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The Impact of the AIDS Pandemic on Health Services in Africa: Evidence from Demographic and Health Surveys


  • Anne Case


  • Christina Paxson


We document the impact of the AIDS crisis on non-AIDS related health services in fourteen sub-Saharan African countries. Using multiple waves of Demographic and Health Surveys (DHS) for each country, we examine antenatal care, birth deliveries, and rates of immunization for children born between 1988 and 2005. We find deterioration in nearly all of these dimensions of health care over this period. The most recent DHS survey for each country collected data on HIV prevalence, which allows us to examine the association between HIV burden and health care. We find that erosion of health services is highly correlated with increases in AIDS prevalence. Regions of countries that have light AIDS burdens have witnessed small or no declines in health care, using the measures noted above, while those regions currently shouldering the heaviest burdens have seen the largest erosion in treatment for pregnant women and children. Using semi-parametric techniques, we can date the beginning of the divergence in health services between high and low HIV regions to the mid-1990s.
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Suggested Citation

  • Anne Case & Christina Paxson, 2011. "The Impact of the AIDS Pandemic on Health Services in Africa: Evidence from Demographic and Health Surveys," Demography, Springer;Population Association of America (PAA), vol. 48(2), pages 675-697, May.
  • Handle: RePEc:spr:demogr:v:48:y:2011:i:2:p:675-697
    DOI: 10.1007/s13524-011-0026-3

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    References listed on IDEAS

    1. McIntyre, Diane & Thiede, Michael & Dahlgren, Göran & Whitehead, Margaret, 2006. "What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts?," Social Science & Medicine, Elsevier, vol. 62(4), pages 858-865, February.
    2. Oster Emily, 2010. "Estimating HIV Prevalence and Incidence in Africa from Mortality Data," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 10(1), pages 1-46, September.
    3. William Easterly, 2009. "Can the West Save Africa?," Journal of Economic Literature, American Economic Association, vol. 47(2), pages 373-447, June.
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    Cited by:

    1. Alsan, Marcella M. & Cutler, David M., 2013. "Girls’ education and HIV risk: Evidence from Uganda," Journal of Health Economics, Elsevier, vol. 32(5), pages 863-872.
    2. Nicholas Wilson, 2015. "Can Disease-Specific Funding Harm Health? in the Shadow of HIV/AIDS Service Expansion," Demography, Springer;Population Association of America (PAA), vol. 52(5), pages 1671-1700, October.
    3. Nicholas Wilson, 2011. "Fertility Responses to Prevention of Mother-to-Child Transmission of HIV," Department of Economics Working Papers 2011-11, Department of Economics, Williams College, revised Sep 2011.
    4. Marcella M. Alsan & David M. Cutler, 2010. "Why did HIV decline in Uganda?," NBER Working Papers 16171, National Bureau of Economic Research, Inc.
    5. Maureen Lewis & Marijn Verhoeven, 2010. "Financial Crises and Social Spending : The Impact of the 2008-2009 Crisis," World Bank Other Operational Studies 12965, The World Bank.
    6. William W. Olney, 2015. "Remittances and the Wage Impact of Immigration," Journal of Human Resources, University of Wisconsin Press, vol. 50(3), pages 694-727.

    More about this item


    AIDS; Health services; DHS; Sub-Saharan Africa;

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development
    • O55 - Economic Development, Innovation, Technological Change, and Growth - - Economywide Country Studies - - - Africa


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