Abstract:
We study the spillover effects of a large-scale public health insurance programme on early learning outcomes in Rwanda. The policy, the community based health insurance programme, which expands affordable healthcare services especially among rural and low-income families, was introduced in different district hospitals at different times. Leveraging detailed administrative data covering the universe of primary school national exam test scores in Rwanda and a difference-in-difference approach that exploits within-region variation in exposure to the reform across district hospitals, we document robust evidence that early life exposure to public health insurance leads to a 0.064σ (approximately 3.4 per cent) increase in student performance. We show that the increase in student test scores is mainly driven by the reduction of household health costs, substantial increase in prenatal care services, and improvement in household education expenditure.
