Aenorm 68

Page 30

my PhD in Economics at Tilburg University. Besides the general M.Phill courses I got a postgraduate diploma on modelling and accounting for sustainable development at ISS and I went to the University of Lugano, Switzerland to learn more about measurement, data collection and data quality. During an information lecture for PhD’s in which the research topics of Professors were explained, I was surprised to see that a lot of research was done in aging, while no one seemed to be investigating the rejuvenation of a population. During my stay in Mozambique, I learned and read a lot about this phenomenon. This became the foundation of my dissertation. In the beginning, I was mainly interested in anticipatory savings in relation to the HIV/AIDS epidemic. In national account compilation in developing countries, it was common practice to set savings equal to zero. Because I saw that poor families have durables, like a refrigerator, I was convinced that also poor households saved as they cannot buy such durables from their weekly payments. Moreover, the poor are more vulnerable for health shocks, which makes the necessity to save stronger. My main question was whether South-Africans’ savings differed across risk perceptions with respect to HIV infection during their lifetime. Savings can however be affected in different ways: the higher expected medical expenses, and the more fluctuating productivity due to expected illness would enhance savings. On the other hand, getting infected might be strongly related to higher risk preferences, more risk taking behaviour and higher discount rates. Together with the reduced life expectancy, this would reduce savings. Initially, most researchers expected the latter effect to be larger. What are the main results of your dissertation? The main result is that I found evidence that people do anticipate the consequences of HIV infection risk. Moreover, the group that is aware of their positive HIV status seemed to anticipate the most. The first effect turned out to be larger then the second effect. People living with HIV save significantly more than others. Also in conversations with HIV positive students the anticipation behaviour turned out to be present. They told that they study harder since their infection, which was also confirmed by their study results. Despite the significant results, I got a lot of criticism about my findings. Major critique was the relatively small sample size, which would be too small to draw conclusions. A valid critique would be a potential selection problem: Only students were in my sample, which means that ex-students - those that dropped out - were not, while potentially HIV positive ex-students have different profiles than HIV positive students that are still in university. To address both potential critiques, I therefore analyzed a large dataset on a representative group of households from Windhoek (the capital of Namibia), after finishing my PhD and found evidence for anticipatory behaviour there as well. In particular, households with a HIV positive notes

28

AENORM

vol. 18 (68)

October 2010

adult invested significantly more in the education of their children, while their income was already decreasing. Also this research receives critique, but employing different estimation models results in the same conclusions. What were the main obstacles during your research? There is always the issue of money. The household survey data I use for my current research include a large number of observations, which means that every additional behavioural question results in longer interviews. In addition, the training of interviewers - usually used to standard questions - is challenging too. An obstacle I had to pass during my fieldwork in South Africa when collecting experimental data for my PhD, was payments of the participants with small cash. Because bank systems were down for several days, we ran out of small cash. The only way to solve this was to go from store to store and buy a bottle of water with large notes in order to gather a lot of small change. Unfortunately, some white students were difficult in cooperation, because of racial discrimination. The experiments were conducted in English and this was thought to be the inferior language of the native Africans. What are the main research projects you are working on now? At the moment I am working on various projects in Namibia, Tanzania and Nigeria, all related to risk behaviour. I am also working on a project in Rwanda on the impact of ‘provider initial testing’ (PIT). This means that every patient that pays a visit to a hospital is obliged to let himself get tested on HIV. The advantage is that with this method a lot of people get tested. In usual practice of VCT (Voluntary Counselling & Practice), research has shown that it is not necessarily those at risk that come for a test. Testing is a risk averse activity. PIT would overcome this problem. In addition, by testing all clinic clients HIV stigma could potentially be reduced. What kind of research are you planning in the near future? There are several potential topics waiting for me on the shelf. One of these is an in depth analysis of PIT and HIV stigma, but also the potential negative effects of PIT. Does it refrain households from not going to a clinic while in need of healthcare? Another topic is moral hazard in micro health insurance, which I can start analyzing as soon as panel data are available. I think it is important to provide information on both positive and negative effects of interventions in developing countries in order to optimize foreign aid. I just started cooperating with different universities and disciplines on eliminating malaria in Rwanda. After implementation of by the community chosen strategies, we will continuously review both the positive and negative impact of the interventions on behaviour, health and


Issuu converts static files into: digital portfolios, online yearbooks, online catalogs, digital photo albums and more. Sign up and create your flipbook.