Parental morbidity, child work, and health insurance in Rwanda

Maame Esi Woode, Marwân-Al-Qays Bousmah, Raouf Boucekkine

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2 Citations (Scopus)


Measuring direct and indirect effects of extending health insurance coverage in developing countries is a key issue for health system development and for attaining universal health coverage. This paper investigates the role played by health insurance in the relationship between parental morbidity and child work decisions. We use a propensity score matching technique combined with hurdle models, using data from Rwanda. The results show that parental health shocks have a substantial influence on child work when households do not have health insurance. Depending on the gender of the sick parent, there is a substitution effect not only between the parent and the child on the labor market, but also between the time the child spends on different work activities. Altogether, results reveal that health insurance protects children against child work in the presence of parental health shocks.

Original languageEnglish
Pages (from-to)111-127
Number of pages17
JournalJournal of Demographic Economics
Issue number1
Publication statusPublished - Mar 2017
Externally publishedYes


  • Health shocks
  • Child work
  • Health insurance
  • Rwanda
  • Propensity scores
  • Hurdle model

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