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Child mortality and public spending on health : how much does money matter?

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  • Filmer, Deon
  • Pritchett, Lant

Abstract

The authors use cross-national data to examine the impact on child (under 5) and infant mortality of both nonhealth (economic, cultural, and educational) factors and public spending on health. They come up with two striking findings: 1) Roughly 95 percent of cross-national variation in mortality can be explained by a country's per capita income, the distribution of income, the extent of women's education, the level of ethnic fragmentation, and the predominant religion. 2) Public spending on health has relatively little impact, with a coefficient that is numerically small and statistically insignificant at conventional levels. Independent variations in public spending explain less than one-tenth of 1 percent of the observed differences in mortality across countries. The estimates imply that for a developing country at average income levels, actual public spending per child death averted is $50,000 to $100,000. This contrasts markedly with a typical range of estimates for the cost-effectiveness of medical interventions to avert the main causes of child mortality of $10 to $4,000. They outline three possible explanations for this divergence between the actual and apparent potential of public spending: the allocation of public spending, the net impact of additional public supply, and public sector efficacy.

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Bibliographic Info

Paper provided by The World Bank in its series Policy Research Working Paper Series with number 1864.

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Date of creation: 31 Dec 1997
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Handle: RePEc:wbk:wbrwps:1864

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Keywords: Health Monitoring&Evaluation; Health Systems Development&Reform; Health Economics&Finance; Public Health Promotion; Early Child and Children's Health; Statistical&Mathematical Sciences; Health Monitoring&Evaluation; Health Systems Development&Reform; Health Economics&Finance; Inequality;

References

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  1. Barro, Robert J & Lee, Jong Wha, 1996. "International Measures of Schooling Years and Schooling Quality," American Economic Review, American Economic Association, vol. 86(2), pages 218-23, May.
  2. Heerink, N. & Folmer, H., 1991. "Income Distribution and the Fulfilment of Basic Needs: Theory and Empirical Evidence," Mansholt Working Papers 1991-1, Wageningen University, Mansholt Graduate School of Social Sciences.
  3. Bidani, Benu & Ravallion, Martin, 1997. "Decomposing social indicators using distributional data," Journal of Econometrics, Elsevier, vol. 77(1), pages 125-139, March.
  4. Easterly, W & Levine, R, 1996. "Africa's Growth Tragedy : Policies and Ethnic Divisions," Papers 536, Harvard - Institute for International Development.
  5. Sudhir Anand & Martin Ravallion, 1993. "Human Development in Poor Countries: On the Role of Private Incomes and Public Services," Journal of Economic Perspectives, American Economic Association, vol. 7(1), pages 133-150, Winter.
  6. Deininger, Klaus & Squire, Lyn, 1996. "A New Data Set Measuring Income Inequality," World Bank Economic Review, World Bank Group, vol. 10(3), pages 565-91, September.
  7. Kakwani, N., 1993. "Performance in living standards : An international comparison," Journal of Development Economics, Elsevier, vol. 41(2), pages 307-336, August.
  8. Kim, Kwangkee & Moody, Philip M., 1992. "More resources better health? A cross-national perspective," Social Science & Medicine, Elsevier, vol. 34(8), pages 837-842, April.
  9. Srinivasan, T. N., 1994. "Data base for development analysis Data base for development analysis: An overview," Journal of Development Economics, Elsevier, vol. 44(1), pages 3-27, June.
  10. Hammer, Jeffrey S., 1996. "Economic analysis for health projects," Policy Research Working Paper Series 1611, The World Bank.
  11. Alberto Alesina & Reza Baqir & William Easterly, 1999. "Public Goods And Ethnic Divisions," The Quarterly Journal of Economics, MIT Press, vol. 114(4), pages 1243-1284, November.
  12. Subbarao, K & Raney, Laura, 1995. "Social Gains from Female Education: A Cross-National Study," Economic Development and Cultural Change, University of Chicago Press, vol. 44(1), pages 105-28, October.
  13. Wolfe, Barbara L., 1986. "Health status and medical expenditures: Is there a link?," Social Science & Medicine, Elsevier, vol. 22(10), pages 993-999, January.
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  1. Gender Equality Matters for Development Outcomes
    by Terra Lawson-Remer in Development Channel on 2012-08-21 19:04:48
  2. Sports, Gender Equality, and Development
    by Terra Lawson-Remer in Development Channel on 2013-05-14 18:37:14
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