Effects of ill-health and health shocks on labour market outcomes under social protection constraints
Creators: name: Shawa, Ken
Publisher: name: Lancaster University
Year: 2025

description: This thesis examines the effects of ill-health and health shocks on labour
 market outcomes. To achieve this, given the paucity of meta-analyses on
 the topic, a systematic review and meta-analysis was initially undertaken
 which is presented as chapter two of the thesis. The results from the
 review and meta-analysis show statistically significant pooled estimates
 of the effects of ill-health and health shocks on hours worked and the
 probability of employment. These results justified the research questions
 pursued in the thesis, including specific analysis of Malawi where no work
 of this nature has been undertaken before and where evidence could be
 useful in policy terms. 
 
 
 To explore the effects of ill-health and health shocks on labour supply,
 in chapter three, data from Malawi were used to assess the effects of
 several proxies of health shocks and ill-health. This included
 illness/injury, hospital admission, and chronic illness, on the
 probabilities of wage employment, casual employment, job search and on
 hours of work. The chapter employed nearest neighbour propensity score
 matching to estimate Average Treatment Effects on the Treated (ATET).
 Overall, results of the analysis showed that a) individuals who reported
 to have suffered an illness or injury in the last fourteen days
 significantly reduced their probability of wage employment but increased
 the probability of casual employment; b) individuals who reported to have
 experienced a hospital admission in the last twelve months significantly
 reduced their probability of wage employment but increased their
 probability of casual employment; and c) individuals who reported that
 they suffered from a chronic disease significantly reduced both their
 probabilities of wage employment and casual employment. Furthermore,
 results showed that individuals who reported to have suffered an illness
 or injury in the last fourteen days, those who reported to have
 experienced a hospital admission in the last twelve months as well as
 those who reported that they suffered from a chronic disease,
 significantly reduced their weekly hours of work. Moreover, in terms of
 the probability of job search, the study found that individuals who
 reported to have suffered an illness or injury in the last fourteen days
 significantly reduced their probability of job search while those who
 reported that they suffered from a chronic disease significantly increased
 the probability of searching for a job. There was no statistically
 significant effect on the probability of job search for individuals who
 reported to have experienced a hospital admission in the last twelve
 months.
 
 In chapter four, a wide range of count data models including negative
 binomial, zero-inflated negative binomial, Poisson, zero-inflated Poisson,
 and a two-part model were used to assess the joint effects of ill-health
 and health shocks together with social protection on the intensive margin
 of labour supply using rich data from Malawi. A standard OLS model was
 also estimated to provide baseline estimates which were not based on a
 count data model. Weekly hours of work were employed in the analysis.
 Results showed that a) individuals who suffered an illness/injury and
 benefited from social protection reduced their hours of work; b)
 individuals who had experienced a hospital admission and benefited from
 social protection increased their hours of work; and c) individuals with
 chronic illnesses who benefited from social protection reduced their
 weekly hours of work. 
 
 
 The results of the thesis have important policy implications for Malawi
 and other low- and middle-income countries (LMICs). More specifically, the
 evidence presented here can inform the development of health and labour
 policies, encompassing initiatives to facilitate job search through public
 employment services, enhance access to social protection, and strengthen
 primary healthcare and universal health coverage as well as the overall
 health infrastructure.