The Socio-Economic and (Indirect) Health Impacts of COVID-19 on Rural Households in Kenya: A Longitudinal Financial and Health Diaries Analysis

Abstract: This study assesses how low-income households in rural Kenya coped with the immediate economic consequences of the COVID-19 pandemic, and how this affected their health care utilization. We use granular financial and health data from weekly household interviews covering six weeks before the first case was detected in Kenya to twenty weeks after. Over this period, substantial containment measures were implemented while confirmed COVID-19 cases remained extremely limited in the study areas. Based on household-level fixed-effects regressions, our results indicate that income from work as well as from gifts and remittances decreased with about one-third after the start of the pandemic. Household expenditures on food remained at pre-COVID levels. We do not find evidence that households coped with reduced income through increased borrowing, selling assets or withdrawing savings. Instead, they gave out less gifts and remittances themselves, lent less money to others and postponed loan repayments, i.e. social support between households was strongly affected. Health spending went down as well. However, this seems to be driven largely by a reduction in (self-reported) prevalence of – mostly infectious – illnesses rather than foregone care. We investigate to what extent school closures, reduced mobility and improved hygiene practices are associated with these health impacts.