Abstract

This article presents unique evidence that orphanhood matters in the long run for health and education outcomes in a region of northwestern Tanzania. We study a sample of 718 non-orphaned children surveyed in 1991–1994 who were traced and reinterviewed as adults in 2004. A large proportion, 19%, lost one or more parents before age 15 in this period, allowing us to assess permanent health and education impacts of orphanhood. In the analysis, we control for a wide range of child and adult characteristics before orphanhood, as well as community fixed effects. We find that maternal orphanhood has a permanent adverse impact of 2 cm of final height attainment and one year of educational attainment. Expressing welfare in terms of consumption expenditure, the result is a gap of 8.5% compared with similar children whose mothers survived until at least their 15th birthday.

The text of this article is only available as a PDF.

References

Ainsworth, M., Beegle, K., & Koda, G. (
2005
).
The Impact of Adult Mortality and Parental Deaths on Schooling in Northwestern Tanzania
.
Journal of Development Studies
,
41
,
412
39
. 10.1080/0022038042000313318
Ainsworth, M., & Filmer, D. (
2006
).
Inequalities in Children’s Schooling: AIDS, Orphanhood, Poverty, and Gender
.
World Development
,
34
,
1099
128
. 10.1016/j.worlddev.2005.11.007
Ainsworth, M., & Semali, I. (
2000
).
The Impact of Adult Deaths on Children’s Health in Northwestern Tanzania
.
Washington, DC
:
The World Bank
.
Alderman, H., J.R. Berman, H.-P. Kohler, J.A. Maluccio, and S.C. Watkins. 2001. “Attrition in Longitudinal Household Survey Data: Some Tests for Three Developing-Country Samples.” Demographic Research 5(4). Available online at http://www.demographic-research.org/volumes/vol5/4/5-4.pdf.
Becketti, S., Gould, W., Lillard, L., & Welch, F. (
1988
).
The Panel Study of Income Dynamics After Fourteen Years: An Evaluation
.
Journal of Labor Economics
,
6
,
472
92
. 10.1086/298192
Beegle, K., Deheija, R., & Gatti, R. (
2006
).
Child Labor and Agricultural Shocks
.
Journal of Development Economics
,
81
,
80
96
. 10.1016/j.jdeveco.2005.05.003
Beegle, K., De Weerdt, J., & Dercon, S. (
2006
).
Kagera Health and Development Survey (KHDS), 2004, Basic Information Document
.
Washington, DC
:
World Bank
.
Beegle, K., De Weerdt, J., & Dercon, S. (
2006
).
Orphanhood and the Long-Run Impact on Children
.
American Journal of Agricultural Economics
,
88
,
1266
72
. 10.1111/j.1467-8276.2006.00943.x
Bell, C., Devarajan, S., & Gersbach, H. (
2006
).
The Long-run Economic Costs of AIDS: With an Application to South Africa
.
World Bank Economic Review
,
20
,
55
89
. 10.1093/wber/lhj006
Bennell, P. (
2005
).
The Impact of the AIDS Epidemic on the Schooling of Orphans and Other Directly Affected Children in Sub-Saharan Africa
.
Journal of Development Studies
,
41
,
467
88
. 10.1080/0022038042000313336
Bhargava, A. (
2005
).
AIDS Epidemic and the Psychological Well-being and School Participation of Ethiopian Orphans
.
Psychology, Health and Medicine
,
10
,
263
75
. 10.1080/13548500412331334181
Bicego, G., Rutstein, S., & Johnson, K. (
2003
).
Dimensions of the Emerging Orphan Crisis in Sub-Saharan Africa
.
Social Science and Medicine
,
56
,
1235
47
. 10.1016/S0277-9536(02)00125-9
Case, A., & Ardington, C. (
2006
).
The Impact of Parental Death on School Outcomes: Longitudinal Evidence From South Africa
.
Demography
,
43
,
402
20
. 10.1353/dem.2006.0022
Case, A., Paxson, C., & Ableidinger, J.H. (
2004
).
Orphans in Africa: Parental Death, Poverty and School Enrollment
.
Demography
,
41
,
483
508
. 10.1353/dem.2004.0019
Centers for Disease Control (CDC)
(
2000
).
Cause-Specific Adult Mortality: Evidence From Community-Based Surveillance—Selected Sites, Tanzania 1992–1998
.
Morbidity and Morality Weekly Report
,
49
,
416
19
.
Chatterji, M., L. Dougherty, T. Ventimiglia, Y. Mulenga, A. Jones, A. Mukaneza, N. Murray, K. Buek, W. Winfrey, and J. Amon. 2005. “The Well-being of Children Affected by HIV/AIDS in Lusaka, Zambia, and Gitarama Province, Rwanda: Findings From a Study.” Community REACH Working Paper No. 2. Community REACH Program, Pact, Washington, DC.
Corrigan, P., Glomm, G., & Mendez, F. (
2005
).
AIDS Crisis and Growth
.
Journal of Development Economics
,
77
,
107
24
. 10.1016/j.jdeveco.2004.02.005
Crampin, A.C., Floyd, S., Glynn, J.R., Madise, N., Nyondo, A., Khondowe, M.M., Njoka, C.L., Kanyongoloka, H., Ngwira, B., Zaba, B., & Fine, P.E. (
2003
).
The Long-term Impact of HIV and Orphanhood on the Mortality and Physical Well-being of Children in Rural Malawi
.
AIDS
,
17
,
389
97
. 10.1097/00002030-200302140-00013
Crump, R., Holtz, J., Imbens, G., & Mitnik, O. (
2006
).
Moving the Goalposts: Addressing Limited Overlap in Estimation of Average Treatment Effects by Changing the Estimand
.
Cambridge, MA
:
National Bureau of Economic Research
.
Davis, R., Apley, J., Fill, G., & Grimaldi, C. (
1978
).
Diet and Retarded Growth
.
British Medical Journal
,
1
,
539
42
. 10.1136/bmj.1.6112.539
Deaton, A., & Zaidi, S. (
2002
).
Guidelines for Constructing Consumption Aggregates for Welfare Analysis
.
Washington, DC
:
The World Bank
.
Deininger, K., Garcia, M., & Subbarao, K. (
2003
).
AIDS-Induced Orphanhood as a Systemic Shock: Magnitude, Impact, and Program Interventions in Africa
.
World Development
,
31
,
1201
20
. 10.1016/S0305-750X(03)00061-5
Evans, D., & Miguel, E. (
2007
).
Orphans and Schooling in Africa: A Longitudinal Analysis
.
Demography
,
44
,
35
57
. 10.1353/dem.2007.0002
Fitzgerald, J., Gottschalk, P., & Moffitt, R. (
1998
).
An Analysis of Sample Attrition in Panel Data
.
Journal of Human Resources
,
33
,
251
99
. 10.2307/146433
Gertler, P., Levine, D., & Ames, M. (
2004
).
Schooling and Parental Death
.
Review of Economics and Statistics
,
86
(
1
),
211
25
. 10.1162/003465304323023769
Glewwe, P., Jacoby, H., & King, E. (
2001
).
Early Childhood Nutrition and Academic Achievement: A Longitudinal Analysis
.
Journal of Public Economics
,
81
,
345
68
. 10.1016/S0047-2727(00)00118-3
Golden, M.H.N. (
1994
).
Is Complete Catch-up Possible for Stunted Malnourished Children?
.
European Journal of Clinical Nutrition
,
48
(
Suppl. 1
),
S58
S70
.
Haddad, L., & Bouis, H. (
1991
).
The Impact of Nutritional Status on Agricultural Productivity: Wage Evidence From the Philippines
.
Oxford Bulletin of Economics and Statistics
,
53
,
45
68
. 10.1111/j.1468-0084.1991.mp53001004.x
Hargreaves, J.R., & Glynn, J.R. (
2002
).
Educational Attainment and HIV-1 Infection in Developing Countries: A Systematic Review
.
Tropical Medicine and International Health
,
7
,
489
98
. 10.1046/j.1365-3156.2002.00889.x
Hirano, K., & Imbens, G. (
2001
).
Estimation of Causal Effects Using Propensity Score Weighting: An Application to Data on Right Heart Catheterization
.
Health Services and Outcomes Research and Methodology
,
2
,
259
78
. 10.1023/A:1020371312283
Hirano, K., Imbens, G., & Ridder, G. (
2003
).
Efficient Estimation of Average Treatment Effects Using the Estimated Propensity Score
.
Econometrica
,
71
,
1161
89
. 10.1111/1468-0262.00442
Killewo, J.Z.J., Nyamuryekunge, K., Sandstrom, A., Bredberg-Raden, U., Wall, S., Mhalu, F., & Biberfeld, G. (
1990
).
Prevalence of HIV-1 Infection in the Kagera Region of Tanzania: A Population-Based Study
.
Acquired Immune Deficiency Syndrome
,
4
,
1081
85
.
Killewo, J.Z.J., Sandstrom, A., Bredberg-Raden, U., Mhalu, F., Biberfeld, G., & Wall, S. (
1993
).
Incidence of HIV-1 Infection Among Adults in the Kagera Region of Tanzania
.
International Journal of Epidemiology
,
22
,
528
36
. 10.1093/ije/22.3.528
Ksoll, C. (
2007
).
Family Networks and Orphan Caretaking in Tanzania
.
United Kingdom
:
Department of Economics, University of Oxford
.
Kwesigabo, G., Killewo, J., Urassa, W., Lugalla, J., Emmelin, M., Mutembei, A., Mhalu, F., Biberfeld, G., Wall, S., & Sandstrom, A. (
2005
).
HIV-1 Infection Prevalence and Incidence Trends in Areas of Contrasting Levels of Infection in the Kagera Region, Tanzania, 1987–2000
.
Journal of Acquired Immune Deficiency Syndrome
,
40
,
585
91
. 10.1097/01.qai.0000168183.22147.c4
Lindblade, K., Odhiambo, F., Rosen, D., & DeCock, K. (
2003
).
Health and Nutritional Status of Orphans < 6 Years Old Cared for by Relatives in Western Kenya
.
Tropical Medicine and International Health
,
8
(
1
),
67
72
. 10.1046/j.1365-3156.2003.00987.x
Martorell, R. (
1999
).
The Nature of Child Malnutrition and Its Long-term Implications
.
Food and Nutrition
,
125
,
1127S
38S
.
Modan-Moses, D., Yaroslavsky, A., Novikov, I., Segev, S., Toledano, A., Miterany, E., & Stein, D. (
2003
).
Stunting of Growth as a Major Feature of Anorexia Nervosa in Male Adolescents
.
Pediatrics
,
111
,
270
76
. 10.1542/peds.111.2.270
Monasch, R., & Boerma, J.T. (
2004
).
Orphanhood and Childcare Patterns in Sub-Saharan Africa: An Analysis of National Surveys From 40 Countries
.
AIDS
,
18
(
Suppl. 2
),
S55
S65
. 10.1097/00002030-200406002-00007
Nyamukapa, C., & Gregson, S. (
2005
).
Extended Family’s and Women’s Roles in Safeguarding Orphans’ Education in AIDS-Afflicted Rural Zimbabwe
.
Social Science and Medicine
,
60
,
2155
67
.
Pugliese, M., Lifshitz, F., Grad, G., Fort, P., & Mark-Katz, M. (
1983
).
Fear of Obesity. A Cause of Short Stature and Delayed Puberty
.
New England Journal of Medicine
,
309
,
513
18
. 10.1056/NEJM198309013090901
Söderbom, M., Teal, F., Wambugu, A., & Kahyarara, G. (
2006
).
The Dynamics of Returns to Education in Kenyan and Tanzania Manufacturing
.
Oxford Bulletin of Economics and Statistics
,
68
,
261
88
. 10.1111/j.1468-0084.2006.00162.x
Stock, J., & Yogo, M. (
2005
).
Testing for Weak Instruments in Linear IV Regression
. In Andrews, D.W.K. (Ed.),
Identification and Inference for Econometric Models
(pp.
80
108
).
New York
:
Cambridge University Press
.
Thomas, D., & Strauss, J. (
1997
).
Health and Wages: Evidence on Men and Women in Urban Brazil
.
Journal of Econometrics
,
77
,
159
85
. 10.1016/S0304-4076(96)01811-8
Children on the Brink 2004A Joint Report of New Orphan Estimates and a Framework for Action
. (
2004
).
New York
:
UNAIDS
.
User’s Guide to the Kagera Health and Development Survey Datasets
. (
2004
).
Washington, DC
:
World Bank
.
Yamano, T., & Jayne, T.S. (
2005
).
Working-Age Adult Mortality and Primary School Attendance in Rural Kenya
.
Economic Development and Cultural Change
,
53
,
619
53
. 10.1086/426463
Yamano, T., Shimamura, Y., & Sserunkuuma, D. (
2006
).
Living Arrangements and Schooling of Orphaned Children and Adolescents in Uganda
.
Economic Development and Cultural Change
,
54
,
833
56
. 10.1086/503586