IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v59y2004i1p163-183.html
   My bibliography  Save this article

Decentralization and public services: the case of immunization

Author

Listed:
  • Khaleghian, Peyvand

Abstract

This study examines the impact of political decentralization on an essential public service provided in almost all countries: childhood immunization. The relationship is examined empirically using a time-series data set of 140 low- and middle-income countries from 1980 to 1997. The study finds that decentralization has different effects in low- and middle-income countries. In the low-income group, decentralized countries have higher coverage rates than centralized ones, with an average difference of 8.5 percent for the measles and DTP3 vaccines. In the middle-income group, the reverse effect is observed: decentralized countries have lower coverage rates than centralized ones, with an average difference of 5.2 percent for the same vaccines. Both results are significant at the 99 percent level. Modifiers of the decentralization-immunization relationship also differ in the two groups. In the low-income group, development assistance reduces the gains from decentralization. In the middle-income group, democratic government mitigates the negative effects of decentralization, and decentralization reverses the negative effects of ethnic tension and ethno-linguistic fractionalization, but institutional quality and literacy rates have no interactive effect either way. Similar results are obtained whether decentralization is measured with a dichotomous categorical variable or with more specific measures of fiscal decentralization. The study confirms predictions in the theoretical literature about the negative impact of local political control on services that have public goods characteristics and inter-jurisdictional externalities. Reasons for the difference between low- and middle-income countries are discussed.

Suggested Citation

  • Khaleghian, Peyvand, 2004. "Decentralization and public services: the case of immunization," Social Science & Medicine, Elsevier, vol. 59(1), pages 163-183, July.
  • Handle: RePEc:eee:socmed:v:59:y:2004:i:1:p:163-183
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(03)00549-5
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Vargas Bustamante, Arturo, 2010. "The tradeoff between centralized and decentralized health services: Evidence from rural areas in Mexico," Social Science & Medicine, Elsevier, vol. 71(5), pages 925-934, September.
    2. repec:eee:jcecon:v:45:y:2017:i:2:p:344-365 is not listed on IDEAS
    3. Anila Channa & Jean-Paul Faguet, 2016. "Decentralization of Health and Education in Developing Countries: A Quality-Adjusted Review of the Empirical Literature," World Bank Research Observer, World Bank Group, vol. 31(2), pages 199-241.
    4. Kis-Katos, Krisztina & Sjahrir, Bambang Suharnoko, 2017. "The impact of fiscal and political decentralization on local public investment in Indonesia," Journal of Comparative Economics, Elsevier, vol. 45(2), pages 344-365.
    5. repec:eee:socmed:v:188:y:2017:i:c:p:69-81 is not listed on IDEAS
    6. repec:cup:apsrev:v:108:y:2014:i:01:p:144-168_00 is not listed on IDEAS
    7. Bossert, Thomas John & Mitchell, Andrew David, 2011. "Health sector decentralization and local decision-making: Decision space, institutional capacities and accountability in Pakistan," Social Science & Medicine, Elsevier, vol. 72(1), pages 39-48, January.
    8. Denis Drechsler & Johannes Jütting, 2005. "Is There a Role for Private Health Insurance in Developing Countries?," Discussion Papers of DIW Berlin 517, DIW Berlin, German Institute for Economic Research.
    9. repec:taf:rrpaxx:v:17:y:2012:i:1:p:1-32 is not listed on IDEAS
    10. Daniel Cobos Muñoz & Paloma Merino Amador & Laura Monzon Llamas & David Martinez Hernandez & Juana Maria Santos Sancho, 2017. "Decentralization of health systems in low and middle income countries: a systematic review," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 62(2), pages 219-229, March.
    11. Khaleghian, Peyvand & Gupta, Monica Das, 2005. "Public management and the essential public health functions," World Development, Elsevier, vol. 33(7), pages 1083-1099, July.
    12. World Bank, 2008. "Serbia : Decentralization and Local Service Delivery," World Bank Other Operational Studies 8099, The World Bank.
    13. Malesky, Edmund J. & Nguyen, Cuong Viet & Tran, Anh, 2014. "The Impact of Recentralization on Public Services: A Difference-in-Differences Analysis of the Abolition of Elected Councils in Vietnam," American Political Science Review, Cambridge University Press, vol. 108(01), pages 144-168, February.
    14. Cavalieri, Marina & Ferrante, Livio, 2016. "Does fiscal decentralization improve health outcomes? Evidence from infant mortality in Italy," Social Science & Medicine, Elsevier, vol. 164(C), pages 74-88.
    15. Jiménez-Rubio, Dolores, 2011. "The impact of fiscal decentralization on infant mortality rates: Evidence from OECD countries," Social Science & Medicine, Elsevier, vol. 73(9), pages 1401-1407.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:59:y:2004:i:1:p:163-183. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.