International Remittances and Private Healthcare in Kerala, India

Authors

  • Mohd Imran Khan Narsee Monji Institute of Management Studies, Mumbai
  • Valatheeswaran C.

DOI:

https://doi.org/10.59670/ml.v17i3.778

Keywords:

international migration, remittances, healthcare expenditure, health care access

Abstract

The inflow of international remittances to Kerala has been increasing over the last three decades. It has increased the income of recipient households and enabled them to spend more on human capital investment. Using data from the Kerala Migration Survey-2010, this study analyses the impact of remittance receipts on the households’ healthcare expenditure and access to private healthcare in Kerala. This study employs an instrumental variable approach to account for the endogeneity of remittances receipts. The empirical results show that remittance income has a positive and significant impact on households’ healthcare expenditure and access to private healthcare services. After disaggregating the sample into different heterogeneous groups, this study found that remittances have a greater effect on lower-income households and Other Backward Class (OBC) households but not Scheduled Caste (SC) and Scheduled Tribe (ST) households, which remain excluded from reaping the benefit of international migration and remittances.

Metrics

Metrics Loading ...

Author Biography

Mohd Imran Khan, Narsee Monji Institute of Management Studies, Mumbai

Assistant Professor, School of Economics

References

Agadjanian, V., Arnaldo, C., & Cau, B. (2011). Health Costs of Wealth Gains: Labor Migration and Perceptions of HIV/AIDS Risks in Mozambique. Social Forces, 89(4), 1097–1117. https://doi.org/10.1093/sf/89.4.1097

Ambrosius, C., & Cuecuecha, A. (2013). Are Remittances a Substitute for Credit? Carrying the Financial Burden of Health Shocks in National and Transnational Households. World Development, 46, 143–152. https://doi.org/https://doi.org/10.1016/j.worlddev.2013.01.032

Amemiya, T. (1979). The Estimation of a Simultaneous Equation Generalized Probit Model. Econometrica. https://doi.org/10.2307/1914210

Amuedo-Dorantes, C., & Pozo, S. (2011). New evidence on the role of remittances on healthcare expenditures by Mexican households. Review of Economics of the Household. https://doi.org/10.1007/s11150-009-9080-7

Antón, J. I. (2010). The Impact of Remittances on Nutritional Status of Children in Ecuador. International Migration Review. https://doi.org/10.1111/j.1747-7379.2010.00806.x

Azzarri, C., & Zezza, A. (2011). International migration and nutritional outcomes in Tajikistan. Food Policy. https://doi.org/10.1016/j.foodpol.2010.11.004

Bhat, P. N. M. (1990). Demographic Transition in Kerala Revisited. Economic and Political Weekly, 25(35–36), 1957–1980. Retrieved from https://www.epw.in/journal/1990/35-36/special-articles/demographic-transition-kerala-revisited.html

Botezat, A., & Pfeiffer, F. (2014). The Impact of Parents Migration on the Well-Being of Children Left Behind--Initial Evidence from Romania. ZEW-Centre for European Economic Research Discussion Paper, (14-029).

Corno, L., & de Walque, D. (2012). Mines, Migration and HIV/AIDS in Southern Africa. Journal of African Economies, 21(3), 465–498. https://doi.org/10.1093/jae/ejs005

de Brauw, A., & Mu, R. (2011). Migration and the overweight and underweight status of children in rural China. Food Policy, 36(1), 88–100. https://doi.org/10.1016/j.foodpol.2010.08.001

Dilip, T. R. (2010). Utilization of inpatient care from private hospitals: trends emerging from Kerala, India. Health Policy and Planning, 25(5), 437–446. https://doi.org/10.1093/heapol/czq012

Drabo, A., & Ebeke, C. (2010). Remittances, Public Health Spending and Foreign Aid in the Access to Health Care Services in Developing Countries. Retrieved from https://ideas.repec.org/p/cdi/wpaper/1125.html

Garg, C. C., & Karan, A. K. (2009). Reducing out-of-pocket expenditures to reduce poverty: a disaggregated analysis at rural-urban and state level in India. Health Policy and Planning, 24(2), 116–128. https://doi.org/10.1093/heapol/czn046

George, A V, Nair, S. (2004). An Overview of the Health Scenario of Kerala. In B. A. Prakash (Ed.), Kerala’s Economic Development Performance and Problems in the Post-Liberalization Period. SAGE Publications Pvt. Ltd.

Gertler, P., Levine, D. I., & Moretti, E. (2009). Do microfinance programs help families insure consumption against illness? Health Economics, 18(3), 257–273. https://doi.org/10.1002/hec.1372

Government of Kerala. (2015). Economic Review 2015, Thiruvananthapuram: State Planning Board, Government of Kerala. Retrieved from http://spb.kerala.gov.in/images/er/er15/index.html

Graham, E., & Jordan, L. P. (2011). Migrant Parents and the Psychological Well-Being of Left-Behind Children in Southeast Asia. Journal of Marriage and Family, 73(4), 763–787. https://doi.org/10.1111/j.1741-3737.2011.00844.x

Hildebrandt, N., & McKenzie, D. J. (2005). The Effects of Migration on Child Health in Mexico. Economía, 6(1), 257–289. https://doi.org/10.1353/eco.2006.0009

Islam, A., & Maitra, P. (2012). Health shocks and consumption smoothing in rural households: Does microcredit have a role to play? Journal of Development Economics, 97(2), 232–243. https://doi.org/10.1016/j.jdeveco.2011.05.003

Khan, M. I., & Valatheeswaran, C. (2016). International Migration, Remittances and Labour Force Participation of Left-behind Family Members: A Study of Kerala. Margin. https://doi.org/10.1177/0973801015612669

Kutty, V. R. (2000). Historical analysis of the development of health care facilities in Kerala State, India. Health Policy and Planning, 15(1), 103–109. https://doi.org/10.1093/heapol/15.1.103

Ladusingh, L., & Pandey, A. (2013). Health Expenditure and Impoverishment in India. Journal of Health Management, 15(1), 57–74. https://doi.org/10.1177/0972063413486031

Levesque J, F, Haddad S, Narayana D, F. P. (2006). Outpatient care utilization in urban Kerala, India. Health Policy and Planning, 21(4), 289–301. https://doi.org/10.1093/heapol/czl013

Lung-Fei, L. (1992). Amemiya`s generalized least squares and tests of overidentification in simultaneous equation models with qualitative or limited dependent variables. Econometric Reviews, 11(3), 319–328. https://doi.org/10.1080/07474939208800242

Lurie, M. N. (2006). The Epidemiology of Migration and HIV/AIDS in South Africa. Journal of Ethnic and Migration Studies, 32(4), 649–666. https://doi.org/10.1080/13691830600610056

Mazzucato, V., Cebotari, V., Veale, A., White, A., Grassi, M., & Vivet, J. (2015). International parental migration and the psychological well-being of children in Ghana, Nigeria, and Angola. Social Science & Medicine, 132, 215–224. https://doi.org/10.1016/j.socscimed.2014.10.058

Mckenzie, D., & Rapoport, H. (2007). Network effects and the dynamics of migration and inequality: Theory and evidence from Mexico. Journal of Development Economics, 84(1), 1–24. https://doi.org/10.1016/j.jdeveco.2006.11.003

Mendola, M., & Carletto, C. (2012). Migration and gender differences in the home labour market: Evidence from Albania. Labour Economics, 19(6), 870–880. https://doi.org/10.1016/j.labeco.2012.08.009

Mincer, J. (1978). Family Migration Decisions. Journal of Political Economy. https://doi.org/10.1086/260710

Nag, M. (1989). Political Awareness as a Factor in Accessibility of Health Services-A Case Study of Rural Kerala and West Bengal. Economic and Political Weekly, 24(8), 417–426. Retrieved from https://www.epw.in/journal/1989/8/special-articles/political-awareness-factor-accessibility-health-services-case-study

Newey, W. K. (1987). Efficient estimation of limited dependent variable models with endogenous explanatory variables. Journal of Econometrics, 36(3), 231–250. https://doi.org/10.1016/0304-4076(87)90001-7

NSSO. (1998). Morbidity and Treatment of Ailments.In Ministry of Statistics and Programme Implementation, New Delhi.

NSSO. (2015). Key Indicators of Social Consumption in India: Health. In Ministry of Statistics and Programme Implementation, New Delhi. https://doi.org/DDI-IND-MOSPI-NSSO-71Rnd-Sch25pt0-Jan-June-2014

Ponce, J., Olivié, I., & Onofa, M. (2011). The Role of International Remittances in Health Outcomes in Ecuador: Prevention and Response to Shocks. International Migration Review, 45(3), 727–745. https://doi.org/10.1111/j.1747-7379.2011.00864.x

Sevoyan, A., & Agadjanian, V. (2010). Male Migration, Women Left Behind, and Sexually Transmitted Diseases in Armenia. International Migration Review, 44(2), 354–375. https://doi.org/10.1111/j.1747-7379.2010.00809.x

Shahrawat, R., & Rao, K. D. (2012). Insured yet vulnerable: out-of-pocket payments and India’s poor. Health Policy and Planning, 27(3), 213–221. https://doi.org/10.1093/heapol/czr029

Staiger, D., & Stock, J. H. (1997). Instrumental Variables Regression with Weak Instruments. Econometrica, 65(3), 557. https://doi.org/10.2307/2171753

Stark, O., & Bloom, D. E. (1985). The New Economics of Labor Migration. The American Economic Review, 75(2), 173–178. Retrieved from http://www.jstor.org/stable/1805591

Taylor, E. J. (1999). The New Economics of Labour Migration and the Role of Remittances in the Migration Process. International Migration, 37(1), 63–88. https://doi.org/10.1111/1468-2435.00066

Terrelonge, S. C. (2014). For Health, Strength, and Daily Food: The Dual Impact of Remittances and Public Health Expenditure on Household Health Spending and Child Health Outcomes. The Journal of Development Studies, 50(10), 1397–1410. https://doi.org/10.1080/00220388.2014.940911

Thresia, C. U., & Mohindra, K. S. (2011). Public Health Challenges in Kerala and Sri Lanka. Economic and Political Weekly, 46(31), 99–107. Retrieved from http://www.jstor.org/stable/23017882

Tumbe, C. (2011). Remittances in India : Facts & Issues. In Indian Institute of management, Research and Publications (No. 331). Retrieved from https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2122689

Valatheeswaran, C., & Khan, M. I. (2018). International Remittances and Private Schooling: Evidence from Kerala, India. International Migration, 56(1), 127–145. https://doi.org/10.1111/imig.12413

WorldBank. (2016). Migration and Remittances Fact Book, Third Edition, Washington DC: World Bank Publication.

Zachariah, K. C., & Rajan, S. I. (2007). Migration remittances and employment short-term trends and longterm implications. Retrieved from https://ideas.repec.org/p/ind/cdswpp/395.html

Zachariah, K. C., & Rajan, S. I. (2011). Impact of Remittances of Non-resident Keralites on Kerala’s Economy and Society. Indian Journal of Labour Economics, 54(3), 503–526. Retrieved from http://link.springer.com/journal/volumesAndIssues/41027%5Cnhttp://search.ebscohost.com/login.aspx?direct=true&db=eoh&AN=1612927&amp%5Cnlang=ja&site=ehost-live

Zhunio, M. C., Vishwasrao, S., & Chiang, E. P. (2012). The influence of remittances on education and health outcomes: a cross country study. Applied Economics, 44(35), 4605–4616. https://doi.org/10.1080/00036846.2011.593499

Downloads

Published

2020-05-08

How to Cite

Khan, M. I., & C., V. (2020). International Remittances and Private Healthcare in Kerala, India. Migration Letters, 17(3), 445–460. https://doi.org/10.59670/ml.v17i3.778

Issue

Section

Articles