Health; Work Disability; Healthcare; Poverty; NCDs; Development
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The main objectives of our proposed research are to (a) deepen knowledge of the relationship between chronic illness and poverty in low-income settings and (b) provide evidence on the health and economic impact of increased access to diagnosis and treatment for selected chronic health problems in the context of poorly resourced health systems with a special focus on mature adult populations who are the main sufferers of NCDs.To further examine the causes of and solutions to health-related poverty traps, our proposed research will investigate the following hypotheses:H1: Chronic illness makes a substantial contribution to the risk and persistence of poverty in LMICs, and it does so more through reduced work capacity/productivity than through the burden of medical expenses.H2: Improved access to healthcare (diagnosis, medication and treatment) for chronic health problems is an effective instrument for maintaining health, reducing disability and combatting economic deprivation.H3b: The communication of risk information-potentially coupled with financial incentives for care seeking-will be effective in increasing healthcare seeking, diagnosis and medical treatment for certain chronic conditions, and consequently improves health (generating resource savings for the health system) and future economic performance (generating health-led economic development).H4: Scaling-up of coverage for diagnosis and treatment of certain NCDs is cost-effective even in low-resource health systems, especially when their impact on reducing disability and improving socioeconomic development is taken into account.H5: Persons with chronic conditions/disabilities have lower prospects of employment. These reduced employment prospects occur even in job for which their chronic disease/disability is largely irrelevant.To test the above four hypotheses, our proposed research will take a quantitative approach that combines the collection and analysis of longitudinal data with the implementation of randomized experiments for the causal study of specific pathways linking NCDs, healthcare use, and subsequent health and economic outcomes. Existing longitudinal survey infrastructures will be built and drawn on for the collection of new data and experiments will efficiently exploit existing data infrastructures within a randomized controlled trail (RCT) study design.