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Chinese Aid and Health at the Country and Local Level

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  • Dreher, Axel
  • Cruzatti C., John
  • Matzat, Johannes

Abstract

We investigate whether and to what extent Chinese development finance affects infant mortality, combining 92 demographic and health surveys (DHS) for a maximum of 53 countries and almost 55,000 sub-national locations over the 2002-2014 period. We address causality by instrumenting aid with a set of interacted variables. Variation over time results from indicators that measure the availability of funding in a given year. Cross-sectional variation results from a sub-national region's "probability to receive aid." Controlled for this probability in tandem with fixed effects for country-years and provinces, the interactions of these variables form powerful and excludable instruments. Our results show that Chinese aid increases infant mortality at sub-national scales, but decreases mortality at the country-level. In several tests, we show that this stark contrast likely results from aid being fungible within recipient countries.

Suggested Citation

  • Dreher, Axel & Cruzatti C., John & Matzat, Johannes, 2020. "Chinese Aid and Health at the Country and Local Level," CEPR Discussion Papers 14862, C.E.P.R. Discussion Papers.
  • Handle: RePEc:cpr:ceprdp:14862
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    Cited by:

    1. Cruzatti C., John, 2021. "Free Trade Agreements and Development: a Global Analysis with Local Data," Working Papers 0702, University of Heidelberg, Department of Economics.
    2. Samuel Brazys & Krishna Chaitanya Vadlamannati, 2021. "Aid curse with Chinese characteristics? Chinese development flows and economic reforms," Public Choice, Springer, vol. 188(3), pages 407-430, September.
    3. Iacoella, Francesco & Martorano, Bruno & Metzger, Laura & Sanfilippo, Marco, 2021. "Chinese official finance and political participation in Africa," European Economic Review, Elsevier, vol. 136(C).
    4. Valentin Lindlacher & Gustav Pirich, 2024. "The Impact of China’s “Stadium Diplomacy” on Local Economic Development in Sub-Saharan Africa," CESifo Working Paper Series 10893, CESifo.
    5. Wellner, Lukas & Dreher, Axel & Fuchs, Andreas & Parks, Bradley & Strange, Austin M., 2022. "Can aid buy foreign public support? Evidence from Chinese development finance," Kiel Working Papers 2214, Kiel Institute for the World Economy (IfW Kiel).
    6. Mandon, Pierre & Woldemichael, Martha Tesfaye, 2023. "Has Chinese aid benefited recipient countries? Evidence from a meta-regression analysis," World Development, Elsevier, vol. 166(C).
    7. Dreher, Axel & Fuchs, Andreas & Hodler, Roland & Parks, Bradley C. & Raschky, Paul A. & Tierney, Michael J., 2021. "Is Favoritism a Threat to Chinese Aid Effectiveness? A Subnational Analysis of Chinese Development Projects," World Development, Elsevier, vol. 139(C).
    8. Marchesi, Silvia & Masi, Tania & Paul, Saumik, 2021. "Project Aid and Firm Performance," IZA Discussion Papers 14705, Institute of Labor Economics (IZA).
    9. Dreher, Axel & Lang, Valentin & Reinsberg, Bernhard, 2024. "Aid effectiveness and donor motives," World Development, Elsevier, vol. 176(C).
    10. Liya Palagashvili & Claudia R. Williamson, 2021. "Grading foreign aid agencies: Best practices across traditional and emerging donors," Review of Development Economics, Wiley Blackwell, vol. 25(2), pages 654-676, May.
    11. Bai, Yu & Li, Yanjun & Wang, Yunuo, 2022. "Chinese aid and local political attitudes," Economic Modelling, Elsevier, vol. 113(C).
    12. Philip Akrofi Atitianti, 2023. "The impact of Chinese aid on political trust," Journal of International Development, John Wiley & Sons, Ltd., vol. 35(2), pages 233-259, March.
    13. Luo, Changyuan & Song, Hong & Zhao, Yi, 2024. "Chinese aid and country image: Average and heterogeneous patterns," China Economic Review, Elsevier, vol. 85(C).
    14. Christopher Kilby, 2020. "Accounting for data uncertainty: Biases in web-scraped Chinese aid data," Villanova School of Business Department of Economics and Statistics Working Paper Series 45, Villanova School of Business Department of Economics and Statistics.
    15. Michael Appiah‐Kubi & Jeneshia Jarrett, 2023. "Chinese aid and crime: Evidence from Africa," Journal of International Development, John Wiley & Sons, Ltd., vol. 35(7), pages 1619-1647, October.
    16. Tritto, Angela & Haini, Hazwan & Wu, Hongsen, 2024. "Help with strings attached? China’s medical assistance and political allegiances during the Covid-19 pandemic," World Development, Elsevier, vol. 178(C).
    17. Lisa Chauvet & Marin Ferry, 2023. "L’efficacité de l’aide : quelles évolutions de la littérature depuis deux décennies ? WP329," Working Papers hal-04141543, HAL.
    18. Li, Jia, 2024. "Less stunted? The impact of Chinese health aid on child nutrition," Social Science & Medicine, Elsevier, vol. 342(C).
    19. Heinzel, Mirko & Reinsberg, Bernhard, 2024. "Trust funds and the sub-national effectiveness of development aid: Evidence from the World Bank," World Development, Elsevier, vol. 179(C).

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    More about this item

    Keywords

    Health aid; Fungibility; Infant mortality;
    All these keywords.

    JEL classification:

    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • F35 - International Economics - - International Finance - - - Foreign Aid

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