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Motivation

“Civil Wars Beyond their Borders: The Human Capital and Health Consequences of Hosting Refugees” Javier E. Baez Human Development Department (LCSHS) World Bank Third Annual Research Conference on Population, Reproductive Health and Economic Development Dublin, Ireland January 16-18, 2009.

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Motivation

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  1. “Civil Wars Beyond their Borders: The Human Capital and Health Consequences of Hosting Refugees”Javier E. BaezHuman Development Department (LCSHS)World BankThird Annual Research Conference on Population, Reproductive Health and Economic DevelopmentDublin, IrelandJanuary 16-18, 2009

  2. Motivation Worldwide stock of refugees (numbers in thousands) JB / WB / 01-17-09

  3. Motivation • But yet, little evidence on the impacts of refugees from wars on the well-being of host communities • Two works: • Alix-Garcia (2006): positive effects on household-level expenditures and proxies of welfare (micro data) • Montalvo & Reynal-Querol (2007): arrival of refugees increased number of cases of malaria (macro data) • My goal: identify the effects of hosting refugees on local populations, in particular on children’s well-being JB / WB / 01-17-09

  4. My approach • Context: a rural region in sub-Saharan Africa • Scope: identify impacts and examine their dynamics (i.e. short and long run analysis) • Strategy: exploit two past genocides as a natural experiment → D-D & D-D-D • Outcomes: • anthropometrics, morbidity & infant mortality (short run) • height, health and human capital accumulation (long run) JB / WB / 01-17-09

  5. Empirical implementation? • Ideal for evaluation purposes: random allocation of refugees among communities. But, is it feasible? • Need a big and exogenous population shock + an instrument for refugee intensity • Exploits population flows from the genocides in Burundi (late 1993’s) and Rwanda (early 1994’s) + geography as a natural experiment JB / WB / 01-17-09

  6. Flows of refugees into Tanzania Source: United Nations High Commission for Refugees (UNHCR) JB / WB / 01-17-09

  7. Area of this study: Kagera Source: U.S. Central Intelligence Agency JB / WB / 01-17-09

  8. Kagera • Remotest region from Dar es Salaam • Mostly rural, major economic activity is agriculture • In 1993 (pre-shock time): • Poorest among all the 20 regions in Tanzania (GDP ≈ US$280) • More than 50% living below the US$1 poverty line • Around 1,550,000 inhabitants • Refugee crisis: • Kagera hosted over 500,000 refugees (≈ 33% of local population, ≈ 80% of population in two main recipient provinces) JB / WB / 01-17-09

  9. Topographic characteristics JB / WB / 01-17-09

  10. Land use JB / WB / 01-17-09

  11. Rainfall JB / WB / 01-17-09

  12. Data • For short-run analysis: • Tanzania Demographic and Health Surveys (TDHS) • Pool of cross-sections (1992, 96), used same sample frame • For long-run analysis: • Kagera Health and Development Survey (KHDS) • A 10-13 year panel of ≈ 900 hh’s (1991-94, 2004) • Both datasets merged with their own GIS modules and 25 years of monthly rainfall data JB / WB / 01-17-09

  13. Evidence supporting the IV story? • Anecdotal evidence • Case studies & reports • Personal talk with former Prime Minister of Tanzania • Quantitative evidence • 5th round of KHDS asked community leaders to assess the intensity of the influx of refugees in their villages (in a scale from 1 to 4) JB / WB / 01-17-09

  14. Location of refugees Districts of Kagera Region by the Intensity of the Influx of Refugees Notes: The indicator of intensity is calculated using retrospective information from the fifth round of the Kagera Health and Development Survey (2004) and shows the percentage of communities that reported having refugees’ resettlements close by in the village or the ward after 1993. JB / WB / 01-17-09

  15. Administrative divisions JB / WB / 01-17-09

  16. Location of refugees Intensity of the Influx of Refugees and Distance from the Village to the Border with Rwanda JB / WB / 01-17-09

  17. Research design • D-D • Two specifications: binary and continuous treatment • Two strategies: intra- & intra-regional variation JB / WB / 01-17-09

  18. Empirical specification (short-run analysis) Y = outcome variable (anthropometrics, morbidity and mortality) X = set of pre-shock covariates (individual & household) , = pre-shock village covariates, village and year fixed effects = treatment indicator (both binary and continuous) Errors clustered at the village-year level Note: pre-shock balance in observables (not shown) JB / WB / 01-17-09

  19. Strategy 1: Short-run local impacts JB / WB / 01-17-09

  20. Strategy 2: Short-run local impacts JB / WB / 01-17-09

  21. Distributional changes Pre- and post-shock distributions of the W/H z-score between treatment and control villages (within Kagera) JB / WB / 01-17-09

  22. Distributional changes Pre- and post-shock distributions of the H/A z-score between treatment and control villages (within Kagera) JB / WB / 01-17-09

  23. Empirical strategy (long-run analysis) • D-D & D-D-D: • Strategy: use intra-regional and intra- and inter- cohort variation in exposure to the shock • Exposed cohort: children 0-5 years old in 01/1994, (10-15 years in 2004) & Western=1, • Less exposed cohorts: children 0-5 years old in 01/1994 & Western=0, • Less responsive cohorts: people 15-20 years old in 01/1994 both at Western=1 & Western=0. • Specifications A & B JB / WB / 01-17-09

  24. Empirical specification • D-D & D-D-D: Y = outcome variable (height, chronic morbidity , schooling and literacy) JB / WB / 01-17-09

  25. Results JB / WB / 01-17-09

  26. Robust analysis 1. Pre-trends? No, based on placebo test with pre-shock data 2. Misspecification bias? D-D PSM replicate results 3. Endogenous migration/attrition? Models suggest not an issue 4. Selection for survival? fixed (comparison of parental height distribution), variable (lower bound) 5. Measurement error in real level of exposure/non-exogeneity of international and local assistance? (lower bound) JB / WB / 01-17-09

  27. Interpretation: why negative effects? • Threats posed to public health • Emergence and spread of existing infectious diseases by food, water and environmental contaminating factors • Multiplicative effects in the transmission/infection of malaria • Overpopulation • Competition for resources (food, land, wood) • Collapse of health and educational services JB / WB / 01-17-09

  28. Conclusions • Evidence of a previously undocumented indirect effect of civil wars on the health and human capital of children in hosting communities. • External validity? • More than 15 civil wars + internally displaced + refugees from political oppression • Persistence of the effects • Health shocks in childhood correlated with cognitive deficits and attained body size later in life • Effects on future productivity (2.8% fall in their earnings) • Policy implications JB / WB / 01-17-09

  29. “Civil Wars Beyond their Borders: The Human Capital and Health Consequences of Hosting Refugees”Javier E. BaezHuman Development Department (LCSHS)World BankThird Annual Research Conference on Population, Reproductive Health and Economic DevelopmentDublin, IrelandJanuary 16-18, 2009

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