Medical emergencies and farm productivity in Cote d'Ivoire

The lack of health insurance for smallholder farmers in most sub-Saharan African countries hurts the families and can also negatively affect agriculture production, exports, and tax revenues. This paper analyzes the linkage between medical emergencies and agriculture exports and the corresponding tax revenues for smallholder farmers in Cote d'Ivoire. It uses two complementary datasets: the 2016 Consultative Group to Assist the Poor (CGAP) smallholder survey and the 2015 Cote d'Ivoire living standard survey. The paper finds that a medical emergency is negatively and significantly associated with a decrease in the likelihood that a smallholder farmer cultivates cocoa of 3.9 percentage points, driving them into poverty and reducing productivity at the lower quantiles. The paper then estimates that medical emergencies can be correlated with the decline in cocoa exports of $853 million and in tax revenues of $125 million, representing 0.2% of the Ivorian gross domestic product (GDP) in 2017.