Very few demographic surveys in developing countries have gathered information on household incomes or consumption expenditures. Researchers interested in living standards therefore have had little alternative but to rely on simple proxy indicators. The properties of these proxies have not been analyzed systematically. We ask what hypotheses can be tested using proxies, and compare these indicators with consumption expenditures per adult, our preferred measure of living standards. We find that the proxies employed in much demographic research are very weak predictors of consumption per adult. Nevertheless, hypothesis tests based on proxies are likely to be powerful enough to warrant consideration.

This paper investigates the effect of health-related expenditure on household welfare in Albania, Bosnia and Herzegovina, Montenegro, Serbia and Kosovo, all of which have undertaken major health sector reform. Two methodologies are used: (i) the incidence and intensity of 'catastrophic' health care expenditure, and (ii) the effect of out-of-pocket payments on poverty headcount and poverty gap measures. Data are drawn from the most recent Living Standards and Measurement Surveys, 2000-05. While our analyses are not without their limitations, and the lack of comparability across instruments precludes a direct comparison across countries, there is no doubt that health expenditure contributes substantially to the impoverishment of households-increasing the incidence of poverty and pushing poor households into deeper poverty-in each country. Both the catastrophic and the impoverishing effects of health expenditures are particularly severe in Albania and Kosovo. Transportation expenditure accounts for a large share of total health expenditures, especially in Albania and Serbia. Informal payments are substantial in all countries, and are particularly high in Albania. As countries in the sub-region continue the process of health system reform, an important policy question should be how to protect vulnerable groups from the catastrophic and impoverishing effects of health care expenditure.

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Levels of child malnutrition in India have fallen only slowly during the 1990s, despite significant economic growth and considerable expenditure on the Integrated Child Development Services (ICDS) programme, of which the major component is supplementary feeding for malnourished children. To begin to unravel this puzzle, this article assesses the programme's placement and its outcomes, using NFHS data from 1992 and 1998. The authors find that programme placement is clearly regressive across states. The states with the greatest need for the programme — the poor Northern states which account for nearly half of India's population and which suffer from high levels of child malnutrition — have the lowest programme coverage and the lowest budgetary allocations from the central government. Programme placement within states is more progressive: poorer and larger villages have a higher probability of having an ICDS centre, as do those with other development programmes or community associations. In terms of outcomes, the authors find little evidence of programme impact on child nutrition status in villages with ICDS centres.

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The objective of this paper is to document the extent and impact of income and of intergenerational effects. distribution of child and adult malnutrition in Education of adults in the household and the availability Guatemala; to analyze the relationship between selected of infrastructure are other important determinants of child, maternal, household and community children's growth attainment. Finally, even controlling characteristics and children's nutritional status; and to for income and other household and community outline the implications of the most important findings characteristics, ethnicity remains an important for nutritional policy.determinant of child nutritional status. The study also The prevalence of chronic malnutrition among reveals an increasing prevalence of excess weights and Guatemalan children in 2000 was the highest in Latin obesity among children and adults. Overnutrition tends America and among the highest in the world. The data to be higher among individuals living in urban areas and show very strong socioeconomic and geographic among non-poor and non-indigenous households. inequality. The econometric analysis reveals a strong This paper-a product of the Human Development Sector Unit, Latin America and the Caribbean Region-is part of a larger effort in the region to study poverty and human development processes. Copies of the paper are available free from the

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This paper uses the 1995 Guatemalan Survey of Family Health (EGSF) to analyze the relationship between child illness and health seeking behavior. The EGSF contains detailed calendar data on the nature and timing of illness and treatment behavior for children age five and below; extensive information about the characteristics of mothers, families and communities; and data on the accessibility of traditional and biomedical providers within and near the community. The analysis is based on 870 children who began a diarrheal or respiratory illness during a 2-week period prior to interview. Estimates are derived from a multinomial logit model of the probability of seeing a specific type of provider on a given day of illness, as a function of characteristics of the illness, child, mother, and community. The results indicate that modern medical care plays a major role in the treatment of infectious illness among children in rural Guatemala. The symptoms associated with the illness, their perceived severity, and mother's beliefs about their causes are important determinants of whether a child is brought to a provider and the type of provider visited. Poverty is a serious constraint on a family's choices about how to treat children's illnesses, whereas education and ethnicity have little effect on treatment behavior when income is held constant. In addition, the availability of modern health facilities within the community-both government-sponsored facilities and private doctors-has a substantial impact on the type of providers sought to treat children's illnesses.