INCOME BETWEEN HARVESTS AND ILLNESS: SEASONAL AGRICULTURAL EARNINGS AND HEALTHCARE UTILISATION IN RURAL CAMEROON
Résumé
Abstract In agrarian economies, income does not arrive smoothly across the year. It comes in waves, often tied to the harvest calendar. Yet illness does not wait for harvest. This study examines the effect of seasonal agricultural income fluctuations on healthcare utilisation in rural Cameroon using nationally representative secondary data. The main objective is to determine whether variability in farm income across seasons significantly influences the likelihood that rural households seek formal healthcare when faced with illness. Specifically, the study seeks to estimate the effect of seasonal income variability on outpatient visits, use of public and private health facilities, and health expenditure patterns. The analysis draws on data from the Fourth Cameroon Household Survey, employing a logistic regression framework and robustness checks using probit and instrumental variable specifications. The findings reveal that households experiencing higher seasonal income volatility are significantly less likely to utilise formal healthcare services during lean seasons. The negative effect is more pronounced among smallholder households without access to savings or credit. The results suggest that income smoothing mechanisms play a critical role in protecting health-seeking behaviour. The study recommends that the Ministry of Public Health, in collaboration with the Ministry of Agriculture and Rural Development and the Ministry of Finance, design seasonal health financing schemes and agricultural income stabilisation policies to reduce vulnerability in rural communities. Keywords: Seasonal income, Agricultural households, Healthcare utilisation, Rural Cameroon, Income volatility, Health economics, Logistic regression
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