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Health outcomes in poor countries and policy options : empirical findings from demographic and health surveys

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  • Wang, Limin
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    Abstract

    Empirical studies on health at a disaggregate level-by socioeconomic group or geographic location-can provide useful information for designing poverty-focused interventions. Using Demographic and Health Survey (DHS) data, the author investigates the determinants of health outcomes in low-income countries both at the national level, and for rural and urban areas separately. DHS data from more than 60 low-income countries between 1990 and 1999 reveal two interesting observations. First is the negative association between the level and inequality in child mortality. Second is the significant gap in child mortality between urban and rural areas, with the rural population having a much slower reduction in mortality compared with the urban population. Given that the poor are mainly concentrated in rural areas, the evidence suggests that health interventions implemented in the past decade may not have been as effective as intended in reaching the poor. The empirical findings in this study consolidate results from earlier studies and add new evidence. the author finds that at the national level access to electricity, vaccination in the first year of life, and public health expenditure can significantly reduce child mortality. The electricity effect is shown to be independent of income. In urban areas only access to electricity has a significant health impact, while in rural areas increasing vaccination coverage is important for mortality reduction.

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    Bibliographic Info

    Paper provided by The World Bank in its series Policy Research Working Paper Series with number 2831.

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    Date of creation: 30 Apr 2002
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    Handle: RePEc:wbk:wbrwps:2831

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

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    1. Jean Dreze & Mamta Murthi, 2000. "Fertility, Education and Development: Further Evidence from India," Working papers, Centre for Development Economics, Delhi School of Economics 76, Centre for Development Economics, Delhi School of Economics.
    2. Hentschel, Jesko & Lanjouw, Jean Olson & Lanjouw, Peter & Poggi, Javier, 1998. "Combining census and survey data to study spatial dimensions of poverty," Policy Research Working Paper Series 1928, The World Bank.
    3. Angus Deaton & Christina Paxson, 1999. "Mortality, education, income and inequality among American cohorts," Working Papers, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing. 279, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
    4. 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.
    5. Lant Pritchett & Lawrence H. Summers, 1996. "Wealthier is Healthier," Journal of Human Resources, University of Wisconsin Press, vol. 31(4), pages 841-868.
    6. Angus Deaton, 2001. "Relative Deprivation, Inequality, and Mortality," NBER Working Papers 8099, National Bureau of Economic Research, Inc.
    7. Filmer, Deon & Pritchett, Lant, 1999. "The impact of public spending on health: does money matter?," Social Science & Medicine, Elsevier, Elsevier, vol. 49(10), pages 1309-1323, November.
    8. 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, American Economic Association, vol. 7(1), pages 133-150, Winter.
    9. Angus Deaton, 1999. "Inequalities in income and inequalities in health," Working Papers, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing. 280, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
    10. Hentschel, Jesko, et al, 2000. "Combining Census and Survey Data to Trace the Spatial Dimensions of Poverty: A Case Study of Ecuador," World Bank Economic Review, World Bank Group, World Bank Group, vol. 14(1), pages 147-65, January.
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    Cited by:
    1. Jane Kabubo-Mariara & Margaret M. Karienyeh & Francis K. Mwangi, 2008. "Child Survival, Poverty and Policy Options from DHS Surveys in Kenya: 1993-2003," Working Papers PMMA, PEP-PMMA 2008-01, PEP-PMMA.
    2. Halicioglu, Ferda, 2011. "Modeling life expectancy in Turkey," Economic Modelling, Elsevier, Elsevier, vol. 28(5), pages 2075-2082, September.
    3. Eva Deuchert & Conny Wunsch, 2010. "Evaluating Nationwide Health Interventions When Standard Before-After Doesn't Work: Malawi's ITN Distribution Program," University of St. Gallen Department of Economics working paper series 2010, Department of Economics, University of St. Gallen 2010-12, Department of Economics, University of St. Gallen.

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