Community-level health programs and child labor: Evidence from Ethiopia

Many developing countries have adopted community-based primary health-care programs. A vital component of these programs is health literacy, which teaches households to avoid physical harm. Child labor can often result in physical harm through injury. Our hypothesis is that health literacy programs make households aware of previously unknown costs of child labor (i.e., risks of injury), resulting in a reallocation of labor away from children. Using Ethiopian data, we investigate if exposure to a community-level health program delivered by Health Extension Workers (HEWs) lowers child labor. We use panel data comprising 5587 observations from 2255 children over four waves of the Young Lives Project. These data are combined with administrative regional-level data on HEWs over the 2006-2016 period. Our identification strategy exploits variations in the deployment of HEWs across regions and time to investigate a plausibly exogenous effect on child labor. We provide evidence that supports our hypothesis. We posit that the mechanism behind our result is likely behavioral change, and rule out several other potential channels, including public safety net programs and the effect of HEWs on education. Our results point to the role that health programs can play in the fight against child labor.