Kohler, Hans-Peter
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Publication Up, Down and Reciprocal: The Dynamics of Intergenerational Transfers, Family Structure and Health in a Low-Income Context(2017-06-07) Payne, Collin F.; Pesando, Luca Maria; Kohler, Hans-PeterIn the absence of well-functioning public transfer systems and safety nets, the family acts as the key provider of income and support through the intergenerational redistribution of resources. In this paper we use micro-level longitudinal data and a mix of methodologies to document the lifecycle patterns of financial transfers in a rural, sub-Saharan African population. Underneath a well-established age-pattern of intergenerational transfers in which transfer patterns change according to broad stages of the economic life cycle, our analyses document significant heterogeneity and fluidity: Intergenerational transfers are variable and reverse their direction, with individuals moving between the provider and recipient states repeatedly across their life course and within each major stage of the life-cycle. Contrary to common perceptions about family transfers ameliorating short-term shocks, transfers in our analyses are driven primarily by demographic factors such as changes in health, household size, and household composition, rather than short-term events. Overall our analyses suggest that the role of transfers in this rural sub-Saharan context is significantly more complex than suggested by theories and evidence on aggregate transfer patterns, and at the micro-level, intergenerational transfers encapsulate multiple functions ranging from direct exchange to old-age support in the absence of a public pension system.Publication Phase 1 Project Report. Social Networks and Norms: Sanitation in Bihar and Tamil Nadu, India(2017-12-31) Bicchieri, Cristina; Ashraf, Sania; Das, Upasak; Kohler, Hans-Peter; Kuang, Jinyi; McNally, Peter; Shpenev, Alexey; Thulin, ErikPublication Cohort Profile: The Malawi Longitudinal Study of Families and Health (MLSFH)(2013-07-31) KOHLER, HANS-PETER; Watkins, Susan C.; Behrman, Jere R; Kohler, Iliana V.; Anglewicz, Philip; Fleming, Peter; Thornton, Rebecca L.; Mkandawire, James; Kalilani-Phiri, Linda; Honde, Hastings; Hawara, Augustine; Chilima, Ben; Bandawe, Chiwoza; Mwapasa, Victor; MLSFH Study Team,The Malawi Longitudinal Study of Families and Health (MLSFH) is one of very few long-standing publicly-available longitudinal cohort studies in a sub-Saharan African (SSA) context. It provides a rare record of more than a decade of demographic, socioeconomic and health conditions in one of the world's poorest countries. With data collection rounds in 1998, 2001, 2004, 2006, 2008, 2010 and 2012 for up to 4,000 individuals, the MLSFH permits researchers to investigate the multiple influences that contribute to HIV risks in sexual partnerships, the variety of ways that people manage risk within and outside of marriage, the possible effects of HIV prevention policies and programs, and the mechanisms through which poor rural individuals, families, households, and communities cope with the impacts of high morbidity and mortality that are often---but not always---related to HIV/AIDS. The MLSFH been used to document (i) the influence of social networks on HIV-related behaviors and perceptions, (ii) the HIV prevention strategies employed by individuals in rural high-HIV prevalence contexts, (iii) the relationship between life-course transitions and HIV infection risks, (iv) the acceptability of HIV testing and counseling (HTC) and the consequences of HTC on subsequent behaviors, and (v) the health and well-being across the life-course of individuals facing multiple challenges resulting from high disease burdens and widespread poverty.Publication Cognitive Health among Older Adults: Evidence from Rural Sub-Saharan Africa(2016-07-26) Payne, Collin F.; Kohler, Iliana V.; Bandawe, Chiwoza; Lawler, Kathy A.; Kohler, Hans-PeterCognitive health is an important dimension of well-being in older ages, but few studies have investigated cognitive health in sub-Saharan Africa’s (SSA) growing population of mature adults (= persons age 45+). We use data from the Malawi Longitudinal Study of Families and Health (MLSFH) to document the age and gender patterns of cognitive health, the contextual and life-course correlates of poor cognitive health, and the understudied linkages between cognitive and physical/mental well-being. Surprisingly, the age-pattern of decline in cognitive health for both men and women is similar to that observed in the U.S. We also find that women have substantially worse cognitive health than men, and experience a steeper decline of cognitive ability with age. Strong social ties and exposure to socially complex environments are associated with higher cognitive health, as is higher socioeconomic status. Poor cognitive health is associated with adverse social and economic well-being outcomes such as less nutrition intake, lower income, and reduced work efforts even in this subsistence agriculture context. Lower levels of cognitive health are also strongly associated with increased levels of depression and anxiety, and are associated with worse physical health measured through both self-reports and physical performance.Publication HIV/AIDS-related Expectations and Risky Sexual Behavior in Malawi(2011-07-29) Delavande, Adeline; Kohler, Hans-PeterSubjective expectations are likely to be an important determinant of health-related behaviors in a high-HIV-prevalence environment. We use probabilistic expectations data elicited from survey respondents in rural Malawi to investigate how risky sexual behavior may be influenced by individuals’ survival expectations, which in turn depend on the perceived impact of HIV/AIDS on survival; expectations about their own and their partner’s HIV status; and expectations about HIV transmission rates. We find that subjective expectations play an important role in determining the decision to have multiple sexual partners. Using our estimated parameters, we simulate the impact of various policies that would influence expectations. An information campaign on mortality risk would decrease risky sexual behavior, while an information campaign on HIV transmission risks, which tend to be overestimated by respondents, would actually increase risky behavior. Also, the expansion of anti-retroviral therapy (ART) treatments to all individuals sick with AIDS would increase risky sexual behavior among HIV-negative individuals or those who have not been tested because individuals are aware that ART increases life expectancy, and thus reduces the cost of becoming HIV-positive.Publication The Likoma Network Study: Context, Data Collection and Initial Results(2007-06-09) Helleringer, Stephane; Kohler, Hans-Peter; Chimbiri, Agnes; Chatonda, Praise; Mkandawire, JamesThe sexual networks connecting members of a population have important consequences for the spread of sexually transmitted diseases including HIV. However, very few datasets currently exist that allow an investigation of the structure of sexual networks, particularly in sub-Saharan Africa where HIV epidemics have become generalized. In this paper, we describe the context and methods of the Likoma Network Study (LNS), a survey of complete sexual networks we conducted in Likoma island (Malawi) between October 2005 and March 2006. We start by reviewing theoretical arguments and empirical studies emphasizing the importance of network structures for the epidemiology of sexually and transmitted diseases. We describe the island setting of this study, and argue that the choice of an island as research site addresses the possible sources of bias in the collection of complete network data. We then describe in detail our empirical strategy for the identification of sexual networks, as well as for the collection of biomarker data (HIV infection). Finally, we provide initial results relating to the socioeconomic context of the island, the size and composition of sexual networks, the prevalence of HIV in the study population, the quality of the sexual network data, the determinants of successful contact tracing during the LNS, and basic measures of network connectivity.Publication Cohort Profile: The Migration and Health in Malawi (MHM) Study(2017-04-05) Anglewicz, Philip; VanLandingham, Mark; Manda-Taylor, Lucinda; Kohler, Hans-PeterThe Migration and Health in Malawi (MHM) Study focuses on a key challenge in migration research: although it has long been established that migration and health are closely linked, identifying the effect of migration on various health outcomes is complicated by methodological challenges. To address these challenges, the MHM Study was designed to measure or control for important characteristics that affect both migration and health outcomes. This approach is particularly well-suited for distinguishing between the effect of migration on health and the selection of individuals of differing health status into migration classes (migrant versus non-migrant). Data are available for two waves of MHM, which took place in 2007 and 2013, and include extensive information on migration history, socioeconomic and demographic characteristics, sexual behaviors, marriage, household/family structure, risk perceptions, social networks and social capital, intergenerational relations, HIV/AIDS and other dimensions of health. The MHM public use data can be requested by contacting the Principal Investigator (Philip Anglewicz, panglewi@tulane.edu).Publication Phase 2 Project Report. Social Networks and Norms: Sanitation in Bihar and Tamil Nadu, India(2018-01-01) BICCHIERI, Cristina; Ashraf, Sania; Das, Upasak; Delea, Maryann; Kohler, Hans-Peter; Kuang, Jinyi; McNally, Peter; Shpenev, Alexey; Thulin, ErikPublication The Social and the Sexual: Networks in Contemporary Demographic Research(2013-01-18) Kohler, Hans-Peter; Helleringer, Stéphane; Behrman, Jere R.; Watkins, Susan C.The analysis of networks has become an important theme in contemporary demographic research in both developed and developing countries, including investigations of the determinants of fertility behaviors, the interaction between social network and social structures and population policies, the role of intergenerational networks in aging societies, and the relevance for sexual networks for the spread of HIV AIDS. This paper reviews the current research on networks across several domains in demographic research, and it discusses some of the specific challenges of network-based approaches with respect to data collection, analytic approaches and methodologies, interpretation of results, and micro-to-macro aggregation by drawing on research conducted as part of the Kenyan Diffusion and Ideational Change Project (KDICP), the Malawi Longitudinal Study of Families and Health (MLSFH) and the Likoma Network Study (LNS).Publication Global Family Change: Persistent Diversity with Development(2018-02-07) Pesando, Luca Maria; Castro, Andrés F.; Andriano, Liliana; Furstenberg, Frank; Behrman, Julia A.; Kohler, Hans-Peter; Billari, Francesco; Monden, ChristiaanThis paper provides a broad empirical overview of the relationship between family change and socio-economic development drawing on 30+ years of Demographic and Health Survey data from 3.5 million respondents across 84 low- and middle-income countries (LMICs). We conduct two sets of analyses. First, we document global and regional-level associations between the Human Development Index (HDI) and novel indicators reflecting multidimensional family change. Second, we use methods from the growth convergence literature to examine whether – and in which domains – there is evidence of cross-country convergence in family indicators over levels of development. We show that families in LMICs have transformed in multiple ways, changing differently across domains, world regions, and genders. Fertility, intra-couple decision-making, and women’s life-course timing indicators are strongly associated with HDI, yet cross-country convergence is limited to the latter domain. Marriage, cohabitation, household structure, and men’s life-course timing indicators are more weakly associated with HDI, and span a broad spectrum of convergence dynamics ranging from divergence to modest convergence. We describe this scenario as “persistent diversity with development,” and shed light on the underlying regional heterogeneity – driven primarily by sub-Saharan Africa.