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SummaryThis paper uses UNICEF’s Multiple Indicators Cluster Surveys cross-country data to shed light on unequal investments in the wellbeing of children (boys and girls) within the household. The paper proposes a new methodology to measure the extent of gender intrahousehold inequality and its contribution to overall levels of inequality using an L-Theil index decomposition. The individual and joint distribution of inequality in four key indicators of child wellbeing is analyzed: stunting, birth registration, school attendance, and time spent on work and chores (working hours) in the search for evidence of gender bias. Evidence from various separate county studies had shown that the direction of the gender bias is not universal. Such conclusion holds when using a consistent methodology and comparable cross-country datasets; this paper shows that disparities inside households do not follow the same bias toward one or the other gender in all countries and the direction of the bias is not the same across indicators of wellbeing. While progress in improving child wellbeing has occurred in many countries, inequalities remain. Intrahousehold inequalities might still be considered a priority in an agenda focused on closing these progress gaps.

This paper assesses whether health insurance is successful in improving health. More specifically, it investigates whether a same health insurance scheme has differentiated impacts on children depending on the way it is implemented and on the characteristics of the beneficiaries. To do so, I analyze the case of Ghana’s National Health Insurance Scheme that provides free coverage for children and has decentralized operations. I exploit the Multiple Indicator Cluster Survey of 2011 and I use propensity score matching to account for selection in the scheme. The study finds that, even though the NHIS is successful in improving health outcomes among insured children in Ghana, gains are not shared equally across regions. To understand this regional heterogeneity, mechanisms are investigated. The positive impact of health insurance is concentrated among the lower-income households in regions with a high quality of public health care. Further evidence points to the importance of health care utilization to explain these results. This paper sheds a new light on the mixed results of the literature on the impact of health insurance on health outcomes. It provides an understanding of the sources of the heterogeneous impact of a National Health Insurance Scheme and highlights the importance of context and implementation as drivers of its effectiveness. Such evidence is relevant for both the evaluation and monitoring of existing health care schemes and for the implementation of new large-scale public policies., info:eu-repo/semantics/published