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Poverty, health infrastructure and the nutrition of Peruvian children

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  • Valdivia, Martin

Abstract

After the Peruvian economic crisis of the late 1980s, the 1990s witnessed a significant pro-poor expansion of the country`s health infrastructure that was instrumental in increasing preventive and primary health care expenditures. Using empirical evidence, this paper discusses the effect of this expansion in health infrastructure on child nutrition in Peru, as measured by the height-for-age z-score. Using a pooled sample from the 1992, 1996 and 2000 rounds of the Peruvian DHS, this analysis controls for biases in the allocation of public investments by using a district fixed effects model. The econometric analysis finds a positive albeit small effect of the expansion of the last decade. After desegregating by type of location, however, the effect was found to be significant only in urban areas. Furthermore, the effect is highly nonlinear and has a pro-poor bias. The estimated coefficient for health infrastructure in less endowed districts is 10 times higher than that in the better-endowed districts. The pro-poor bias refers to the fact that the estimated effect is larger for children of less educated mothers. In this sense, this policy seems to have had a pro-poor bias within urban areas, while at the same time excluding the rural population, a traditionally marginalized population group in Peru. These findings support the idea that reducing distance and waiting time barriers may be necessary, but that more explicitly inclusive policies are required to improve the health of the rural poor, especially indigenous groups, so that they can escape this kind of poverty trap.

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Bibliographic Info

Article provided by Elsevier in its journal Economics & Human Biology.

Volume (Year): 2 (2004)
Issue (Month): 3 (December)
Pages: 489-510

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Handle: RePEc:eee:ehbiol:v:2:y:2004:i:3:p:489-510

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Web page: http://www.elsevier.com/locate/inca/622964

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  1. John Strauss & Duncan Thomas, 1998. "Health, Nutrition, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 36(2), pages 766-817, June.
  2. Jere R. Behrman & Yingmei Cheng & Petra E. Todd, 2004. "Evaluating Preschool Programs When Length of Exposure to the Program Varies: A Nonparametric Approach," The Review of Economics and Statistics, MIT Press, vol. 86(1), pages 108-132, February.
  3. Martín Valdivia, 2002. "Acerca de la magnitud de la inequidad en salud en el Perú," Documentos de Investigación dt37, Grupo de Análisis para el Desarrollo (GRADE).
  4. Behrman, Jere R. & Deolalikar, Anil B., 1988. "Health and nutrition," Handbook of Development Economics, in: Hollis Chenery† & T.N. Srinivasan (ed.), Handbook of Development Economics, edition 1, volume 1, chapter 14, pages 631-711 Elsevier.
  5. Barrera, Albino, 1990. "The role of maternal schooling and its interaction with public health programs in child health production," Journal of Development Economics, Elsevier, vol. 32(1), pages 69-91, January.
  6. Paul Glewwe, 1999. "Why Does Mother's Schooling Raise Child Health in Developing Countries? Evidence from Morocco," Journal of Human Resources, University of Wisconsin Press, vol. 34(1), pages 124-159.
  7. Deon Filmer & Lant Pritchett, 1999. "The Effect of Household Wealth on Educational Attainment: Evidence from 35 Countries," Population and Development Review, The Population Council, Inc., vol. 25(1), pages 85-120.
  8. Rosenzweig, Mark R & Wolpin, Kenneth I, 1986. "Evaluating the Effects of Optimally Distributed Public Programs: ChildHealth and Family Planning Interventions," American Economic Review, American Economic Association, vol. 76(3), pages 470-82, June.
  9. Richard H. Steckel, 1995. "Stature and the Standard of Living," Journal of Economic Literature, American Economic Association, vol. 33(4), pages 1903-1940, December.
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Cited by:
  1. Juan José Díaz & Miguel Jaramillo, 2009. "El impacto de PARSalud sobre la calidad de la atención de salud materna entre la población indígena," IDB Publications 8396, Inter-American Development Bank.
  2. Ramirez, N.F. & Gamboa, L.F. & Bedi, A.S. & Sparrow, R.A., 2012. "Child malnutrition and antenatal care: Evidence from three Latin American countries," ISS Working Papers - General Series 536, International Institute of Social Studies of Erasmus University (ISS), The Hague.
  3. Jere R. Behrman & Emmanuel Skoufias, 2004. "Correlates and Determinants of Child Anthropometrics in Latin America: Background and Overview of the Symposium," Research Department Publications 3191, Inter-American Development Bank, Research Department.
  4. Richard H. Steckel, 2008. "Heights and Human Welfare: Recent Developments and New Directions," NBER Working Papers 14536, National Bureau of Economic Research, Inc.
  5. César P. Bouillon & Luis Tejerina, 2006. "Do We Know What Works?: A Systematic Review of Impact Evaluations of Social Programs in Latin America and the Caribbean," IDB Publications 23598, Inter-American Development Bank.
  6. repec:idb:brikps:31358 is not listed on IDEAS

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