IDEAS home Printed from https://ideas.repec.org/a/wly/ectrin/v34y2026i1p87-100.html

Healing or Harming? Unveiling the Dual Impact of IMF Reforms on Child Health Outcomes in Developing Nations

Author

Listed:
  • Michael Chletsos
  • Nikolaos Mylonidis
  • Andreas Sintos

Abstract

We provide new insights regarding the impact of IMF programme participation and imposed policy reforms on child mortality rates using a sample of developing countries from 2000 to 2013. To account for the selection bias related to both IMF participation and conditionality, we employ a recently developed compound instrumental variables methodology. Using annual data, we show that IMF programme participation and state‐owned enterprise (SOE) privatisation conditions improve recipient countries' child mortality rates, whereas all other conditions exert an adverse effect on child mortality rates. These novel findings highlight the heterogeneous effect of IMF conditionalities and document that mandated policy reforms aimed at alleviating mismanagement and inefficiencies in SOEs can actually lead to lower child mortality rates. More generally, our results suggest that the IMF's focus on specific structural reforms, rather than on widening the scope of conditionality, is likely to yield better public health outcomes.

Suggested Citation

  • Michael Chletsos & Nikolaos Mylonidis & Andreas Sintos, 2026. "Healing or Harming? Unveiling the Dual Impact of IMF Reforms on Child Health Outcomes in Developing Nations," Economics of Transition and Institutional Change, John Wiley & Sons, vol. 34(1), pages 87-100, January.
    • Handle: RePEc:wly:ectrin:v:34:y:2026:i:1:p:87-100
    DOI: 10.1111/ecot.70003
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/ecot.70003
    Download Restriction: no
    File URL: https://libkey.io/10.1111/ecot.70003?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Daoud, Adel & Herlitz, Anders & Subramanian, S.V., 2022. "IMF fairness: Calibrating the policies of the International Monetary Fund based on distributive justice," World Development, Elsevier, vol. 157(C).
    2. Vreeland,James Raymond, 2003. "The IMF and Economic Development," Cambridge Books, Cambridge University Press, number 9780521016957.
    3. Sebastian Galiani & Paul Gertler & Ernesto Schargrodsky, 2005. "Water for Life: The Impact of the Privatization of Water Services on Child Mortality," Journal of Political Economy, University of Chicago Press, vol. 113(1), pages 83-120, February.
    4. Guilkey, David K. & Riphahn, Regina T., 1998. "The determinants of child mortality in the Philippines: estimation of a structural model," Journal of Development Economics, Elsevier, vol. 56(2), pages 281-305, August.
    5. Kosec, Katrina, 2014. "The child health implications of privatizing africa's urban water supply," Journal of Health Economics, Elsevier, vol. 35(C), pages 1-19.
    6. Paolo Verme, 2011. "The Poverty Reduction Capacity of Public and Private Transfers in Transition," Journal of Development Studies, Taylor & Francis Journals, vol. 47(6), pages 870-893.
    7. Michael Clemens and Michael Kremer, 2016. "The New Role of the World Bank - Working Paper 421," Working Papers 421, Center for Global Development.
    8. Forster, Timon & Kentikelenis, Alexander E. & Stubbs, Thomas H. & King, Lawrence P., 2020. "Globalization and health equity: The impact of structural adjustment programs on developing countries," Social Science & Medicine, Elsevier, vol. 267(C).
    9. Kentikelenis, Alexander E., 2017. "Structural adjustment and health: A conceptual framework and evidence on pathways," Social Science & Medicine, Elsevier, vol. 187(C), pages 296-305.
    10. Valentin Lang, 2021. "The economics of the democratic deficit: The effect of IMF programs on inequality," The Review of International Organizations, Springer, vol. 16(3), pages 599-623, July.
    11. Michael A. Clemens & Michael Kremer, 2016. "The New Role for the World Bank," Journal of Economic Perspectives, American Economic Association, vol. 30(1), pages 53-76, Winter.
    12. Navarro, Vicente & Shi, Leiyu, 2001. "The political context of social inequalities and health," Social Science & Medicine, Elsevier, vol. 52(3), pages 481-491, February.
    13. Stubbs, Thomas H. & Kentikelenis, Alexander E. & King, Lawrence P., 2016. "Catalyzing Aid? The IMF and Donor Behavior in Aid Allocation," World Development, Elsevier, vol. 78(C), pages 511-528.
    14. Chletsos, Michael & Sintos, Andreas, 2023. "The effects of IMF conditional programs on the unemployment rate," European Journal of Political Economy, Elsevier, vol. 76(C).
    15. Bird, Graham & Hussain, Mumtaz & Joyce, Joseph P., 2004. "Many happy returns? Recidivism and the IMF," Journal of International Money and Finance, Elsevier, vol. 23(2), pages 231-251, March.
    16. Ruger, J.P., 2005. "The changing role of the World Bank in global health," American Journal of Public Health, American Public Health Association, vol. 95(1), pages 60-70.
    17. Nooruddin, Irfan & Simmons, Joel W., 2006. "The Politics of Hard Choices: IMF Programs and Government Spending," International Organization, Cambridge University Press, vol. 60(4), pages 1001-1033, October.
    18. Mbiankeu Nguea, Stéphane, 2024. "Uncovering the linkage between sustainable development goals for access to electricity and access to safely managed drinking water and sanitation services," Social Science & Medicine, Elsevier, vol. 345(C).
    19. Barro, Robert J. & Lee, Jong-Wha, 2005. "IMF programs: Who is chosen and what are the effects?," Journal of Monetary Economics, Elsevier, vol. 52(7), pages 1245-1269, October.
    20. Stephen C. Nelson & Geoffrey P. R. Wallace, 2017. "Are IMF lending programs good or bad for democracy?," The Review of International Organizations, Springer, vol. 12(4), pages 523-558, December.
    21. Rickard, Stephanie J. & Caraway, Teri L., 2014. "International Negotiations in the Shadow of National Elections," International Organization, Cambridge University Press, vol. 68(3), pages 701-720, July.
    22. George R.G. Clarke & Katrina Kosec & Scott Wallsten, 2009. "Has private participation in water and sewerage improved coverage? Empirical evidence from Latin America," Journal of International Development, John Wiley & Sons, Ltd., vol. 21(3), pages 327-361.
    23. Bird, Graham, 2002. "The credibility and signalling effect of IMF programmes," Journal of Policy Modeling, Elsevier, vol. 24(9), pages 799-811, December.
    24. Byungwon Woo, 2013. "Conditional on Conditionality: IMF Program Design and Foreign Direct Investment," International Interactions, Taylor & Francis Journals, vol. 39(3), pages 292-315, July.
    25. Li, Larry & Sy, Malick & McMurray, Adela, 2015. "Insights into the IMF bailout debate: A review and research agenda," Journal of Policy Modeling, Elsevier, vol. 37(6), pages 891-914.
    26. Oberdabernig, Doris A., 2013. "Revisiting the Effects of IMF Programs on Poverty and Inequality," World Development, Elsevier, vol. 46(C), pages 113-142.
    27. Benedict Clements & Sanjeev Gupta & Masahiro Nozaki, 2013. "What happens to social spending in IMF-supported programmes?," Applied Economics, Taylor & Francis Journals, vol. 45(28), pages 4022-4033, October.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Thomas Stubbs & Bernhard Reinsberg & Alexander Kentikelenis & Lawrence King, 2020. "How to evaluate the effects of IMF conditionality," The Review of International Organizations, Springer, vol. 15(1), pages 29-73, January.
    2. Chletsos, Michael & Sintos, Andreas, 2023. "The effects of IMF conditional programs on the unemployment rate," European Journal of Political Economy, Elsevier, vol. 76(C).
    3. Iasmin Goes, 2023. "Examining the effect of IMF conditionality on natural resource policy," Economics and Politics, Wiley Blackwell, vol. 35(1), pages 227-285, March.
    4. Marijana Andrijić & Tajana Barbić, 2021. "When the Going Gets Tough … the Effect of Economic Reform Programmes on National Well-Being," Sustainability, MDPI, vol. 13(20), pages 1-19, October.
    5. Stubbs, Thomas & Kentikelenis, Alexander & Stuckler, David & McKee, Martin & King, Lawrence, 2017. "The impact of IMF conditionality on government health expenditure: A cross-national analysis of 16 West African nations," Social Science & Medicine, Elsevier, vol. 174(C), pages 220-227.
    6. Chletsos, Michael & Sintos, Andreas, 2021. "Hide and seek: IMF intervention and the shadow economy," Structural Change and Economic Dynamics, Elsevier, vol. 59(C), pages 292-319.
    7. Forster, Timon & Kentikelenis, Alexander E. & Stubbs, Thomas H. & King, Lawrence P., 2020. "Globalization and health equity: The impact of structural adjustment programs on developing countries," Social Science & Medicine, Elsevier, vol. 267(C).
    8. Donnat, Grégory, 2025. "IMF programs for growing out of debt: Evidence of a catalytic effect on foreign direct investment," International Economics, Elsevier, vol. 183(C).
    9. Bomprezzi, Pietro & Marchesi, Silvia, 2023. "A firm level approach on the effects of IMF programs," Journal of International Money and Finance, Elsevier, vol. 132(C).
    10. Andreas Kern & Bernhard Reinsberg & Claire Lee, 2025. "The unintended consequences of IMF programs: Women left behind in the labor market," The Review of International Organizations, Springer, vol. 20(4), pages 741-767, December.
    11. Bernhard Reinsberg & Thomas Stubbs & Alexander Kentikelenis & Lawrence King, 2020. "Bad governance: How privatization increases corruption in the developing world," Regulation & Governance, John Wiley & Sons, vol. 14(4), pages 698-717, October.
    12. Valentin Lang, 2021. "The economics of the democratic deficit: The effect of IMF programs on inequality," The Review of International Organizations, Springer, vol. 16(3), pages 599-623, July.
    13. Mr. Christian Mumssen & Yasemin Bal Gündüz & Mr. Christian H Ebeke & Ms. Linda Kaltani, 2013. "IMF-Supported Programs in Low Income Countries: Economic Impact over the Short and Longer Term," IMF Working Papers 2013/273, International Monetary Fund.
    14. Bernhard Reinsberg & Alexander Kentikelenis & Thomas Stubbs & Lawrence King & Centre for Business Research, 2018. "The World System & the Hollowing-out of State Capacity: How Structural Adjustment Programs Impact Bureaucratic Quality in Developing Countries," Working Papers wp503, Centre for Business Research, University of Cambridge.
    15. Stephanie J. Rickard & Teri L. Caraway, 2019. "International demands for austerity: Examining the impact of the IMF on the public sector," The Review of International Organizations, Springer, vol. 14(1), pages 35-57, March.
    16. Bernhard Reinsberg & Thomas Stubbs & Alexander Kentikelenis, 2022. "Compliance, defiance, and the dependency trap: International Monetary Fund program interruptions and their impact on capital markets," Regulation & Governance, John Wiley & Sons, vol. 16(4), pages 1022-1041, October.
    17. Gehring, Kai & Lang, Valentin, 2020. "Stigma or cushion? IMF programs and sovereign creditworthiness," Journal of Development Economics, Elsevier, vol. 146(C).
    18. Axel Dreher & Katharina Michaelowa, 2008. "The political economy of international organizations," The Review of International Organizations, Springer, vol. 3(4), pages 331-334, December.
    19. Brendan Skip Mark & Huei-Jyun Ye & Andrew Foote & Tiffani Crippin, 2021. "It’s a Hard-Knock Life: Child Labor Practices and Compliance with IMF Agreements," Social Sciences, MDPI, vol. 10(5), pages 1-21, May.
    20. Ricardo Alonzo Fern'andez Salguero, 2025. "The Crisis Simulator for Bolivia (KISr-p): An Empirically Grounded Modeling Framework," Papers 2510.16537, arXiv.org.

    More about this item

    Statistics

    Access and download statistics

    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:wly:ectrin:v:34:y:2026:i:1:p:87-100. See general information about how to correct material in RePEc.

    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.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with 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.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: https://doi.org/10.1111/(ISSN)2577-6983 .

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

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.