81194 enGender Impact: The World Bank’s Gender Impact Evaluation Database AIDS treatment and intrahousehold resource allocation: Children's nutrition and schooling in Kenya Author(s) Joshua Graff Zivin, Harsha Thirumurthy, & Markus Goldstein Contact mgoldstein@worldbank.org Country Kenya Organizing Theme Health, Economic Opportunities and Access to Assets Status Completed Intervention Category Antiretroviral Treatment Sector Health, Nutrition & Population The provision of antiretroviral medications is a central component of the response to HIV/AIDS and consumes substantial public resources from around the world, but little is known about this intervention's impact on the welfare of children in treated persons' households. Using longitudinal survey data from Kenya, we examine the relationship between the provision of treatment to adults and the schooling and nutrition outcomes of Abstract children in their households. Weekly hours of school attendance increase by over 20% within 6 months after treatment is initiated for the adult patient. We find some weak evidence that young children's short-term nutritional status also improves. These results suggest how intrahousehold allocations of time and resources may be altered in response to health improvements of adults. Gender Connection Gender Focused Intervention Gender Outcomes Reproductive Health, school attendance, labor force participation, nutrition IE Design Quasi experimental- Pipeline control This paper uses survey data from Kenya to examine the impact of (free) antiretroviral (ARV) treatment on the time allocated to various household tasks by treated HIV-positive Intervention patients and their household members. An increase in funding in late 2003 enabled the Mosoriot HIV clinic to grow rapidly with the number of patients rising from 150 to 3714. Late 2003- present, the study examines individuals who have been receiving ARV therapy Intervention Period for more than 100 days The survey sample contains two different groups of households. The first group comprises 503 households chosen randomly from a census of all households in Kosirai Division without a patient receiving HIV/AIDS treatment (AMPATH). The second group Sample population comprises 200 households that were chosen at the clinic and contained at least one adult HIV-positive AMPATH patient who began receiving ARV therapy (ARV households) prior to Round 2. There is significant variation in the treatment dates of ARV. The study compares Comparison conditions households who receive ARV at different times. Unit of analysis Individual Level Last updated: 14 August 2013 1 enGender Impact: The World Bank’s Gender Impact Evaluation Database Evaluation Period March 2004-Feb2005 Treating adult AIDS patients with ARV treatment results in substantial improvements in the welfare of children living with the patients: A significant increase in the children’s weekly hours of school attendance (impact larger for boys than girls). After nine months of treatment, the increases in school attendance are maintained with no significant drop off over the time period of our study. For boys in particular, the increase in hours of attendance is almost exactly equal to the treatment-driven decrease in their hours of market Results labor supply (for girls, no significant change in MARKET labour supply, can't say for work within the HH). The short-term nutritional status of young children in adult patients’ households improves significantly, also within six months after treatment is initiated for the patients (not presented separately for boys and girls). These gains in nutritional status can be expected to improve the physical and cognitive abilities of children and eventually, their post-school productivity levels. It is difficult to measure the total impact of the treatment because there is no control group Primary study limitations of AIDS patients who do not receive treatment. Economic and Social Research Council, Pfizer, The World Bank, Yale University's Center Funding Source for Interdisciplinary Research on AIDS, The National Institute of Mental Health, The Social Science Research Council, and the Calderone Program at Columbia University Zivin, J. G., Thirumurthy, H., & Goldstein, M. (2009). AIDS treatment and intrahousehold Reference(s) resource allocation: Children's nutrition and schooling in Kenya. Journal of Public Economics, 93(7), 1008-1015. Link to Studies http://www.sciencedirect.com/science/article/pii/S0047272709000346 Microdata Last updated: 14 August 2013 2