Political Turnover and Public Health Provision in Brazilian Municipalities

The objective of this work is to estimate the effects of political turnover on municipal health indicators. For this purpose, we used a regression discontinuity design applied to a pool of data on close municipal elections that occurred in 2008 and 2012. The outcome variables tested were municipal health indicators observed 1 and 3 years after the elections. We assume that the change of parties in the leadership of the municipal executive power alters the managers and public health policies and, therefore, affects the indicators of this sector. Our results indicate that health indicators linked to administrative issues appeared to benefit from political turnover in the period immediately after the elections (1 year). These results were corroborated by our additional estimates (robustness). We highlight that the number of health workers and coverage of primary care remained better 3 years after the elections in municipalities that suffered political turnover, indicating that this improvement resulting from the change in management may not be transient. Finally, through averaging tests, we found that in municipalities where the incumbent lost the election and there was a turnover, health managers were more qualified, and there was greater creation of basic health units.