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Effects of Adult Health Interventions at Scale on Children's Schooling: Evidence from Antiretroviral Therapy in Zambia


  • Adrienne M. Lucas
  • Margaret Chidothe
  • Nicholas L. Wilson


In 2007, approximately one in five children in Zambia lived with an HIV positive adult. We identify the effect of adult antiretroviral therapy (ART) availability at scale on children's educational outcomes by combining data on the expansion of ART availability with two national household surveys that include HIV testing. Through a triple difference specification, we find that the availability of ART increased the likelihood that children in households with HIV positive household heads started school on time and were the appropriate grade-for-age. The mechanisms were likely decreased opportunistic infections in the household and related care giving duties.

Suggested Citation

  • Adrienne M. Lucas & Margaret Chidothe & Nicholas L. Wilson, 2016. "Effects of Adult Health Interventions at Scale on Children's Schooling: Evidence from Antiretroviral Therapy in Zambia," NBER Working Papers 22767, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:22767
    Note: CH ED HE

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    References listed on IDEAS

    1. Adrienne M. Lucas & Nicholas L. Wilson, 2013. "Adult Antiretroviral Therapy and Child Health: Evidence from Scale-Up in Zambia," American Economic Review, American Economic Association, vol. 103(3), pages 456-461, May.
    2. Baranov, Victoria & Bennett, Daniel & Kohler, Hans-Peter, 2015. "The indirect impact of antiretroviral therapy: Mortality risk, mental health, and HIV-negative labor supply," Journal of Health Economics, Elsevier, vol. 44(C), pages 195-211.
    3. Victoria Baranov & Hans-Peter Kohler, 2018. "The Impact of AIDS Treatment on Savings and Human Capital Investment in Malawi," American Economic Journal: Applied Economics, American Economic Association, vol. 10(1), pages 266-306, January.
    4. Harsha Thirumurthy & Joshua Graff Zivin & Markus Goldstein, 2008. "The Economic Impact of AIDS Treatment: Labor Supply in Western Kenya," Journal of Human Resources, University of Wisconsin Press, vol. 43(3), pages 511-552.
    5. David Evans & Edward Miguel, 2007. "Orphans and schooling in africa: a longitudinal analysis," Demography, Springer;Population Association of America (PAA), vol. 44(1), pages 35-57, February.
    6. James Habyarimana & Bekezela Mbakile & Cristian Pop-Eleches, 2010. "The Impact of HIV/AIDS and ARV Treatment on Worker Absenteeism: Implications for African Firms," Journal of Human Resources, University of Wisconsin Press, vol. 45(4), pages 809-839.
    7. James Levinsohn & Zoë M. McLaren & Olive Shisana & Khangelani Zuma, 2013. "HIV Status and Labor Market Participation in South Africa," The Review of Economics and Statistics, MIT Press, vol. 95(1), pages 98-108, March.
    8. Pitt, Mark M & Rosenzweig, Mark R, 1990. "Estimating the Intrahousehold Incidence of Illness: Child Health and Gender-Inequality in the Allocation of Time," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 31(4), pages 969-980, November.
    9. Mevlude Akbulut-Yuksel & Belgi Turan, 2013. "Left behind: intergenerational transmission of human capital in the midst of HIV/AIDS," Journal of Population Economics, Springer;European Society for Population Economics, vol. 26(4), pages 1523-1547, October.
    10. Jane Fortson, 2008. "The gradient in sub-saharan Africa: Socioeconomic status and HIV/AIDS," Demography, Springer;Population Association of America (PAA), vol. 45(2), pages 303-322, May.
    11. Tirivayi, J.N. & Groot, W.N.J., 2014. "The impact of food transfers for people living with HIV/AIDS: Evidence from Zambia," MERIT Working Papers 065, United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT).
    12. Andrew Dillon, 2013. "Child Labour and Schooling Responses to Production and Health Shocks in Northern Mali-super- †," Journal of African Economies, Centre for the Study of African Economies (CSAE), vol. 22(2), pages 276-299, March.
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    Cited by:

    1. Adrienne M. Lucas & Nicholas L. Wilson, 2017. "Can at Scale Drug Provision Improve the Health of the Targeted in Sub-Saharan Africa?," NBER Working Papers 23403, National Bureau of Economic Research, Inc.

    More about this item

    JEL classification:

    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • 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
    • O18 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Urban, Rural, Regional, and Transportation Analysis; Housing; Infrastructure

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