C4EDC4ED

By Marija

Von der Krankenversicherung zur Kinderarbeit

Wie Krankenversicherung Kinderarbeit vorbeugt

Eine randomisiert kontrollierte Studie zeigte, wie eine kleine Veränderung von Krankenversicherungen für Arme in Pakistan zu einem Rückgang von Kinderarbeit und gefährlicher Arbeit geführt hat.

Vielen ruft der Begriff „Kindheit“ sorglose Zeiten zwischen Schulbänken und Spielplätzen hervor, für viele Kinder aber sieht die Realität anders aus. Millionen junger Menschen im Schulalter verbringen weltweit ihre Tage bei der Arbeit. Häufig müssen sie riskante Arbeiten verrichten, die ihre Gesundheit gefährden. Junge Menschen, die für ihr eigenes Überleben arbeiten oder zum Lebensunterhalt der Familie beitragen müssen, haben häufig nicht einmal eine basale Schulbildung und deswegen keine Möglichkeit, ihre Lebensbedingungen zu verbessern.

 

Zwanzig Prozent Kinderarbeit in Pakistan

 

Kinder sind in Pakistan besonders katastrophalen Bedingungen ausgesetzt. Schätzungen der International Labor Organization (ILO) von 2004 prognostizierten eine Kinderarbeitsrate von 12,5 Millionen pakistanischer Kinder im Alter von 5-17 Jahren im Jahr 2012 – dies entsprichteinem Anteil von nahezu 20% dieser Altersgruppe. Ein Großteil der Kinder arbeitet in der Landwirtschaft, andere in der Ziegel- oder Glasarmreifenherstellung, wieder andere in der Herstellung von chirurgischen Instrumenten, sowie in der Teppichknüpferei.

Kinderarbeit ist in vielen Entwicklungsländern eine Konsequenz aus wirtschaftlichen Rückschlägen in der Familie. Da nur eine Minderheit krankenversichert ist, ist es üblich, dass, sobald ein Elternteil krank wird oder stirbt, ein oder mehrere Kinder der Familie die Schule verlassen und arbeiten, um den Verlust des elterlichen Einkommens zu kompensieren und einen Beitrag für die Familie zu leisten.

 

NRSPs Krankenversicherung…

 

Das National Rural Support Programm (NRSP) eine pakistanische Nichtregierungsorganisation, trat dieser Problematik mit einer breiteren Abdeckung von Kranken- und Unfallversicherung entgegen. NRSP hatte die Erwartung, durch das neue Angebot von Versicherungen krankheitsbedingte Kosten zu reduzieren.Dies soll die Möglichkeiten der Familien, Schicksalsschläge finanziell zu verkraften, verbessern und dadurch die Notwendigkeit reduzieren, über Kinderarbeit unerwartete Kosten aufzufangen. Um NRSP bei der Evaluierung ihres innovativen Versicherungsansatzes zu unterstützen, wurden zufällig ausgewählte Gebiete im städtischen Hyderabad, in denen wahlweise die neuen Versicherungsansätze eingeführt wurden oder die als Vergleichsgruppe fungieren, mithilfe von Daten aus Haushaltsbefragungen untersucht.

 

… und wie sie zu einem Rückgang der Kinderarbeit führte

 

In der Evaluation konnte gezeigt werden, dass die Maßnahmen vielfältige positive soziale Einflüsse hatten. Zusätzlich zu einem erheblichen Wachstum des Deckungsgrads und der Nutzung der Krankenversicherung, kam es zu einem Rückgang von Arbeitslosigkeit um 3,4 Prozentpunkte. Außerdem reduzierte sich das der Ausübung gefährlicher Tätigkeiten um 4,6 Prozentpunkte. Monatliche Lohneinnahmen aus Kinderarbeit fielen ebenso und die durchschnittlichen Kinderarbeitswochenstunden wurden um 1,8 Stunden reduziert. Da Jungen viel häufiger von Kinderarbeit betroffen sind, profitierten diese besonders vom Programm.

Aufgrund dieser ermutigenden Ergebnisse hat NRSP in einem ersten Schritt das Programm auf 500 weitere Gemeinden ausgeweitet. Das Programm hat eine hohe politische Relevanz, da die pakistanische Regierung ein hohes Interesse daran hat, den Krankenversicherungsschutz auszuweiten und plant, ähnliche Strategien auf ganz Pakistan anzuwenden.

 

Eine Zusammenfassung der Ergebnisse aus dieser Wirkungs-Evaluation wurde veröffentlicht im Journal of Health Economics:

LANDMANN, FRÖLICH (2015): Can health-insurance help prevent child labor? An impact evaluation from Pakistan, Journal of Health Economics, 39 (2015), 51-59.

By Marija

Pakistan | Child labor survey

Pictures courtesy of Katia Gallegos/ Viviana Garcia

Background

C4ED is advising UNICEF and the government of Pakistan for the upcoming child labor surveys in Pakistan.

According to global estimates by the International Labour Organization, more than 168 million children are engaged in child labor worldwide, out of which 86 million in hazardous occupations. The harmful relationship between children’s work and their health, education, and well-being is well documented. In Pakistan a large proportion of children and young adolescents are involved in child labor. These occupations are often harmful to their health, safety or morals. Especially in the informal sector, the worst forms of child labor are common, often in the form of bonded labor, linked to the pesghi debt bondage system, and include engagement in illicit activities (such as drug production and trafficking), begging, sexual exploitation and armed conflict.

Evaluation

Updated data on the scope and major causes of child labor in Pakistan is urgently needed, as the last national child labor survey took place in 1996. C4ED supports UNICEF and the Government of Pakistan in the preparation of child labor surveys in the country. We provide assistance and advice with regard to the survey design and implementation and we analyze the prevalence and incidence of child labor as well as its causes and consequences. In addition to providing up-to-date disaggregated information on child labor, the survey also serves as a baseline for evaluations of programs to reduce child labor.

By Marija

From health insurance to child labor

How health insurance can help prevent child labor

A randomized control trial evaluation shed light on how a micro health insurance innovation targeting poor households in Pakistan reduced child labor and hazardous work.

For many, the term “childhood” generally evokes oblivious times spent between school benches and playgrounds, but many children experience another reality. Millions of school-aged youth around the world spend their day at work, often involved in hazardous activities that put them at risk and badly impact their health. Youth obliged to work for their own survival or to provide for their families rarely complete basic schooling and are thereby denied the opportunity to investing in a better life.

Twenty percent involved in child labor in Pakistan

Children face a particularly dire situation in Pakistan. Estimates by the International Labor Organization (2004) predicted 12.5 million Pakistani children aged 5 to 17 to be involved in child labor in 2012, which represents nearly 20 percent of the age category. A majority of these children work in agriculture, while others are employed in brick or glass bangles making, surgical instruments manufacturing, or carpet weaving.

Child labor is a common consequence of economic shocks in many developing countries. As an overwhelming majority of people in Pakistan are not covered by health insurance, if a parent becomes sick, or passes away, it is common for one or several children of the family to drop out of school and start working to compensate for the loss of parental income and provide for their family.

NRSP’s health insurance…

The National Rural Support Programme (NRSP), a Pakistani NGO, set out to address this issue through an extension of a health and accident insurance scheme. By enabling households to reduce health-related expenses, NRSP expected to improve their capacity to manage shocks, and hence reduce the need for households to resort to child labor to cover unforeseen expenses. In order to help NRSP assess the impact of their innovative insurance package, randomly selected control and intervention branches were compared in urban Hyderabad using data collected in household panel surveys.

… and how it led to a drop in child labor

The evaluation showed that the intervention generated several positive social impacts. In addition to leading to a significant increase in coverage and usage of the health insurance, the extension innovation led to a decrease of child labor of 3.4 percentage points. Furthermore, the risk of hazardous occupations decreased by 4.6 percentage points. Monthly child labor earnings also dropped and the average number of hours worked by children was reduced by 1.8 hours per week. The program particularly benefitted boys, who were also generally more often engaged in child labor.

After these encouraging results, NRSP decided to scale it up to 500 further villages, as a first step. The program has high policy relevance, as the national government is interested in expanding social health protection and plans to implement similar policies all over Pakistan.

A summary of the results of this impact evaluation is published in the Journal of Health Economics:

LANDMANN, FRÖLICH (2015): Can health-insurance help prevent child labor? An impact evaluation from Pakistan, Journal of Health Economics, 39 (2015), 51-59.

By Marija

Ecuador | Primary school education for street working youth

Picture: courtesy of Roberto (Bear) Guerrera

Background 

Together with the Centro Integral de la Niñez y Adolescencia (CENIT) and ViaNiños e.V. in Germany, we support an innovative primary school for working youth in Quito, Ecuador. In Quito many children and youth are forced to work from an early age to support themselves and their families. While initial primary school enrollment has recently increased in Ecuador, it is especially difficult for working street children and youth to continue their education. Older children that did not attend, or only partly attended, primary school have almost no chance to return to the regular public school system. As the case in many countries, the education system offers little flexibility to children and youth who have not attended part of the curriculum. This poses a high risk of losing these children for the rest of the educational process and foregoing high returns to education for the individuals and society.

Evaluation

In this project CENIT offers a specialized primary school “ESTAR” geared towards older youth who wish to retake their primary school education. Being the only school of its type in Quito, ESTAR offers these students a three-year version of the regular six-year primary school curriculum. This allows the adolescents to attend a regular high school upon completion and/or undergo vocational training. This is a step towards giving them the skills and knowledge to earn higher income and break the cycle of poverty. C4ED, together with ViaNiños e.V and the implementing partner CENIT, is dedicated to evaluating this project in a rigorous manner. In this first pilot project implemented in the South of Quito we will focus on ex-post evaluation using a mix of quantitative and qualitative methods.

Pakistan | Kinderarbeits-untersuchung
Ecuador | Grundschulausbildung für Jugendliche, die auf der Straße arbeiten
Pakistan | Child labor survey
Ecuador | Primary school education for street working youth