Int J Health Econ Manag. 2026 Jul 24;26(3):16. doi: 10.1007/s10754-026-09420-2.
ABSTRACT
This article analyzes the economic responses of household heads confronted with SARS-CoV-2 symptoms during the partial lockdown period imposed in Cameroon in 2020. By isolating the specific effect of the individual symptomatic shock from that of general health restrictions, it fills a gap that the literature on the economic effects of COVID-19 has not yet directly addressed. The data come from a household survey conducted in Cameroon, and five economic responses are analyzed, namely over-indebtedness, active occupational mobility, and reductions in health, education, and sanitary protection expenditures. To address endogeneity, two complementary strategies are employed, namely the kinky least squares (KLS) method, which corrects endogeneity bias without resorting to an external instrument, and the recursive bivariate probit with instrumental variable, which jointly models binary treatment and outcome while accounting for the correlation between their unobserved error terms. Kinky least squares estimates establish a positive and statistically significant relationship between SARS-CoV-2 symptomatic manifestations and all of the selected economic responses. The recursive bivariate probit confirms these results, with the exception of active occupational mobility, whose coefficient remains positive but loses its statistical significance once non-linearity and the correlation of unobserved disturbances are fully accounted for. The decomposition of average treatment effects indicates that SARS-CoV-2 symptomatic manifestations increase the probability of reducing sanitary protection expenditures by 37.3% across the entire population (ATE) and by 38.1% among household heads who were actually affected (ATET). For education expenditures, these effects are 28.6% and 25.6%, respectively. For health expenditure reductions, these effects are 23.2% and 18.6%, respectively. These findings argue in favor of the free distribution of sanitary protection devices, the subsidization of medical consultations and community drug stockpiles, the maintenance of school transfer payments, and zero-interest emergency credit lines for informal workers experiencing temporary work incapacity. These measures will nonetheless remain insufficient as long as the health coverage system remains critically underdeveloped.
PMID:42496914 | DOI:10.1007/s10754-026-09420-2
