Gender patterns in household health expenditure allocation: a study of South Africa

Abstract

This paper explores the extent and nature of gender differences, by age, in household health expenditure allocation. Using South African data, we adopt a hurdle methodology, constructing a sequence of decision stages (reporting sickness, consulting medical practitioner, incurring positive medical expenditure, and the conditional amount of expenditure) in order to examine all these possible channels of gender differentiation. Our results provide evidence of significant pro-female bias among prime age persons (ages 16-40) after controlling for gender differences in the opportunity cost of time spent on seeking medical attention. We infer that expenditure on female health is viewed as an important investment in household welfare in light of women's contribution to household production, particularly over child bearing/ rearing ages. This provides an alternative narrative to the 'investment motive' hypothesis traditionally employed to explain differential allocation of resources to males and females within the household. We also compare the relative explanatory power of household and individual level equations in revealing intra-household gender bias. Our findings suggest that the dimensions of gender differentiation are revealed more clearly in individual level regressions.