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

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Author Info
Filmer, Deon
Pritchett, Lant

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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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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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Related research
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;

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References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Hammer, Jeffrey S, 1997. "Economic Analysis for Health Projects," World Bank Research Observer, Oxford University Press, vol. 12(1), pages 47-71, February. [Downloadable!]
    Other versions:
  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.
    Other versions:
  3. Bidani, Benu & Ravallion, Martin, 1997. "Decomposing social indicators using distributional data," Journal of Econometrics, Elsevier, vol. 77(1), pages 125-139, March. [Downloadable!] (restricted)
    Other versions:
  4. Alberto Alesina & Reza Baqir & William Easterly, 1997. "Public Goods and Ethnic Divisions," NBER Working Papers 6009, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
  5. 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. [Downloadable!] (restricted)
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  9. Easterly, W & Levine, R, 1996. "Africa's Growth Tragedy : Policies and Ethnic Divisions," Papers 536, Harvard - Institute for International Development.
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  10. Deininger, Klaus & Squire, Lyn, 1996. "A New Data Set Measuring Income Inequality," World Bank Economic Review, Oxford University Press, vol. 10(3), pages 565-91, September.
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Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. Kimalu, Paul Kieti, 2002. "Debt Relief and Health Care in Kenya," Working Papers UNU-WIDER Research Paper , World Institute for Development Economic Research (UNU-WIDER). [Downloadable!]
  2. Dollar, David & Kraay, Aart, 2001. "Growth is good for the poor," Policy Research Working Paper Series 2587, The World Bank. [Downloadable!]
    Other versions:
  3. Burnside, Craig & Dollar, David, 1998. "Aid, the incentive regime, and poverty reduction," Policy Research Working Paper Series 1937, The World Bank. [Downloadable!]
  4. Suhrcke, Marc, 2000. "Are Reforms From a Centrally Planned to a Market System Bad for Health?," Discussion Paper Series 26142, Hamburg Institute of International Economics. [Downloadable!]
  5. Christiaensen, Luc & Scott, Christopher & Wodon, Quentin, 2002. "Cibles du développement et coûts
    [Development targets and costs]    ," MPRA Paper 10494, University Library of Munich, Germany. [Downloadable!]
  6. Ablo, Emmanuel & Reinikka, Ritva, 1998. "Do budgets really matter? - evidence from public spending on education and health in Uganda," Policy Research Working Paper Series 1926, The World Bank. [Downloadable!]
  7. Belkacem Laabas and Imed Limam, . "Impact of public policies on poverty, income distribution and growth," API-Working Paper Series 0401, Arab Planning Institute - Kuwait, Information Center. [Downloadable!]
  8. Jane Kabubo-Mariara & Margaret M. Karienyeh & Francis K. Mwangi, 2008. "Child Survival, Poverty and Policy Options from DHS Surveys in Kenya: 1993-2003," Cahiers de recherche PMMA 2008-01, PEP-PMMA. [Downloadable!]
  9. Filmer, Deon & King, Elizabeth M. & Pritchett, Lant, 1998. "Gender disparity in South Asia : comparisons between and within countries," Policy Research Working Paper Series 1867, The World Bank. [Downloadable!]
  10. Easterly, William, 2000. "the middle class consensus and economic development," Policy Research Working Paper Series 2346, The World Bank. [Downloadable!]
    Other versions:
  11. Christiaensen, Luc & Scott, Christopher & Wodon, Quentin, 2002. "Development Targets and Costs," MPRA Paper 12299, University Library of Munich, Germany. [Downloadable!]
  12. Christiaensen, Luc & Scott, Christopher & Wodon, Quentin, 2002. "Задачи Развития И Затраты
    [Development targets and costs]    ," MPRA Paper 10495, University Library of Munich, Germany. [Downloadable!]
  13. Philip Arestis, Asena Caner, 2004. "Financial Liberalization and Poverty: Channels of Influence," Economics Working Paper Archive 411, Levy Economics Institute, The. [Downloadable!]
  14. Anit N Mukherjee, 2007. "Public Expenditure on Education : A Review of Selected Issues and Evidence," Working Papers id:856, esocialsciences.com. [Downloadable!]
  15. Dolores Jimenez & Peter C Smith, . "Decentralisation of health care and its impact on health outcomes," Discussion Papers 05/10, Department of Economics, University of York. [Downloadable!]
  16. Robert Lensink & Howard White, 2000. "Aid allocation, poverty reduction and the Assessing Aid report," Journal of International Development, John Wiley & Sons, Ltd., vol. 12(3), pages 399-412.
  17. Hermann Sautter, 2002. "Equity and growth – an uneasy relationship," Ibero America Institute for Econ. Research (IAI) Discussion Papers 089, Ibero-America Institute for Economic Research. [Downloadable!]
  18. Easterly, William, 1999. "Life during growth : international evidence on quality of life and per capita income," Policy Research Working Paper Series 2110, The World Bank. [Downloadable!]
  19. Christiaensen, Luc & Scott, Christopher & Wodon, Quentin, 2002. "Metas y costos del desarrollo
    [Development Targets and Costs]    ," MPRA Paper 10493, University Library of Munich, Germany. [Downloadable!]
  20. Alun H. Thomas, 2006. "Do Debt-Service Savings and Grants Boost Social Expenditures?," IMF Working Papers 06/180, International Monetary Fund. [Downloadable!]
  21. Mukherjee, Anit N., 2007. "Public expenditure on education: A review of selected issues and evidence," Working Papers hd1, National Institute of Public Finance and Policy. [Downloadable!]
  22. Andrew Sumner & Meera Tiwari, 2005. "Poverty and economic policy: what happens when researchers disagree?," Journal of International Development, John Wiley & Sons, Ltd., vol. 17(6), pages 791-801. [Downloadable!]
  23. Dasgupta, Susmita & Deichmann, Uwe & Meisner, Craig & Wheeler, David, 2003. "The poverty/environment nexus in Cambodia and Lao People's Democratic Republic," Policy Research Working Paper Series 2960, The World Bank. [Downloadable!]
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