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Poverty, Health Infrastructure and the Nutrition of Peruvian Children

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  • Martin Valdivia

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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Paper provided by Inter-American Development Bank, Research Department in its series Research Department Publications with number 3193.

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Date of creation: Mar 2004
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Handle: RePEc:idb:wpaper:3193

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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. 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., The Population Council, Inc., vol. 25(1), pages 85-120.
  4. Richard H. Steckel, 1995. "Stature and the Standard of Living," Journal of Economic Literature, American Economic Association, vol. 33(4), pages 1903-1940, December.
  5. Martín Valdivia, 2002. "Acerca de la magnitud de la inequidad en salud en el Perú," Documentos de Investigación, Grupo de Análisis para el Desarrollo (GRADE) dt37, Grupo de Análisis para el Desarrollo (GRADE).
  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. 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.
  8. Behrman, Jere R. & Deolalikar, Anil B., 1988. "Health and nutrition," Handbook of Development Economics, Elsevier, in: Hollis Chenery & T.N. Srinivasan (ed.), Handbook of Development Economics, edition 1, volume 1, chapter 14, pages 631-711 Elsevier.
  9. 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.
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Cited by:
  1. 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, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague 536, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
  2. Jere R. Behrman & Emmanuel Skoufias, 2004. "Correlates and Determinants of Child Anthropometrics in Latin America: Background and Overview of the Symposium," Research Department Publications, Inter-American Development Bank, Research Department 3191, Inter-American Development Bank, Research Department.
  3. Richard H. Steckel, 2008. "Heights and Human Welfare: Recent Developments and New Directions," NBER Working Papers 14536, National Bureau of Economic Research, Inc.
  4. 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 80443, Inter-American Development Bank.
  5. Djimeu, Eric W., 2014. "The impact of social action funds on child health in a conflict affected country: Evidence from Angola," Social Science & Medicine, Elsevier, vol. 106(C), pages 35-42.
  6. Krause, Brooke Laura, 2012. "Childhood Malnutrition and Educational Attainment: An Analysis using Oxford’s Young Lives Longitudinal Study in Peru," Master's Theses, University of Minnesota, Department of Applied Economics 146072, University of Minnesota, Department of Applied Economics.
  7. Krause, Brooke Laura, 2013. "Childhood Malnutrition and Educational Attainment: An Analysis using Oxford's Young Lives Longitudinal Study in Peru," 2013 Annual Meeting, August 4-6, 2013, Washington, D.C., Agricultural and Applied Economics Association 150598, Agricultural and Applied Economics Association.

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