Background: Saudi Arabia’s healthcare sector is growing at a hasty stride; nevertheless, the quality of healthcare consumption remains challenged by the growing caseload in free public health facilities. Insurance could ease this pressure by moving some healthcare demand to private facilities conditional on its ability to enact health-seeking behaviour. These potential effects remain under-investigated. Therefore, the aim of this study was to investigate whether health insurance nudges health-seeking behaviour using data from Saudi Arabia. Materials and Methods: The study used nationally representative secondary data, obtained from the Family Health Survey, conducted in 2018, in Saudi Arabia. Health-seeking behaviour was measured by individual attendance of medical check-up. To account for endogeneity due to non-random selection of individuals into insurance, the analysis employed the inverse propensity weighting and the instrumental variables methods. Results: The results revealed that health insurance leads to increased chances of going for medical check-up. The effects are higher amongst non-Saudi nationals relative to citizens. Furthermore, people who purchase personal health insurance schemes are more likely to go for checks-ups, followed by individuals provided by the private sector and government sector. Finally, the study found that insurance positively nudges hypertension, diabetes, and cholesterol specific medical check-ups. Conclusion: The findings indicated the need for health policy to increase access to health insurance in Saudi Arabia. A notable policy response is the introduction of national health insurance coverage, which has already proven in other countries as an effective measure to attain universal access to improved health. Nevertheless, results from this study highlighted variations in demand for health seeking based on type of insurance with highest returns in personal insurance. Policy should leverage on this behaviour response by introducing insurance packages that share premiums with citizens to incentivise utilisation. The results can also be used to design policy responses to demand for insurance, in the entire Arabian Gulf region, since these countries have similar health financing mechanism with Saudi Arabia.

Background: Having access to convenient and quality healthcare at all times is not only a human right but also a goal that many countries strive to achieve for their population. However, access to healthcare might face blocks in the presence of financial exclusions. Saudi Arabia has, over the years, continued to pursue policy and system reforms to enhance its population’s access to financial inclusion, as well as proper health coverage to improve health outcomes. This study seeks to estimate the effects of financial inclusion on the financial hardships in accessing healthcare in Saudi Arabia. Methods: This study uses a nationally representative survey conducted with 1009 adults, using the 2017 World Bank Global Findex Study data. The study estimates the conditional probability of coming up with emergency funds and the conditional probability of borrowing for medical purposes to understand access to healthcare. A composite value is created for financial inclusion using several variables for individuals’ interactions with financial institutions, such as access to financial services and loans. Results: The results revealed that financially included individuals have a higher conditional probability of both borrowing for medical purposes and coming up with emergency funds, compared to those who are financially excluded. Additionally, the study showed that individuals in low-income brackets are more likely to be financially excluded and have a reduced chance of coming up with emergency funds and borrowing for medical purposes. Conclusion: These findings indicate that there is need for authorities to roll out a financial inclusion drive that will not only incentivise the financially excluded population to become included but that will also aim at promoting various financial products so that those who are already financially included have a wide range from which they can choose.

The paper investigates whether cultural lineage mediates gender gaps in child nutrition. It captures nutrition using height-for-age and stunting. The analysis uses the 2014 Malawi Millennium Development Goals Endline Survey data. We find evidence of male child nutrition deprivation in matrilineal cultural lineage. The gender of the household head does not relate to the mediating role of lineage on gendered nutrition gaps. As such, the analysis of gendered nutrition should account for the potential impact of culture to produce policy relevant estimates. Furthermore, deficiencies in male nutrition remains a strong health problem, particularly in cultures that benefit most from returns on female children. In these cultures, lineage dominates personal parental preferences. Therefore, there is a need to revisit received wisdom that providing more resources to female heads eliminates gender gaps by provision of culture-tailored nutritional interventions.

The Malawi Farm Input Subsidy Program (FISP) was praised for turning the country's food deficit into a surplus after inception in 2005. It is, however, not clear whether these food security gains spill over to equity in distribution of welfare. We examine the effects of the FISP on per-capita consumption convergence, on 2251 households interviewed in 2010–2013 Malawi Integrated Household Panel Survey. The analysis employs a Lewbel method of instrumental variables to account for non-random selection of beneficiaries into the programme. The results reveal that FISP helps relatively poor farmers increase household per-capita consumption towards converging to that of the relatively rich. This convergence is robust only among small but not large farmers. Past studies that evaluated the FISP while not paying attention to the welfare equity gains in household per-capita consumption, may have underestimated its benefits. Therefore, policy should support the programme with an additional objective of reducing inequality, beyond the primary aim of enhanced food security. Considering that the effects of FISP are limited to small farmers, alternative interventions such as inputs for credit should be made available to large farmers. This will allow FISP to induce widespread welfare gains.

Understanding gender differences in body mass index (BMI) between males and females has been much debated and received considerable attention. This study aims to decompose gender differentials in the BMI of people of the Kingdom of Saudi Arabia. The study decomposed the BMI gender gap into its associated factors across the entire BMI distribution by using counterfactual regression methods. The main method of analysis was newly developed unconditional quantile regression-based decomposition, which applied Blinder–Oaxaca decomposition using data from the Saudi Health Interview Survey. Gender differentials were found in the BMI, with females showing a higher BMI than males. The aggregate decomposition showed that both the covariate effect and the structural effect were significant at the 25th and 50th quantiles. Detailed decomposition indicated that income level and employment status as well as soda consumption and the consumption of red meat were significantly correlated in explaining gender differentials in BMI across various quantiles, but the magnitude varied by quantile. Our study suggests the government should consider introducing programs that specifically target women to help them reduce BMI. These programs could include organizing sporting events at the workplace and at the national level. Furthermore, the effect of soda consumption could be reduced by levying a tax on beverages, which might reduce the demand for soda due to the increased price.

The study examines whether education externality effects on migration among household heads in Malawi exists and uses data from the Fourth Malawi Integrated Household Survey. Following the Von Neumann Morgenstern in the random utility maximization framework, the paper aims at contributing to literature in three strands. Firstly, by delving into the possible intra-household and inter-household effects of education on migration decision. Secondly, by assessing the effects of education at different levels of schooling in Malawi and finally by questioning who benefits more from education externalities between the household and the community. Drawing from a discrete choice model and using both the Probit and the random effects Probit models the study finds statistically significant spillover effects measured through the intra-household and inter-household externality effects. Almost 65% of the variations in the propensity to migrate are due to intra-household heterogeneity implying that households benefit more to migration than community. Different levels of education have different levels of impact on migration decision with an increasing positive effect as a person moves up on education ladder. Communities with higher literacy is more unlikely to send its members into migration.