BackgroundIn Kenya, where 60 to 80% of the urban residents live in informal settlements (frequently referred to as slums), out-of-pocket (OOP) payments account for more than a third of national health expenditures. However, little is known on the extent to which these OOP payments are associated with personal or household financial catastrophe in the slums. This paper seeks to examine the incidence and determinants of catastrophic health expenditure among urban slum communities in Kenya.MethodsWe use a unique dataset on informal settlement residents in Kenya and various approaches that relate households OOP payments for healthcare to total expenditures adjusted for subsistence, or income. We classified households whose OOP was in excess of a predefined threshold as facing catastrophic health expenditures (CHE), and identified the determinants of CHE using multivariate logistic regression analysis.ResultsThe results indicate that the proportion of households facing CHE varies widely between 1.52% and 28.38% depending on the method and the threshold used. A core set of variables were found to be key determinants of CHE. The number of working adults in a household and membership in a social safety net appear to reduce the risk of catastrophic expenditure. Conversely, seeking care in a public or private hospital increases the risk of CHE.ConclusionThis study suggests that a substantial proportion of residents of informal settlements in Kenya face CHE and would likely forgo health care they need but cannot afford. Mechanisms that pool risk and cost (insurance) are needed to protect slum residents from CHE and improve equity in health care access and payment.

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This article uses a dynamic panel data model to analyse the effects of terrorism on demand for tourism in Kenya. We use annual data from 2010 to 2013 for a widely dispersed set of 124 countries of origin covering Europe, Asia, the Americas and Africa. The result suggests that a 1% increase in fatalities significantly reduces tourist arrivals by about 0.13%. This translates to a reduction of about 2507.5 visitors per year and roughly 157.1 million Kenya Shillings lost in tourism revenue per year for every one unit increase in fatality. Other proxies for terrorism, such as incidence or casualties, have a similar effect, indicating the robustness of the results. On the other hand, previous visits have a strong and positive effect on the level of current arrivals.

AimsIn Kenya, it is estimated that 60 to 80% of urban residents live in slum or slum-like conditions. This study investigates expenditures patterns of slum dwellers in Nairobi, their coping strategies and the determinants of those coping strategies.MethodWe use a dataset from the Indicator Development for Surveillance of Urban Emergencies (IDSUE) research study conducted in four Nairobi slums from April 2012 to September 2012. The dataset includes information related to household livelihoods, earned incomes of household members, expenditures, shocks, and coping strategies.ResultsFood spending is the single most important component, accounting for 52% of total households' income and 42% of total expenditures. Households report a variety of coping strategies over the last four weeks preceding the interview. The most frequently used strategy is related to reduction in food consumption, followed by the use of credit, with 69% and 52% of households reporting using these strategies respectively. A substantial proportion of households also report removing children from school to manage spending shortfalls. Formal employment, owning a business, rent-free housing, belonging to the two top tiers of income brackets, and being a member of social safety net reduced the likelihood of using any coping strategy. Exposure to shocks and larger number of children under 15 years increased the probability of using a coping strategy.Policy ImplicationsPolicies that contain food price inflation, improve decent-paying job opportunities for the urban poor are likely to reduce the use of negative coping strategies by providing urban slum dwellers with steady and reliable sources of income. In addition, enhancing access to free primary schooling in the slums would help limit the need to use detrimental strategies like “removing” children from school.

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There is a proposal for a fast-tracked approach to the African Community (EAC) monetary union. This paper uses cointegration techniques to determine whether the member countries would form a successful monetary union based on the long-run behavior of nominal and real exchange rates, the monetary base and real gdp. The four variables are each analyzed for co-movements among the five countries. The empirical results indicate only partial convergence for the variables considered, suggesting there could be substantial costs for the member countries from a fast-tracked process. This implies the EAC countries need significant adjustments to align their monetary policies and to allow a period of monetary policy coordination to foster convergence that will improve the chances of a sustainable currency union. th ordinary summit directed that the preparation for the establishment of a monetary union be moved into high gear upon the coming into operation of the common market. Macroeconomic convergence of member countries is crucial to the sustainability of a monetary union over the long term. Monetary policy convergence, exhibited mainly in similarity of inflation and interest rates among other indicators, is necessary to ensure a single monetary policy is optimal policy for all the union members. In an influential study Rose (2000) followed by others (a good summary is provided by Rose and Stanley, 2005), estimated that currency union enhances trade among member countries by two to three times. This boosts similarity of the demand patterns and price co-movements. Countries then could become more similar in a currency union than before currency union. If suitability for membership in a monetary union is endogenous, this suggests it may not be crucial for members to meet optimum currency area criteria before currency union. However recent assessment of the EMU experience (see Chintrakarn, 2008;Frankel, 2008) show a much smaller trade impact of the Euro of only about 15%. The endogeneity effect may even be smaller for African monetary unions. Carmignani (2009) and Tapsoba (2009) study the endogeneity effect of trade in African monetary unions and find that currency union increases synchronicity of business cycles but the effect is very small. While trade effects and endogeneity cannot be discounted, these subsequent results cautions against excessive optimism on the magnitude of the effects from an EAC monetary union. First, the trade effect benefits seem to be slow to achieve (about 15% from EMU nearly ten years later). Secondly, the EAC countries are starting from relatively low intra-EAC trade levels. Given the high dependency on primary product exports, the scope for increased trade is unlikely to be as great as more developed countries. (Note 4) Therefore this makes convergence before monetary union critical for the EAC to minimize any adverse effects from a loss of monetary policy for member countries. No specific enforceable convergence targets have been laid down for eligibility in the proposed EAMU. It is h...

Overlaps in membership of monetary integration initiatives in the Eastern and Southern Africa (ESA) region is a major stumbling block to deeper integration. For example, a strict implementation of the East African Community (EAC) customs union concluded in 2004 would violate existing Common Market for Eastern and Southern Africa (COMESA) and Southern Africa Development Community (SADC) free trade agreements. To resolve this problem the paper applies cluster analysis to assign countries to the most suitable monetary union initiative based on real and nominal convergence criteria. The results indicate that the ESA region is not converged enough for an ESA-wide monetary union. Instead two fairly distinct clusters, one in the southern cone around South Africa and the other around the EAC, are identified. This implies that a two-track monetary integration route is more appropriate for the region. The EAC is identified as a subgroup within COMESA, suggesting Tanzania should cede SADC membership for COMESA.Ã Acknowledgements: I wish to thank the editor (Benn Steil) and two anonymous referees for very constructive comments. All errors are mine.