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The enduring influence of institutions on universal health coverage: An empirical investigation of 62 former colonies

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  • Miller, Michael
  • Toffolutti, Veronica
  • Reeves, Aaron

Abstract

In this paper, we argue that particular institutional arrangements partly explain the large and persistent differences in health systems and health outcomes observed in former colonies. Drawing on data from the World Health Organization for 62 countries, covering the period 2000–2014, we explore whether economic (risk of expropriation) and health (complete cause of death registries) institutions explain mortality rates and access to healthcare. To identify this relationship, we use settler mortality and the distance of the capital from the nearest major port – factors associated with institutional arrangements – to explain cross-national variation in health outcomes and the universality of health systems. We find that inclusive institutions arrangements – that protect and acknowledge the rights of citizens – are associated with better health outcomes (e.g. lower infant mortality and lower maternal mortality) as well as with better health systems (e.g. more skilled birth attendance and greater immunization). Inclusive institutions not only foster economic growth but improve health and well-being too.

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  • Miller, Michael & Toffolutti, Veronica & Reeves, Aaron, 2018. "The enduring influence of institutions on universal health coverage: An empirical investigation of 62 former colonies," World Development, Elsevier, vol. 111(C), pages 270-287.
    • Handle: RePEc:eee:wdevel:v:111:y:2018:i:c:p:270-287
    DOI: 10.1016/j.worlddev.2018.07.010
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    2. Xiaofeng Shi & Jianying Li & Fei Wang & Hasan Dinçer & Serhat Yüksel, 2019. "A Hybrid Decision-Making Approach for the Service and Financial-Based Measurement of Universal Health Coverage for the E7 Economies," IJERPH, MDPI, vol. 16(18), pages 1-20, September.
    3. Thang, Doan Ngoc & Ha, Le Thanh, 2022. "Trade credit and global value chain: Evidence from cross-country firm-level data," International Economics, Elsevier, vol. 171(C), pages 110-129.
    4. Reeves, Aaron & Sochas, Laura, 2022. "When do democratic transitions reduce or increase child mortality? Exploring the role of non-violent resistance," Social Science & Medicine, Elsevier, vol. 314(C).
    5. Ghasemi, Abdolrasoul & Boroumand, Yasaman & Shirazi, Masoud, 2020. "How do governments perform in facing COVID-19?," MPRA Paper 99791, University Library of Munich, Germany, revised 20 Apr 2020.

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    More about this item

    Keywords

    Institutions; Health coverage; Instrumental variables;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • P16 - Political Economy and Comparative Economic Systems - - Capitalist Economies - - - Capitalist Institutions; Welfare State
    • P51 - Political Economy and Comparative Economic Systems - - Comparative Economic Systems - - - Comparative Analysis of Economic Systems

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