collected and administrated by the Pakistan Bureau of Statistics (PBS). Oaxaca-Blinder decomposition methodology is used for estimation. The findings of the study show that education and experience significantly increase the average income. Oaxaca-Blinder decomposition indicates that the wage gaps are; 0.172 between 1998-2007, -0.062 between 2007-2018, and 0.110 between 1998-2018, and significant at a 1% significance level. The wage gap was positive between 1998-2017 and 1998-2018, implying that the wage inequality increased in that period mainly due to the coefficient component, while the wage gap was negative between 2007-2018, showing the decrease in wage inequality due to the endowment component. Moreover, the endowment component of decomposition is negative for all years of interest and highly significant except for the wage gap during 1998-2007. The coefficients component is highly significant and positive for all the years, meaning that applying the coefficients of the labor force in 2007 and 2018 to the characteristics of the labor force in 1998. The interaction component is negative during 1998-2007 and 1998-2018 whereas positive during 2007-2018 and has a high p-value, except for 1998-2018. It is recommended that government policies should ensure an equitable distribution of income.

Decomposing inequality of opportunity in child health in Tanzania: The role of access to water and sanitation.

Poor child nutrition is a major public health challenge in Tanzania. Large between and within regional nutritional inequalities exist in rural and urban areas. We looked at how locational circumstances hinder children from having an equal opportunity for good nutrition. We used the 2008/09 Living Standards Measurement Study data for Tanzania to identify the part played by water and sanitation in rural and urban inequality of opportunity in child nutrition. We used the dissimilarity index and the Shapley decomposition technique to quantify and decompose inequality of opportunity in nutrition. We find that 16% of the circumstance-driven inequality of opportunity needs to be redistributed for equality of opportunity to prevail. We find that in rural areas, about 42% of the inequality of opportunity in nutrition is due to water and sanitation problems and 22% to child age. In urban areas, we find that the inequality of opportunity is related mainly to the child's sex, price fluctuations and intergenerational factors. The findings suggest that policies to improve water and sanitation coverage could help equalize opportunities for children in rural areas. In urban areas, policies that could help equalize opportunities require incentives to change social norms and behavior around feeding practices and vaccination.

Consumption of healthy and unhealthy foods by the African poor: Evidence from Nigeria, Tanzania, and Uganda

AbstractWe use national Living Standards Measurement Study (LSMS) datasets from Nigeria, Tanzania, and Uganda to examine consumption by the rural and urban poor of “unhealthy foods” (including ultra‐processed foods such as sweets and sugary beverages) versus “healthy foods” beyond starchy staples (such as vegetables, beans, animal products, and fruits). Consumption of processed foods and nonstaples is often associated in policy discussion in Africa with middle‐class urban consumers rather than the poor. We analyzed household food consumption expenditure with Locally Weighted Scatterplot Smoothing (LOWESS) curves and augmented Engel regressions. We found that substantial shares of the consumption expenditure of the poor, both rural and urban, are on healthy and unhealthy foods. We found, surprisingly, that the poor's food consumption patterns do not differ sharply from the middle classes’, in rural and urban areas, except for the case of ultra‐processed foods of which the poor still consume much less than the middle class. We found that the poor dedicate 25% of their food consumption expenditure to the category vegetables/beans, versus 22% and 17% by the lower‐middle and upper‐middle‐income strata. Fruits/animal products constitute 17% of the poor's consumption expenditure compared to 23% and 27% by the lower‐ and upper‐middle strata. Ultra‐processed food (e.g., sugar‐sweetened beverages) form 12% of the consumption of the poor, versus 20% and 32% for the lower‐ and upper‐middle strata. Shares are increasing with income starting at incomes well below the poverty line. Nonincome factors play important roles: e.g., rural off‐farm employment is associated with more consumption expenditure of processed foods by the poor due to the opportunity cost of time.

The joint effects of terrorism and land access on livestock production decisions: Evidence from northern Nigeria

Livestock production is an integral part of the livelihoods of many households around the developing world and plays a significant role in farming households' food and nutrition security. However, conflict is a major challenge for livestock production in Africa and Nigeria in particular. We employ the Living Standards Measurement Study – Integrated Surveys on Agriculture (LSMS-ISA) panel data for Nigeria with a global georeferenced conflict dataset to examine the effect of terrorism on small-scale livestock production and the role of agricultural land access. Terrorism is an important factor that undermines livestock production. We find that increase in the incidents of terrorism reduces cattle herd size but does not reduce the herd size of households that manage a larger area of land. Also, terrorism significantly increases livestock diversification independently and jointly with land access. However, higher fatalities from terrorism reduces herd size irrespective of the size of land managed by households. Our findings suggest a plausible land abandonment in areas where terrorism is severe. Curbing terrorism in Nigeria would ensure farmers have physical access to their land and sustain livestock production.

Resilience of Ethiopian Agropastoral Households in the Presence of Large-Scale Land Investments

Agropastoral societies in Ethiopia and elsewhere in Africa are facing challenges in their land use. Land shifts toward large-scale land investments have exacerbated the scarcity of pastures, thus affecting the resilience of pastoral systems. In this study, we assessed how large-scale land investments affect household resilience using data from the Living Standards Measurement Survey in Ethiopia. We estimated household resilience capacity by a multivariate two-step factor analysis and welfare resilience from net changes in welfare outcomes between two survey intervals. We also assessed the effect of large-scale land investment on household resilience using random effects ordered logistic regression model. Factors that enhanced the resilience capacities of households included access to livestock markets, social safety nets, extension, mobility, and social services. Approximately one-third of the study population had a low resilience capacity, and more than half had low welfare resilience. Moreover, proximity to a large-scale land investment significantly reduced households' likelihood of having high resilience capacity. Therefore, future resilience programs in agropastoral areas should mitigate the adverse effect of large-scale land investments by enhancing livelihood diversification and households' access to communal pastures.

Education as a dimension of human development: A Provincial-level Education Index for Ecuador.

This article deepens in the differences in educational development between the Ecuadorian provinces and in their evolution over time by estimating the Provincial-level Education Index. This index is built using the micro-databases of the two latest rounds of the Ecuador`s Living Standards Measurement Survey (2005–2006 and 2013–2014). The results show an overall increase in the educational development of the Ecuadorian provinces, as well as a slight reduction in inequality. However, differences between them continue to exist. Underlying our results, which are consistent with the provincial production structure and socioeconomic context, some public policies seem to affect the educational sector, as their impact has been evidenced during the period covered in this research.

Privacy protection, measurement error, and the integration of remote sensing and socioeconomic survey data

When publishing socioeconomic survey data, survey programs implement a variety of statistical methods designed to preserve privacy but which come at the cost of distorting the data. We explore the extent to which spatial anonymization methods to preserve privacy in the large-scale surveys supported by the World Bank Living Standards Measurement Study-Integrated Surveys on Agriculture (LSMS-ISA) introduce measurement error in econometric estimates when that survey data is integrated with remote sensing weather data. Guided by a pre-analysis plan, we produce 90 linked weather-household datasets that vary by the spatial anonymization method and the remote sensing weather product. By varying the data along with the econometric model we quantify the magnitude and significance of measurement error coming from the loss of accuracy that results from privacy protection measures. We find that spatial anonymization techniques currently in general use have, on average, limited to no impact on estimates of the relationship between weather and agricultural productivity. However, the degree to which spatial anonymization introduces mismeasurement is a function of which remote sensing weather product is used in the analysis. We conclude that care must be taken in choosing a remote sensing weather product when looking to integrate it with publicly available survey data.

Maternal Employment, Parental Education Levels and Household’s Income: Differential Impacts on the Schooling of Male and Female Children in Pakistan

The present research empirically investigates the impact of a mother’s employment status, parental education levels, and household income on school enrollment of male and female children (aged 5-15 years) in Pakistan. Child school enrollment is taken as a binary dependent variable, i.e., attending the school or not. A micro data set of 31,294 children from the Pakistan Social and Living Standard Measurement Survey (PSLM) is utilized and analyzed by applying binary logistic regression. Maternal employment, parental education, and household income had discrepancies in their estimated marginal effects on the school enrollment of male child (N = 15266) and female child (N = 14113). A unit increase in maternal employment was responsible for bringing less than one percent decrease in the school enrollment of male child while more than five percent decrease in the school enrollment of female child. Similarly, a unit increase in maternal education (graduation) resulted in respectively 25.32% and 33.55% increase in the school enrollment of male and female child. Whereas a unit increase in paternal education (graduation) resulted in respectively 19.14% and 15.82% increase in the school enrollment of male and female child. A unit increase in a household’s income brought a 2.59% and 5.95% increase in the school enrollment of male and female child. The study signifies maternal education as the most influential and decisive factor in enhancing school enrollments of male child and female child in Pakistan.

Farm size and productivity in Nicaragua: Parametric and nonparametric analyses for panel data

This paper examines the inverse relationship hypothesis (IR-H) between farm size and agricultural productivity in Nicaragua using parametric and nonparametric methods designed specifically for panel data. The data employed are from the World Bank’s Living Standards Measurement Study for the years 1998, 2001 and 2005. The analysis reveals strong support for the IR-H based on a number of alternative parametric specifications. The results from the nonparametric models lend partial support to the IR-H,and such support is weaker than what is obtained from the parametric models, particularly among medium and large landholders.

Climate change and child malnutrition: A Nigerian perspective

Erratic temperatures and precipitation influence nutrition, human capital investment, and living standards, particularly for children. This study investigates the effect of climate change (changes in the monthly maximum average near-surface temperature and total monthly precipitation) on children’s health outcomes, particularly stunting and underweight, in Nigeria. We combine Living Standards Measurement Study - Integrated Surveys on Agriculture (LSMS-ISA) data with high resolution gridded climate data. We find that the rise in temperature is associated with higher levels of stunting – even more so in rural areas. The paper’s findings highlight the need for climate-friendly policies to mitigate the long-term effect of climate change on malnourishment. Without such policies, climate change could reverse years of progress in lowering children’s malnutrition.

Inter-regional socioeconomic disparity levels within rural Sindh

The purpose of this study is to investigate the existence of socioeconomic disparity levels in rural Sindh. Determining the reasons behind such disparity is not the scope of this research. Previous studies reflected that compared to lower Sindh, upper Sindh has performed better as per socioeconomic indicators such as health and literacy rate, the Multidimensional Poverty Index (MPI) calculated shows no such pattern on a closer look. Even though the MPI values for upper Sindh district are lower in comparison to lower Sindh, the intensity of poverty in upper Sindh is extreme. Pakistan Social and Living Standard Measurement (PSLM) household survey questionnaire was used to calculate the MPI of various districts selected through a stratified sampling technique. The results show the MPI values for districts in lower Sindh reflect a greater incidence of poverty compared to upper Sindh. However, the intensity of deprivation in upper Sindh is higher. For instance, the MPI value recorded for Qambar, an upper Sindh district was 0.091 and the intensity of poverty recorded was 0.67.

The effect of terrorism on continuing education: evidence from Pakistan

ABSTRACT Education has wide-ranging benefits to both the individual and wider society. This article investigates the consequences of terrorist incidents on whether households can further their children’s schooling. Using both the Global Terrorism Database and Pakistan’s Social and Living Standards Measurement, we find that persistent exposure to terrorism significantly reduces the likelihood that parents will continue their children’s education. The result suggests, that for every million people, an increase in terrorist incidents causes 26,501 fewer children to continue their education at the primary school education level. We also examine the results by various demographic segments and types of terrorism attacks.

Farm-level production diversity and child and adolescent nutrition in rural sub-Saharan Africa: a multicountry, longitudinal study

Child malnutrition remains widespread in sub-Saharan Africa, especially in rural areas where many households are involved in subsistence farming. Increasing farm-level production diversity (FPD) is often considered a useful strategy to improve child diets and nutrition, but the empirical evidence is mixed. Most studies have investigated associations between FPD and dietary diversity. We therefore aimed to analyse associations between FPD and child and adolescent nutritional status. In this multicountry, longitudinal study, we used representative panel data from four countries in sub-Saharan Africa (Ethiopia, Malawi, Tanzania, and Uganda) to test the hypothesis that higher FPD is positively associated with child and adolescent nutritional status. The data were from the Living Standards Measurement Study-Integrated Surveys on Agriculture collected between 2008 and 2019. We included data from all children and adolescents aged 0-18 years with available anthropometric data who were living in households involved in farming activities for home consumption, market sales, or both. FPD was measured in terms of the number of different crop and livestock species and food groups produced on each farm. Child and adolescent nutritional status was measured in terms of height-for-age Z scores (HAZ). We estimated panel data regression models with correlated random effects to control for confounding factors and time-invariant unobserved heterogeneity. The total sample size included 50 689 child and adolescent observations. In combined models, with data from all countries included, we found one additional species produced on the farm (crop and livestock combined) was associated with a mean 0·015 SD greater child or adolescent HAZ (p<0·0001). The role of FPD tended to decrease with better market access (in more remote locations mean 0·020 SD [p<0·0001] and in less remote locations mean 0·008 SD [p=0·091]). In individual-country models, the effects were smaller and statistically insignificant in three of the four countries. Livestock diversity had larger positive associations with HAZ than crop diversity (livestock diversity effect on HAZ mean 0·085 SD [p<0·0001] and crop diversity effect on HAZ mean 0·007 SD [p=0·080]). In Tanzania and Uganda, higher crop diversity was negatively associated with child and adolescent HAZ. Our findings suggest that further farm-level diversification is not a suitable general strategy to improve child and adolescent nutrition but might be useful in some situations. Livestock production seems to be conducive for improving child and adolescent nutrition on average. Context-specific approaches need to be developed. None.

A Correlation of Socio-economic Determinants and Food Security Status in Pakistan

This study gives details of the interrelationship among important socioeconomic variables and food security status in Pakistan. The major socio-economic explanatory variables; education, livestock, poverty, receipts of foreign remittances, and female house-head status were analyzed against food security. The data was derived from Pakistan Social and Living Standard Measurement survey dataset 2019-20. A binary logistic model has been applied for the estimation of poverty and food security indices. The study results showed that education, livestock, foreign remittances, and female house-head have a positive significant impact on food security while poverty has a negative and significant impact on food security. The study recommendations are that government must focus to increase agriculture growth, increased dependence on livestock, foreign remittances, and education.

Sex-disaggregated agricultural extension and weather variability in Africa south of the Sahara

Climate change and extreme weather shocks pose serious threats to a number of agricultural outcomes, including agricultural production, productivity, and income, especially when households depend heavily on this activity. Agricultural extension and rural advisory services are key instruments in promoting technical change, advancing agricultural productivity growth and, ultimately, improving farm livelihoods, and are expected to mitigate the negative effects of climate change and extreme weather shocks. Their mitigation effects, however, may vary depending on the sex of the recipient. This paper investigates the role of sex-disaggregated agricultural extension recipients in contexts where agricultural performance of farm households is affected by weather variability. To this aim, we match multiple rounds of panel microdata from the nationally representative, consumption-based Living Standards Measurement Study -Integrated Surveys on Agriculture (LSMS-ISA), collected in four sub-Saharan African countries, with remote sensing data on biophysical dimensions over a long-term horizon as well as year-specific weather shocks. To our knowledge, this is the first time that a micro-level dataset with individual-level information on agricultural extension services’ recipients has been assembled and examined to investigate the effects of extreme weather shocks and climate change. Applying panel data econometric estimators, the study finds that agricultural extension and advisory services translate into higher agricultural performance of farm households where women are also among the beneficiaries, as compared to non-beneficiaries and households where beneficiaries are men only. Moreover, these services can mitigate the negative effects of weather variability and climate change, controlling for country and time fixed effects as well as holding all other variables constant. These results call for national and international policies and interventions strengthening rural advisory services, especially targeted to women in settings where household livelihoods are predominantly agriculture-based and weather variability and shocks are expected to negatively affect farming activities.

The microeconomics of adaptation: Evidence from smallholders in Ethiopia and Niger

Climate change is expected to bring higher temperatures, changes to rainfall patterns and in many places increased frequency and severity of extreme weather. Climate change is slated to affect the global food equation both on the supply and demand side as well as local level food systems where small farm communities often depend on local and their own production. As climate change has become more pronounced, the risk to land-based food security faced by many of the world’s poor, such as rural communities in Ethiopia and Niger, seems to have become more intense and less predictable. To avoid food insecurity in response to climatic and other stressors, adaptation by small-scale, subsistence farms needs to be accelerated. To effectively intervene to do so, there is a need to understand adaptive behavior in terms of its drivers and its relation with welfare outcomes such as food security. In this paper, we develop a conceptual framework of risk and adaptation, use regression and cluster analysis and the most recent version of the Living Standards Measurement Surveys data for rural areas in Ethiopia and Niger, to advance our understanding. We find that adaptation is associated with lower food insecurity in Ethiopia but not in Niger. Formal education appears as a central element of adaptive capacity and is associated with both adaptive production and income strategies. Female-headed households are much less adapted to a changing climate. Perceived risk based on past hazard experience is crucial for adaptation. Results from the cluster analysis confirm that spatial poverty traps exist. To maintain or enhance welfare in the short term and resilience in the long run in the face of a changing climate, policy makers would do well to focus on micro-regions identified as highly food insecure and build adaptive capacity through, for example, gender inclusive education interventions.

Social inequalities in healthcare utilization during Ecuadorian healthcare reform (2007\u20132017): a before-and-after cross-sectional study

BackgroundLimited research is available about the impact of healthcare reforms on healthcare utilization according to socioeconomic group. Although most health reforms in Latin America have focused on reducing the gap between the most advantaged and disadvantaged groups and improving the quality of health services, the available information has shown limited progress. Therefore, this study assessed whether the recent Ecuadorian healthcare reform (2007–2017) contributed to decreasing the socioeconomic inequalities in healthcare utilization.MethodsWe used data from the National Living Standards Measurement surveys conducted in 2006 and 2014. Unmet healthcare needs (UHCN) were used as the dependent variable and proxy for difficulties in accessing health services. Place of residence, ethnicity, education and wealth were selected as indicators of socioeconomic status. The slope and relative inequality indexes were calculated for adult men and women for each period and socioeconomic variable. A multiplicative interaction term between midpoint scores and time was applied to estimate changes in inequalities over time. Sample weights were applied to all analyses, and 95% confidence intervals were calculated to assess statistical significance in the regression analysis.ResultsIn 2006, the poor, Indigenous, those living in rural areas and with low education had lower access to health services. In 2014, the overall prevalence of UHCN decreased from 27 to 18% and was higher in women than men. Statistically significant reductions of refraining were observed in absolute and relative terms in all social groups, both in men and women.ConclusionsOur results showed remarkable and significant decreases in inequalities in all examined socioeconomic groups in absolute and relative terms in this period. Although a new model of healthcare was established to achieve universal health coverage, its performance must be continuously evaluated and monitored with specific indicators. Further studies are also needed to identify the main barriers that contribute to UHCN among socially disadvantaged groups.

Can income growth alone increase household consumption of cleaner fuels? Evidence from Pakistan

Consumption of solid fuels by households is a major cause of indoor air pollution (IAP) and can severely damage health and the environment. The Environmental Kuznets Curve (EKC) literature suggests that as poor and middle-income countries grow, households will climb the ‘energy ladder' and adopt cleaner fuel technologies. This paper critically assesses that claim, using data from the Pakistan Social and Living Standards Measurement (PSLM) Survey 2013- 14. A novel aspect of our study is that, rather than treating the choice to use each fuel type as independent, we instead focus on the households' choice of fuel mix, using cluster analysis to determine in a data-driven way the fuel mixes that households actually employ. Importantly, despite income being a strong determinant of fuel mix selection, we show that income growth alone is unlikely to lead to substantial uptake of cleaner fuels. Our results challenge a practical aspect of countries moving along the EKC, and suggest that in order to reduce IAP direct policy intervention will be required.