TITLE:
Effects of AIDS-related disability on workforce participation and earned income in Botswana: A quasi-experimental evaluation
AUTHORS:
Mansour Farahani, Danae Roumis, Ajay Mahal, Marionette Holmes, Gillian Moalosi, Chris Molomo, Richard Marlink
KEYWORDS:
HIV/AIDS; Botswana; Absenteeism; Earnings; Propensity Score Matching; Heckman Selection Model
JOURNAL NAME:
Health,
Vol.5 No.3,
March
11,
2013
ABSTRACT:
Background: Botswana is regarded as a leader of
progressive HIV/AIDS policy, as the first country in sub-Saharan Africa to
establish a free, national antiretroviral therapy program. In light of such
programmatic successes, it is important to evaluate the potentially changing relationship
of HIV/AIDS to the wellbeing of individuals, households, and institutions in
the country. Methods: We evaluate the effects of HIV-related illness on
absenteeism and earnings several years after the
start of the national treatment program among a random sample of adults
in Botswana using survey data from 3999 individuals aged 15 to 49, using
quasi-experimental methods. We compare absenteeism between individuals with and
without HIV-related illness, using a propensity score matching approach. We
then estimate the effect of HIV-related illness on earnings using a Heckman
selection model to account for selection into the workforce. We stratify our
analyses by sex. Results: Men and women with HIV-related illness were absent by
about 5.2 and 3.3 additional days, respectively, in the month prior to the
survey compared to matched controls, and earned approximately 38% and 43% less,
respectively, in the month prior to the survey compared to those without
HIV-related illness. Conclusions: HIV-related illness appears to increase
absenteeism in this sample and dramatically reduce earnings. The findings
suggest a need for policies that confer greater financial security to
individuals with HIV/AIDS in Botswana.