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20 Figure 1: Map of Kagera Region

21 Tables Table 1: Percent of individual reporting illness and injury in the four weeks prior to survey, by age and gender Age Total Male Female > Total Source: author's calculation on KHDS

22 Table 2: Percent of individual reporting illness and injury in the four weeks prior to survey, by age and gender Age Total Male Female > Total Source: author's calculation on KHDS

23 Table 3: Types of symptoms of those reporting illness or injury in month prior to survey By Gender By Age Type of Symptom Total Male Female >45 Acute Diarrhea Chronic Diarrhea Weight Loss Acute Fever Recurring Fever Skin Rash Weakness Severe Headache Fainting Chills Vomiting Cough Productive Cough Coughing blood Urine Pain Genitals sores Mental Abdominal pain Sore Throat Breathing Burn Fracture Wound Child Birth Other No obs. 9,463 4,415 5, ,456 2,198 1,137 1,852 Source: author's calculation on KHDS

24 Table 4 : Choice of health care provider on sample of ill individuals By Gender By age Place Total Male Female >45 No care Informal care Pharmacy Practitioner s Own home Other Formal Care Hospital Health Centre Dispensary Clinic No. Obs. 10,703 4,963 5, ,645 2,74 1,324 2,011 Source: author's calculation on KHDS 5 Table 5: Benefits and Costs of formal health care Formal Infor P-value No. No P-value No. Sample μ F μ I μ F -μ I =0 μ NC μ F -μ NC =0 Fraction of individuals ill at time t-1 who are still ill at time t Pooled Sample Routine Symptoms Not Routine Symptoms Fraction of ill individuals, treated by a doctor Pooled Sample Distance (Km) between the facility and the household Pooled Sample Notes: The table includes only 4 waves, because of lack of data about distance and individuals Source: author's calculation on KHDS

25 Table 6: Probability of illness Dependent variable=1 if an individual reported an illness Probit HH FE Baseline By age Baseline By age Age >12 Age<=12 Age >12 Age<=12 (1) (2) (3) (4) (5) (6) Age (0.003)*** (0.004)*** (0.018)*** (0.001)** (0.001)*** (0.005)*** Age sq. (a) (0.000)*** (0.000) (0.001)*** (0.000)*** (0.000) (0.000)*** Female (0.027)*** (0.040)*** (0.035) (0.008)*** (0.012)*** (0.011) Education (0.006)** (0.006)** (0.002)*** (0.002)* Education of HH (0.006)* (0.000) Female Head (0.074)** (0.080)* (0.023)** (0.027) HH head (0.050)*** (0.057) (0.015)*** (0.017) HH size (0.003)*** (0.004)*** (0.005)** (0.003) (0.004) (0.006) Log Phys. Stock (0.008)*** (0.011)** (0.013) (0.005) (0.006) (0.007)* Bad House (0.029)** (0.038)*** (0.043) (0.019) (0.022) (0.029) Bad Water (0.030) (0.038) (0.044) (0.017) (0.020)* (0.030) Dep. Ratio (b) (0.048) (0.015) (0.000) (0.000) Child<= (0.066) (0.080) (0.045) (0.053) Wave Dummies yes yes yes District Dummies yes yes yes Constant (0.132) (0.167)** (0.182) (0.069)*** (0.085)*** (0.106)*** Observations Number of pid R-squared Notes: Sample includes waves 1-4 Robust standard errors in parentheses. * significant at 10%; ** significant at 5%; *** significant at 1% (b) Dependency Ratio=N. of elderly and kids in the HH over HH size (a) Marginal probit coefficients are calculated at the mean. Fordummies, marginal effect is calculated for disrete change from 0 to 1.

26 Table 7: Probability of care by formal providers Dependent variable=1 if an individual consulted a formal provider, conditional on illness Baseline By age Type of symptom Age >12 Age <=12 Routine Non Routine (1) (2) (3) (4) (5) Age (0.005) (0.007)** (0.027)*** (0.006)* (0.013) Age sq (0.000) (0.000)** (0.002)*** (0.000) (0.000) Female (0.047) (0.074) (0.056) (0.049) (0.115) Education (0.009)*** (0.011)*** (0.010)*** (0.022)** Education of HH (0.009)** Female Head (0.113) (0.134) (0.120) (0.263) HH head (0.083) (0.103) (0.087) (0.196) Log Phys. Stock (0.014) (0.019) (0.021) (0.015) (0.037) Bad House (0.049)* (0.068)** (0.070) (0.052) (0.117)*** Bad Water (0.048)*** (0.065)*** (0.070)*** (0.051)*** (0.120)** HH size (0.005) (0.008) (0.007) (0.006) (0.014)* Child<= (0.085) (0.090) (0.216) Dep. Ratio (0.107) (0.137)* (0.113) (0.256) Wave Dummies yes yes yes yes yes District Dummies yes yes yes yes yes Constant (0.222) (0.299) (0.293) (0.236) (0.548) Observations Number of pid Notes: Sample includes waves 1-4.Robust standard errors in parentheses. * significant at 10%; ** significant at 5%; *** significant at 1% (b) Dependency Ratio=N. of elderly and kids in the HH over HH size (a) Marginal probit coefficients are calculated at the mean. Fordummies, marginal effect is calculated for disrete change from 0 to 1.

27 Table 8: Probability of care by formal providers, same individual over time Dependent variable=1 if an individual seek formal care Baseline By Age Non Ciclic Diseases Age >12 Age<=12 (1) (3) (4) (5) (6) (7) Switch to Formal (0.082)*** (0.088)*** (0.105)*** (0.147)** (0.104)*** (0.095)*** Routine Symptoms (0.146)* (0.206) Age (0.010) (0.011) (0.012) (0.074)*** (0.013) (0.012) Age sq. (b) (0.000) (0.000) (0.000) (0.006)*** (0.000) (0.000) Female (0.083) (0.088) (0.118) (0.133) (0.103)* (0.096)* Education (0.019) (0.020) (0.021) (0.024) (0.022) Head Education (0.023) HH Head (0.128)** (0.137)*** (0.143)** (0.165)*** (0.153)* Log Phys. Stock (0.031) (0.034) (0.039) (0.058) (0.042) (0.037) Bad house (0.096)* (0.136) (0.121) (0.181) (0.158) (0.110)** Bad water (0.095) (0.105) (0.125) (0.171) (0.124) (0.111) HH size (0.012) (0.013) (0.016) (0.021) (0.016) (0.014) Dependency Ratio (0.197) (0.214) (0.239) (0.421) (0.254) (0.229) Child < (0.191) (0.201) (0.240) (0.227) Constant (0.472) (0.616)* (0.610) (0.859) (0.731) (0.586) Wave Dummies yes yes yes yes yes yes District Dummies yes no yes yes no yes Cluster Dummies no yes no no yes no Observations Number of pid Notes: Robust standard errors in parentheses. * significant at 10%; ** significant at 5%; *** significant at 1%. Probit Estimates. (a) Marginal probit coefficients are calculated at the mean. Fordummies, marginal effect is calculated for discrete change from 0 to 1.

28 Table 9: Instrumenting illness First Stage Selection Bias Control Dependent variable Illness Formal Care (1) (2) (3) (4) (5) Disaster (0.019)*** Switch to Formal Care (0.030)*** (0.031)*** Age (0.020)*** (0.022) (0.020) (0.094) (0.083) Age sq. (b) (0.000)*** (0.000) (0.000) (0.001) (0.001) Female (0.022)*** (0.030) (0.028) (0.110) (0.100) Education (0.017) (0.011)*** (0.011)*** (0.027) (0.026) Female Head (0.337) (0.104) (0.109) (0.258) (0.251) HH Head (0.257) (0.130) (0.125)* (0.390) (0.367) HH Sice (0.010)*** (0.013) (0.013)* (0.047) (0.044) Log Phys. Stock (0.014)** (0.007) (0.008)* (0.022) (0.023) Bad house (0.052) (0.081)** (0.087)*** (0.217) (0.218) Bad water (0.054) (0.073)*** (0.069)*** (0.201)* (0.195) Dependency Ratio (0.139)*** (0.131)* (0.139)** (0.336) (0.344) Child < (0.085) (0.242) (0.245)* (0.699) (0.658) routine (0.023)** (0.024)** (0.050) (0.054) Wave Dummies yes yes yes yes District Dummies yes no yes no Cluster Dummies no yes no yes Constant (0.125)*** (1.182) (1.148) (3.537) (3.233) Observations Note: standard errors in parentheses. * significant at 10%; ** significant at 5%; *** significant at 1%. The first stage estimate includes all five waves. (a) Disaster includes drought, epidemic, insect and crop diseases. (b) Controls: Age, Age Sq., Female, Female HH Head, HH Head, HH Size, Child<=12, Dependency Ratio, and all the mean of these covariates.

29 Appendix Tables Table A1: Definition of variables and descriptive statistics Variable Definition Obs Mean S.D. Min Max Ill Equal to 1 if individual reported ill or injury and Formal Equal 1 if formal provider (hospital, health centre Switch To Formal Equal 1 if an individual ill in time t-2, consulted an informal provider in t-2 and he is still ill in time t Female Equal 1 if female, 0 otherwise Age Age in years Age sq. Age squared in years Education Years of education HH head Equal 1 if head of household, 0 otherwise Female head Interaction between head and female HH size Number of member in each hh Phys. stock Value of physical asset held by the HH e+1 6.4e e+17 Log Phys. Stock Log value of physical asset Bad water Equal 1 if the source of drinking water for household river/lake, well without pump, rain 0 Bad floor Equal 1 if main floor material is earth, 0 otherwise Bad wall Equal 1 if main wall material is mud brick or Bad roof Equal 1 if main roof material is grass or mud Bad house Equal 1 if inadequate house (bad wall bad floor bad roof), 0 otherwise Symtom Symptoms suffered:1= Acute diarrhea, 2=Chronic Diarrhea, 3=weight loss, 4=Acute Fever, 5=Recurring Fever, 6=skin rash, 7=weakness, 8=severe headache, 9=fainting, 10=chills (feeling hot and cold), 11=vomiting, 12=cough, 13=productive cough, 15=pain on passing urine, 16=genitals pain, 17=mental problems, 18=abdominal pain, 19=sore throat, 20=difficult breathing, 21=burn, 22=fracture, 23=wound, Routine Equal 1 if it is a routine symptom, 0 otherwise Distance Distance from the nearest health establishment (Km) Facility distance Distance between the community and the nearest health establishment (Km) Disasters Equal 1 if there was a disaster in the past 6 months in the community, such as: drought, epidemic,

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