Publications
Tafesse, W. Hussain, A., Suhrcke, M. (2025) Women’s age at marriage and obesity in Pakistan (with Akseer Hussain and Marc Suhrcke) Economics & Human Biology, Forthcoming, https://doi.org/10.1016/j.ehb.2025.101525
Mohan, S. et al. (2024) “Factors associated with medical consumable availability in level 1 facilities in Malawi: A secondary analysis of a facility census”, The Lancet Global Health, 12, 6.
Tafesse, W., & Chalkley, M. (2024). "The Difference in Clinical Knowledge Between Staff Employed at Faith-based and Public Facilities in Malawi", Christian Journal for Global Health, 11(1), 46–63. https://doi.org/10.15566/cjgh.v11i1.853
Tafesse, W., Jemutai, J., Mayora, C., Margini, F. (2024) "Scoping Review of Health Economics Research on Refugee Health in Sub-Saharan Africa", Value in Health Regional Issues, Volume 39, 98-106, https://doi.org/10.1016/j.vhri.2023.10.008.
Dolton, P., Tafesse, W. (2022) “Childhood obesity, is fast food exposure a factor?” Economics & Human Biology, 46, 101153, https://doi.org/10.1016/j.ehb.2022.101153.
Tafesse, W. (2022) “The effect of Universal Salt Iodization on cognitive test scores in rural India”, World Development, Volume 152, 105796, https://doi.org/10.1016/j.worlddev.2021.105796.
Tafesse, W., Chalkley, M.(2021) “Faith-based provision of sexual and reproductive healthcare in Malawi”, Social Science & Medicine, 282, 113997, https://doi.org/10.1016/j.socscimed.2021.113997.
Kamanzi, A., McKay, A., Newell, A., Rienzo, C., Tafesse, W. (2021). "Education, Access to Better Quality Work and Gender: Lessons from the Kagera Panel Data Set". Journal of African Economies, Volume 30, 103–127, https://doi.org/10.1093/jae/ejaa011.
Ramponi, F., Tafesse, W., Griffin, S. (2020). "Economic evaluation of interventions to address undernutrition: a systematic review". Health Policy and Planning. https://doi.org/10.1093/heapol/czaa149.
Working papers
Chalkley, M et al. (2025), "Incorporating an economic approach to production in a health system model" medRxiv 2508.11730}
Mohan, S. et al. (2025), “Method for costing a health system using a Health Systems Model". medRxiv 2025.01.22.25320881.
Nkhoma, D. et al. (2024)“Thanzi La Mawa (TLM) datasets: health worker time and motion, patient exit interview and follow-up, and health facility resources, perceptions and quality in Malawi". medRxiv 2024.11.14.24317330. Submitted to Wellcome Open Research.
Work in progress
The Effects of Public-Private Partnerships and Fee Removal on Maternal Health Utilisation and Infant Survival in Malawi (with Gerald Manthalu and Martin Chalkley) Link to old version. Under Review
Abstract: Governments in many low- and middle-income countries partner with faith-based healthcare providers to expand healthcare in rural and remote areas. Yet, little is known about the effects of these public-private partnerships. We examine the impact of Service Level Agreements (SLAs) in Malawi, under which non-profit faith-based healthcare facilities remove user fees for maternal and newborn services in exchange for government reimbursement. Leveraging village-level variation in the staggered implementation of SLAs, we use difference-in-differences to analyse retrospective birth history data from the 2010 Malawi Demographic and Health Survey. We find that SLAs reduced home deliveries by at least 20% and increased faith-based facility deliveries by 38% for financially constrained women. The policy also improved antenatal care utilisation, including the timeliness of the first visit. Importantly, SLAs led to an overall 2.7 percentage point reduction in infant mortality representing 38.6% of the baseline average. The results suggest that user fee removal in conjunction with financial reforms for non-profit faith-based providers has the potential to increase equitable access to healthcare and improve health outcomes in rural populations across developing countries.
The causal effect of iodised salt consumption on children's height in rural India'' Link to paper
Abstract: Height is often used as a proxy for human capital. Research has established that nutrition in early life is an important predictor of height. Less is known about in what way nutrition may impact height. Medical evidence points to a mechanistic relationship between iodine deficiency and growth. This paper investigates whether the consumption of iodised salt improves height among children in rural India. I use 2SLS regression to circumvent concerns regarding the endogeneity of a household's availability of iodised salt and children's anthropometric status. I instrument for iodised salt consumption with the distance to the major salt producing state. Salt transported for longer distances is likely to be transported by rail rather than by road. Monitoring of iodised salt is only mandatory before and during rail transport. Therefore, distance serves as a proxy for the likelihood that the salt has been inspected for iodine, and thus iodised. I find that the availability of adequately iodised salt improves height-for-age by 0.664 Z-scores for children up to 1 year.
What doesn’t kill you, makes you more anxious: The effect of civil conflict on mental health in Nepal
Abstract: This paper provides the first nationwide evidence on the effect of early-life exposure to civil conflict on mental health in adolescence and adulthood. I analyse the effect of childhood exposure to the 1996-2006 Nepali civil conflict on clinically valid measures of anxiety and depression using data on the time and location of all conflict casualties combined with the 2022 Nepal Demographic and Health Survey. Leveraging variation in conflict by village and year of birth, I find that conflict exposure in early life is associated with an increased generalised anxiety score, predominantly due to not being able to control worrying. Moreover, conflict intensity increases the risk of reporting sleep problems and receiving counselling for a mental health condition. Comparing conflict exposure by age shows that exposure four years after birth has the strongest effects. The effects are larger for younger cohorts, rural respondents and individuals without access to nearby mental healthcare services. Exposure to conflict for these sub-groups also increases the risk of clinically diagnosed anxiety.
Mind the gap: Accounting for the absence of health workers in Malawi (with Martin Chalkley)
Abstract: 30-50% of all healthcare workers in low- and middle-income countries (LMICs) are found to be absent from facilities. Previous research has not identified any successful interventions to reduce absenteeism in the long-run and there is limited information on how different types of absence depend on key incentive structures within the existing health system. We investigate the prevalence of different types of healthcare worker absence, their potential effects and predictors using a census of all facilities in Malawi, the 2018/2019 Malawi Harmonised Health Facility Assessment. The survey collects detailed facility information, including on the number of staff who are absent during an unannounced facility visit. We find that 30% of all healthcare workers are absent. The most common reasons are reported to be work-related and non-authorised absence constitutes 10% of all absences. Facility-level regressions indicate that higher average non-work absence is associated with longer facility waiting times for antenatal care and under 5 children's visits. Regression results at the individual staff level show that salary delay is a robust predictor of absence driven by non-authorised reasons or being on call. Accounting for hospital management practices reveals a negative association between external supervision and absence. Thus, timely salary payments and external monitoring potentially constitute important policy levers to reduce absence.
Differences in healthcare worker performance by ownership in Malawi (with Martin Chalkley, Luigi Siciliani and Tim Colbourn)
Quality of care and patient outcomes in Malawi (with Joseph Collins and Tim Colbourn)
Health worker time use in Malawi: a time and motion study (with Bingling She and Tim Colbourn)