Better Health for Better Productivity

Burkina Faso faces persistent high morbidity rates due to malaria, respiratory infections, malnutrition, diarrheic diseases, and HIV/AIDS, according to the country’s Ministry of Health. These health burdens can negatively impact the agricultural labor productivity of rural households by reducing both available labor and farming know-how. A new Working Paper from the African Growth and Development Policy Modeling Consortium (AGRODEP) examines whether the use of health services can mitigate these negative effects, looking specifically at whether the use of a Health and Social Promotion Center (HSPC) improves households’ agricultural labor productivity.

Since 2000, Burkina Faso’s national health policy has focused on making primary healthcare more accessible, especially to rural populations. Between 2000 and 2009, the government’s healthcare spending increased from 7.07 percent to 15.46 of the total budget, and the average area covered by an HSPC decreased from 9.38 km in 2000 to 7.34 km in 2010. Despite these improvements, however, the country has still not achieved the goal set forth by the 1987 Bamako Initiative , which recommends a maximum area of 5 km per HSPC.

The AGRODEP paper uses a household’s distance from the HSPC as an instrumental variable to determine what effect the use of an HSPC has on agricultural labor productivity in the case of unexpected disease during the rainy season.  The study posits that thecloser an HSPC is to a household, the more likely that household will be to use the health service in times of illness because reaching the facility will be easier and less costly.

The data on which the study is based divided Burkina Faso’s rural area into six categories based on the population’s social characteristics (including health, education, nutrition, and access to drinking water); eight of the country’s 45 provinces were then chosen based on the weight of their social characteristics and their agricultural potential. Within these provinces, this study examines 233 households that recorded at least one case of illness during the rainy season. A survey was conducted using questionnaires covering historical data from the 12 months prior to the survey; this data focused on households’ health and education status, access to and use of social safety nets, and agricultural productivity.

The treatment group consists of households that had at least one sick member during the rainy season that lost working time due to the illness and that used the services of an HSPC. The control group consists of households that had at least one sick member during the rainy season and that lost working time due to the illness, but that did not use an HSPC or any other health service. One hundred and seven households belonged to the treatment group and 126 to the control group.

After accounting for selection bias and non-complier issues, the study’s results show that households within 5 km of an HSPC were more likely to use the health service and that using an HSPC to treat an unexpected illness during the rainy season resulted in an increase in agricultural labor productivity per day of FCFA 3170.5880 (approximately USD 5.50).These results point to the fact that access to and use of health services can have important impacts on sectors other than health. The study’s author suggests that policymakers in Burkina Faso should continue to focus on improving both the availability and quality of HSPC services in rural areas in order to improve both human health indicators and agricultural labor productivity.

By: Sara Gustafson, IFPRI