Listening to Young Lives at Work Covid-19 Phone Survey: First Call shows widening inequality

With the virtual fieldwork just completed on our second Covid-19 phone survey, we reflect on seven key findings from the first call that point to widening inequality. 

Young Lives at Work adapted to the coronavirus situation to implement a Covid-19 phone survey about the pandemic's short and medium term impacts. You can read more about Young Lives' response to the pandemic here and here. In June, we wrote about the design of the first call and what we were hoping to find out.  After virtual training in four countries, seven weeks of on-line fieldwork, almost 40,000 phone calls, data cleaning, coding, merging, and preliminary analysis, the headline reports of our first Covid-19 Phone survey were released in August and the data are available here.  In this blog we share our approach to the first call and key findings. 

We interviewed a total of 9,541 individuals in the Older and Younger Cohorts, reaching almost 91% of those who we were aiming to reach (see our attrition report here).  We discovered seven common findings, as well as key differences between the four countries, Ethiopia, India, Peru and Vietnam (below). The crisis is impacting the poorest most severely and widening inequalities, with poorer people less able to protect themselves, get information, work from home or stay in education.


Seven Findings from the Young Lives at Work Covid-19 Phone Survey

 

1. Poverty and a lack of information has impacted people’s ability to take precautionary measures against Covid-19 infection, especially in Ethiopia.

2. The economic effects of lockdown policies have been more significant than the health impacts to date - although many households in Peru and India are likely to have been exposed to Covid-19.

3. Across all countries, except Vietnam, many young people are going hungry. Although government support is well targeted, it is not sufficient in Peru and Ethiopia.

4. Remote working has been the exception, not the rule. Job losses or suspension without pay are widespread, even in Vietnam, the least affected country.

5. Education of 19-year-olds, in all countries, has been severely disrupted while access to online learning has been highly unequal.

6. Caring responsibilities increased for 25-year-olds with the burden still tending to fall on young women most of all.

7. Levels of anxiety about the current situation are high, especially in India​.

Poverty and a lack of information impact people’s ability to take precautionary measures against Covid-19 infection

According to the WHO, the most common symptoms associated with COVID-19 are a dry cough, fever, and tiredness. Public information in each country has emphasized a list of symptoms which overlap with this but there are some differences (e.g. in Peru difficulty breathing is highlighted on the official government website). Most respondents were able to identify at least two of the symptoms, and those with internet access were most likely to be informed. 

We asked respondents about the five behaviours which are widely recommended as a means of preventing infection: social distancing, washing hands more frequently, avoiding handshakes or physical greetings, avoiding groups and wearing protective gear when outside. Only slightly more than half (56%) of the Ethiopia sample adhered to all five, rising to 69% in Vietnam, 72% in India and 84% in Peru. Those with internet access or residing in urban areas showed a higher degree of compliance with these measures, and overall, females tended to comply more than males. In Peru, social distancing is the behavior with the least adherence, especially among vulnerable households.

We also assessed the resources available in households to comply with the World Health Organization's (WHO) recommendations on self-isolation, through an adapted version of the Home Environment for Protection Index (HEP) developed by Brown et al., 2020. The HEP measures the ability to receive reliable information on virus protection and the presence of available space and facilities suitable for implementing social distancing within the household.  

Young Lives Households: Home Environment for Protection


 

Information/ communication device

2 or less people per room

Household toilet

Household piped water

HEP score all indices

Ethiopia

0.58

0.40

0.59

0.32

0.47

India

0.97

0.62

0.52

0.24

0.59

Peru

0.98

0.73

0.96

0.89

0.89

Vietnam

0.99

0.78

0.87

0.38

0.76

Notes: Proportion of households. Adapted from Brown et al, 2020. Detail on the Young Lives HEP index can be found here.

Peru and Vietnam have relatively high averages for the protective index, but in Ethiopia, under a third have access to a piped water source, and the number of people sharing a room also makes it difficult to implement self-isolation when someone is believed to be infected with Covid-19. We find that young people who are the most vulnerable, are living in households with lower protection. Households in the higher HEP group (who are wealthier, on average) are also more likely to follow all behaviours, relative to those in the lower HEP group. 

A cause for concern is the number of those employing ineffective (though benign) preventative measures. A large number reported eating garlic or ginger to protect themselves against the virus, as well as drinking lemon, or adding hot pepper to food to prevent infection.

So far, the health impact of the crisis has been higher in Peru and India than in Ethiopia and Vietnam. In both Peru and India, approximately 6% believed someone in their household had been infected. In contrast, this figure was fewer than 1% in Ethiopia, and almost zero in Vietnam. Whilst our sample are not representative of the national populations, the rates do reflect the situation in each country. Of those who were believed to be infected in Peru and India, only around one-in-three were tested for the virus in both countries.

Many young people are going hungry in all countries except Vietnam: although government support is well targeted it is not sufficient in Peru and Ethiopia. 

The crisis has impacted food security in Vietnam notably less than in the other countries. One in six Young Lives households in Peru, India, and Ethiopia reported running out of food at some point since the beginning of the crisis. This percentage was even larger among households that faced food shortages (food insecurity) in our last visit in 2016 (about twice as high in India). In Vietnam, the overall proportion was much lower, at 4%.

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Source: Young Lives COVID-19 phone survey. We defined food insecure households as those reporting “sometimes do not eat enough” or “frequently do not eat enough” and food secure households those reporting “eating enough but not always what they would like” or “eat enough of what we want”.

Government assistance has reached our respondents to very different degrees. About 92% of the households in India received at least one form of support from the government during the lockdown, although in many cases the support consists of a small basket of food or face masks.  This compares to around half of those in Peru, falling to just 6% in Ethiopia. In all countries it was relatively well targeted, reaching proportionately more of those households that reported food insecurity in a previous visit. However, in Peru the proportion of the most vulnerable households that received a direct cash transfer was far from universal. This could signal either a targeting problem, a delay in payments, or both. Moreover, the size of the transfer appears insufficient (as its value corresponds to about 82% of a minimum wage per family for the entire period).  

Job losses or suspension without pay are widespread even in Vietnam, the least affected country, and remote working is the exception rather than the rule

Many of our 25-year-old respondents lost their jobs. This was particularly severe for respondents who had been informal workers with no written contract in our last visit. In Peru and India, 7 out of 10 respondents had reduced or lost their source of income due to lockdown, 6 in 10 in Vietnam, and 4 in 10 in Ethiopia.  A concentration of income losses among those in the informal sector is an indication of this group’s additional vulnerability to the economic consequences associated with the pandemic. However, it is important to state that everyone, even those who were formal workers prior to the crisis, was severely affected.

The proportion of those who lost income or employment was also relatively higher in urban areas compared to rural areas and a higher proportion of males experienced these losses in both locations. 

Remote working has been possible only for a lucky minority of 25-year-old workers living in urban areas. The highest proportion (28%) in India were able to work from home during the outbreak, falling to 20% in Vietnam, 18% in Ethiopia and 17% in Peru. The percentage is much higher within households who are better equipped for protective measures against Coronavirus (High-HEP). Presumably, this is due to the availability of better infrastructure (e.g. access to internet, computer ownership) and the nature of the work activities performed. 

Education of 19-year olds in all countries has been severely disrupted and access to online learning has been highly unequal

With schools and universities closed very early on in the outbreak in all countries, the interruption to education was striking. Inequalities in those whose studies were interrupted are clear both across countries, gender and wealth. Access to study from home was slightly higher for females than males in all countries, and wealth and parental education almost doubled the chances of being able to study at home. In Vietnam, the vast majority of our 19-year-old cohort (almost 90%) accessed remote learning, falling to 70% in Peru, and 38% in India. In contrast, only 28% in Ethiopia continued to learn remotely, this fell to 14% if their parents had no education. 

This echoes the findings of another Young Lives study that interviewed headteachers in Ethiopia and India, see here for more information

Caring responsibilities increased for 25-year olds and the burden still tends to fall on young women

Although slightly more 19 year-old women have been able to continue their studies online, wide disparities are clear when looking at caring. In all countries except Peru, more than double the number of young women, relative to young men, have had to take on extra caring responsibilities during the lockdown.  The disparity is particularly striking in India and Ethiopia.

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Source: Young Lives COVID-19 phone survey.

Levels of anxiety about the current situation are high, especially in India

How is this impacting on young people’s stress levels? We asked respondents whether the statement "I am nervous when I think about current circumstances" applies to them. We found that stress levels are worryingly high – in India more than 90% of all the young people indicated it applied or strongly applied to them. In Vietnam and Ethiopia 65% agreed with these statements. Peru had surprisingly the lowest anxiety levels, with just under 50% feeling nervous. In the second call we have asked more detailed questions about mental health based on validated scales.

What happens next? 

The data are available on open access (see here).  Due to the nature of the confidentiality agreement that Young Lives has with the families, the datasets are anonymized, and information on geographical location is limited. 

The second call fieldwork has now been completed. We will release headline findings in November. This second phone call has gone into more depth about young people’s labour market experiences, to understanding the medium-term impacts of the pandemic on their work life, their home life, and their education. More specifically, it contains information on the household socio-economic status, food security, labour, education, time use, health (including mental health) - the main themes of the YL survey that can be implemented over the phone.

This is a longer version of our blog first published in The Conversation in August, here.  Follow us on Twitter @yloxford for news on Young LIves at Work. 

 

Can the Major Public Works Policy Buffer Negative Shocks in Early Childhood? Evidence from Andhra Pradesh, India

Poverty and shocks
Social protection
Journal Article

The study examines the role of the largest public works programme in the world—the National Rural Employment Guarantee Scheme (NREGS)—in buffering the negative effects of early childhood exposure to rainfall shocks on long-term health outcomes. Exploiting the spatial and temporal variation in NREGS coverage, the study estimates the extent to which nutritional shocks in early childhood can be offset by access to the programme.

The study employs a unique identification strategy by integrating detailed administrative records of drought shock and phased rollout information of NREGS with household-level panel data—the Young Lives survey—conducted over three waves (2002, 2007, and 2009–10) in the state of Andhra Pradesh, India. Using individual fixed effects estimation, the study finds that while the policy does not help correct for long-term past health deficiencies it is useful in buffering recent drought shocks, which vary by policy relevant subgroups.

 

"Can the Major Public Works Policy Buffer Negative Shocks in Early Childhood? Evidence from Andhra Pradesh, India," Aparajita Dasgupta, Economic Development and Cultural Change, online April 2017

What do Indian children say about nutrition, food insecurity and food programmes?

The United Nations Food and Agriculture Organization estimates that about 795 million people in the world are food insecure. Out of those, one in four lives in India, and given the demographic structure of the country, there are good chances it can be a child.  Similarly, the country has the gloomy record of highest burden of child malnutrition globally, with 48 million of stunted children under 5. An indicator of chronic malnutrition, stunting has lifelong repercussions on children through impaired learninghealth and productivity, and even socio-emotional aspects such as self-esteem and aspirations.

Amidst the numerous statistics about child food insecurity and nutrition, however, the views seldom heard of are those of the children themselves. By ignoring these, are we risking underestimating the impact of food insecurity on children’s overall well-being and life chances?   

These are the topics of a recent paper Ginny Morrow and I wrote, in which we investigated the experiences of food insecurity and food programmes of young people aged between 8 and 15 years old in Andhra Pradesh and Telangana, Southern India, and how these affect their food choices and, more broadly, their lives.

So, what did we learn? 

First, healthy foods and diets were central to what constituted “a good life” for those children.  Regardless of their age, caste or gender, or of whether they live in an urban slum or a remote tribal settlement, it was astonishing how many times food, food insecurity and food programmes were mentioned in a wider study that was asking children to talk about their well-being. 

Second, children had a very clear understanding of the relevance of varied diets for their education, health or productivity. For instance, Krishna, from Patna (a rural community), mentioned: “We need to study, we need to answer the question, and we must eat well...If we eat well, we can study.” Or Santhi, who had been ill, knew that food could help her to recover from illness:  ‘Now my health is not good. I should take proper food. Food long can do me good... I take more milk, I might get enough strength’.

Third, even more striking was the extent to which, from a very early age, young people grasped the complex social, economic and political factors that permeate the concept of food. For instance, the quality of the food was often associated to social status status (“Poor people ate rice with chetni while the rich ate good food”), or to the ability to participate to be part of community celebrations (“Those who have money cook delicious food on festive occasions whereas the poor do not do so.”).

Further, children were fully aware of the impacts of economic, family and natural shocks on their family’s diet. The food price increases of 2008/2009 were mentioned often, particularly by adolescent boys, who are often responsible for the weekly shop in communities like Polur (an urban slum in Hyderabad) where girls’ mobility is limited: “Since the food prices rose, the dal is not thick anymore.” Vinay (another 15-year-old-boy) said that because of the price rises, they had stopped eating curries at home, and that “the dal was watery”.

Finally, children were able to critically assess the impact of government food programmes, and mostly spoke positively about them. In Polur, Sania, for example, maintained that they help poor people “to lead life without starvation and children are able to eat full meals regularly”. School meals were seen favourably by both children and their families as fulfilling multiple objectives, ranging from improvement of nutritional status to encouraging children to attend school in the first place. This is coherent with the evidence, which has shown a positive impact of the scheme  on nutrition, classroom effort, and even recovery from early childhood shocks.

An Employment Guarantee as Risk Insurance?

Social protection
Working paper

This paper assesses inhowfar employment guarantees can support households in managing agricultural production risks. Using representative panel data for Andhra Pradesh, India, it analyzes the effects of the National Rural Employment Guarantee Scheme (NREGS) on households' crop choices. This paper shows that the introduction of the NREGS reduces households' uncertainty about future income streams because it provides reliable employment opportunities in rural areas independently of weather shocks and crop failure. Households with access to the NREGS can therefore shift their production towards riskier but also more pro table crops. These shifts in agricultural production can considerably raise the incomes of smallholder farmers. Linking the employment guarantee to risk  considerations is the key innovation of this paper. Therewith, it provides empirical evidence that employment guarantees can, similarly to crop insurance, help households in managing agricultural productions risks and contributes to the ongoing debate on the effects of the NREGS on agricultural productivity.

Keywords: Uncertainty; Employment Guarantee; Crop choice
JEL: I38; O12; Q16

Paper written by author from the German Development Institute (Deutsches Institut fuer Entwicklungspolitik) and University of Passau, using Young Lives data from the UK Data Archive.

Coping with risk and difficult times in rural Andhra Pradesh

Social protection

Countries in the Young Lives study are especially vulnerable to environmental shocks.

On global indicators, Ethiopia is second most at risk of drought, India the third most at risk for flooding, and Vietnam fourth for being affected by storms and tenth for flooding. Poor households tend to be located in the areas most at risk to environmental hazards and to have more precarious livelihoods and so are prone to experience the same shocks repeatedly. Recurrent shocks, combined with food insecurity, have long-term impacts on children'€™s development and well-being.

Children who have experienced food shortages are at additional risk of poorer outcomes in physical health, learning and subjective well-being. Governments have responded by expanding social protection schemes, to attempt to reduce poverty and to provide a safety net in the event of shocks. Our recent research highlights the impact of the Mahatma Gandhi Rural Guarantee Scheme (MGNREGS) on a rural community in Andhra Pradesh. MGNREGS was introduced in 2005 and provides 100 days of employment a year at a minimum wage rate to every adult in a rural household willing to undertake unskilled manual work.

One of our study sites, Katur village, is located in the Rayalaseema region of Andhra Pradesh. Katur is a drought-prone area and all the major crops grown, such as sunflower, peanuts, pulses and peas, are dependent on rainfall. During the non-agricultural season, many inhabitants used to migrate in search of paid work to cities like Mumbai and Tirupati and to Bangalore for work in a concrete factory.

Adults report improving living conditions over the years 2007-€“10 and attribute this to the increases in social protection and security schemes. Women described the important role played by more than 20 self-help groups in Katur, organised under the state government IKP programme. One woman explained:

 "€œMany of the families have purchased cows and goats through the group loans. There is no problem repaying the loans and we are regularly repaying the loans taken. We are taking the loans only in [the self-help] groups and completely banned the outside loans which have more interest rates (2 rupees per 100 rupees) ... as the group loans are being provided with one rupee interest."€

This has also meant that there is less bonded labour to repay debts as families no longer need to borrow from Kamma (higher) caste families. However, other women felt that self-help groups were a '€œbig headache'€ as '€œwhen we do not have work, then how can we repay the amount to the self-help groups?'€ In addition not all community members can obtain loans. As one woman explained, '€œIf a household has more sons then there is more inclination to lend money as the family can send the sons to work and repay the amount without fail. As is the case with households who own individual assets like land, there are more chances for recovery of the money.'€

Community members also describe the positive impact of MGNREGS. Among Young Lives households in Katur, 95 per cent had job cards and had worked on the scheme in 2008-€“9. Community members report that migration to urban areas for work has declined and that MGNREGS has created a wage floor. Tejaswini, aged 8, stated that only the landlords had not benefited from MGNREGS as no one was prepared to work for 40 rupees per day any more. Children felt that there was more money available to meet their needs. For example, Triveni, aged 16, described how '€œpreviously when there was less money, I used to buy fewer notebooks and used to write two subjects in one book only. Now after the drought works [MGNREGS] came, I am able to keep one book for each subject.'€

MGNREGS also helps families cope with shocks. Govindh, aged 17, described the struggles his family had faced over the past few years:

"Seeds did not grow in the first year, and the second year rains have not come ... so we didn't harvest ... We did not have money to buy vegetables and other things to celebrate festivals ... so it was not well at home."

In addition, his mother was ill and the family had to pay 10,000 rupees for treatment. Govindh said: 'We borrowed money from my grandmother's village ... We borrowed a little, two, three times', and they also borrowed from his uncle. However, the introduction of the MGNREGS has enabled the family to cope better: 'Through the employment guarantee scheme we cleared the loans.' Govindh works on MGNREGS in the college holidays and at the weekend in order to support his family.

References

This is one of a series of six case studies included in a new Young Lives paper Changing Children's Lives, which explore how location - where children live - and change - how their communities are transforming - are important factors in the opportunities open to children and the risks they face.

See also:

F. Afridi, F. Mukhopadhyay and S. Sahoo (2013) Female Labour-Force Participation and Child Education in India: The Effect of the National Rural Employment Guarantee Scheme, Working Paper 95, Oxford: Young Lives.

Laura Camfield and Uma Vennam (2012) From Policy to Implementation: An In-depth Exploration of the MGNREGs in Andhra Pradesh, Working Paper 82, Oxford: Young Lives.

Health Shocks and Coping Strategies: State Health Insurance Scheme of Andhra Pradesh, India

Poverty and shocks
Social protection
Health
Working paper

The objectives of the study are three-fold: to investigate who are vulnerable to welfare loss from health shocks, what are the household responses to cope with the economic burden of health shocks and if policy responses like state health insurance schemes are effective in reducing the economic vulnerability. Existing literature have investigated the impact of state health insurance schemes in reducing the vulnerability to financials risks of medical care using catastrophic health expenditure (CHE) measure. This has several limitations like setting arbitrary threshold levels, exclusion of those that did not seek medical care due to inability to pay and non-accounting for risks posed by different sources of financing. So we use self-reported measure of reduction in economic wellbeing of households due to serious illness or death of one or more members from the recent Young Lives longitudinal study in Andhra Pradesh, India. Three-level random intercept logistic regression analysis that accounts for role of contextual or environmental factors like access to healthcare is used to determine the characteristics of vulnerable population and effectiveness of the state insurance scheme.

 

Paper written by Sowmya Dhanaraj (PhD candidate at IGIDR, Mumbai) using Young Lives data from UK Public Data Archive.

Keywords: health shocks, coping strategies, state health insurance scheme, three-level random intercept model

JEL classification: I100, I130, O150

School Meals as a Safety Net

Social protection
Nutrition
Journal Article

Despite the popularity of school meals, little evidence exists on their effect on health outcomes. This study uses newly available longitudinal data from the state of Andhra Pradesh in India to estimate the impact of the introduction of a national midday meal program on anthropometric z-scores of primary school students, and investigates whether the program ameliorated the deterioration of health in young children caused by a severe drought. Correcting for self-selection into the program using a non-linearity in how age affects the probability of enrollment, we find that the program acted as a safety net for children, providing large and significant health gains for children whose families suffered from drought.

The article is reproduced in accordance with the rules of Chicago University Press.

The final published version of the article is available on the journal website.

 

The Impact of Social Protection Schemes on Girls’ Roles and Responsibilities

Social protection
Gender
Children's work and time-use
Journal Article

The focus of this article is the effect on adolescent girls' roles and responsibilities of public works schemes or cash transfers, which are the main forms of social protection in developing countries. Increasing participation in social protection is intended to enhance the development of girls in participating households, but evidence on their school participation and workloads suggests that the reverse may be happening. The article probes what happens to girls' roles and responsibilities when households participate in social protection schemes in rural Ethiopia and Andhra Pradesh. It argues that effects are complex, and often context-specific; however, the assumption that "beneficiaries" benefit means that negative impacts are rarely acknowledged. The article combines a review of other papers addressing the effects of social protection on children's work with analysis of quantitative and qualitative data, recognising that this question cannot be answered with a methodology that considers girls' schooling or workloads in isolation.

Available on the journal publisher's website.

Can the Major Public Works Policy Buffer Negative Shocks in Early Childhood?

Poverty and shocks
Social protection
Working paper

The study examines the role of the largest public works program in the world-the National Rural Employment Guarantee Scheme (NREGS) - in buffering the negative effects of early childhood exposure to rainfall shocks on long-term health outcomes. Exploiting the spatial and temporal variation in NREGS coverage, the study estimates the extent to which nutritional shocks in early childhood can be offset by access to the policy. The study employs a unique identification strategy by integrating detailed administrative records of drought shock and phase-wise roll-out information of NREGS with a household level panel data-the Young Lives survey- conducted over three waves (2002, 2007 and 2009-10) in the state of Andhra Pradesh, India. Using individual fixed effects estimation the study finds that while the policy does not help correct for long term past health deficiencies it is useful in buffering recent drought shocks, which varies by policy relevant sub-groups. We find that an increase in 22 working days per household increases height-for-age by around 0.26 standard deviations which is bridging about half the rural-urban gap in average height for age score.We find the program is most effective for the case of lower educated households and scheduled castes, who are presumably more vulnerable in the face of climatic variability.  Hence there is much room to reap in the indirect benefits of the program by ensuring food security issues of these households.

This paper was presented at a conference on Inequalities in Children's Outcomes in Developing Countries hosted by Young Lives at St Anne's College, Oxford on 8-9 July 2013.

In 2017, this paper was published in a special edition of Economic Development and Change journal, available at: http://www.journals.uchicago.edu/doi/full/10.1086/691992

Growing Up in Ethiopia and Andhra Pradesh: How Is Increasing Participation in Social Protection Schemes Affecting Girls’ Roles and Responsibilities?

Social protection
Gender
Children's work and time-use
Working paper

The focus of this paper is the effect on adolescent girls' roles and responsibilities of public works schemes or cash transfers, which are the main forms of social protection in developing countries. Increasing participation in social protection is intended to enhance the development of girls in participating households, but evidence on their school participation and workloads suggests that the reverse may be happening. The paper probes what happens to girls? roles and responsibilities when households participate in social protection schemes in rural Ethiopia and Andhra Pradesh. It argues that effects are complex, and often context-specific, however, the assumption that "beneficiaries" benefit means that negative impacts are rarely acknowledged. Nonetheless, the most important question to ask is not "do schemes increase girls' work?" but "how do they change the nature of girls' work and its relation to other valued dimensions of their lives?" The paper combines review and analysis of quantitative and qualitative data, recognising that this question cannot be answered with a methodology that considers girls? schooling or workloads in isolation.