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Abolishing User Fees, Fertility Choice, and Educational Attainment

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  • Shinsuke Tanaka

    (The Fletcher School of Law and Diplomacy, Tufts University)

  • Takahiro Ito

    (Graduate School of International Cooperation Studies, Kobe University)

Abstract

This study examines the effect of abolishing user fees from health services on fertility and educational attainment as a test of the quantity-quality tradeoff model. Exploiting sudden improvements in nutritional status among South African children as an exogenous decline in price of quality investments, we document evidence consistent with the model that parents substitute fertility and increase educational investments. The absence of treatment effects among children not subject to the health policy eliminates channels through heterogeneous preexisting trends or unobserved concurrent changes. Overall, our findings highlight a health policy as a motivating force underlying the demographic transition and economic growth.

Suggested Citation

  • Shinsuke Tanaka & Takahiro Ito, 2014. "Abolishing User Fees, Fertility Choice, and Educational Attainment," IDEC DP2 Series 4-1, Hiroshima University, Graduate School for International Development and Cooperation (IDEC).
    • Handle: RePEc:hir:idecdp:4-1
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    2. Ahsan,Md Nazmul & Banerjee,Rakesh & Maharaj,Riddhi, 2020. "Early-Life Access to a Basic Health Care Program and Adult Outcomes in Indonesia," Policy Research Working Paper Series 9243, The World Bank.
    3. Huang, Wei & Liu, Hong, 2023. "Early childhood exposure to health insurance and adolescent outcomes: Evidence from rural China," Journal of Development Economics, Elsevier, vol. 160(C).
    4. Jonah S. Goldberg, 2023. "What we measure when we measure the effects of user fees: a replication, reanalysis, and extension of Tanaka, 2014," Empirical Economics, Springer, vol. 65(4), pages 1981-2009, October.
    5. Kasuga, Hidefumi & Morita, Yuichi, 2022. "The health gap and its effect on economic outcomes," Journal of Macroeconomics, Elsevier, vol. 74(C).

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    More about this item

    Keywords

    user fees; fertility; education; South Africa;
    All these keywords.

    JEL classification:

    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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