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Is Results-Based Aid More Effective than Conventional Aid?: Evidence from the Health Sector in El Salvador

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  • Bernal, Pedro
  • Martinez, Sebastian
  • Celhay, Pablo

Abstract

Results-based aid (RBA) models link funds to outcomes, rather than paying for inputs. Despite their theoretical appeal and recent adoption by donors and multilateral development banks, there is limited empirical evidence supporting this form of aid for national governments. We estimate the effects of a RBA model using a natural experiment in El Salvador, where the same community health intervention was implemented in 98 municipalities using one of three financing models. The Salud Mesoamerica Initiative funded fourteen municipalities with a RBA model that partially conditions funds on the attainment of externally measured maternal and child health targets. Fifty-four municipalities funded inputs using conventional aid and thirty had national funds. Using a difference-in-difference approach and national health systems data we find that preventive health services increased by 19.8% in conventional aid municipalities and by 42% in RBA municipalities compared to national funds, suggesting that the results-based conditionality roughly doubled aid effectiveness. Effects are driven by increases in maternal and child preventive services incentivized by the RBA model. Rather than diverting resources from other populations, we find that the expansion of health services under RBA also benefited men and the elderly, not explicitly incentivized by the results model. While data on final health outcomes are not available, our results on proxy measures point to potential improvements in population health. The effects appear to have been driven by a more rapid expansion of health infrastructure and qualified personnel by motivated national authorities.

Suggested Citation

  • Bernal, Pedro & Martinez, Sebastian & Celhay, Pablo, 2020. "Is Results-Based Aid More Effective than Conventional Aid?: Evidence from the Health Sector in El Salvador," IDB Publications (Working Papers) 8750, Inter-American Development Bank.
    • Handle: RePEc:idb:brikps:8750
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    1. Kaufmann, Daniel & Kraay, Aart & Zoido-Lobaton, Pablo, 1999. "Governance matters," Policy Research Working Paper Series 2196, The World Bank.
    2. Katharina PISTOR, 2000. "The Standardization Of Law And Its Effect On Developing Economies," G-24 Discussion Papers 4, United Nations Conference on Trade and Development.
    3. Yifu Lin, Justin & Nugent, Jeffrey B., 1995. "Institutions and economic development," Handbook of Development Economics, in: Hollis Chenery & T.N. Srinivasan (ed.), Handbook of Development Economics, edition 1, volume 3, chapter 38, pages 2301-2370, Elsevier.
    4. Dani Rodrik, 1998. "Why Do More Open Economies Have Bigger Governments?," Journal of Political Economy, University of Chicago Press, vol. 106(5), pages 997-1032, October.
    5. David H. Romer & Jeffrey A. Frankel, 1999. "Does Trade Cause Growth?," American Economic Review, American Economic Association, vol. 89(3), pages 379-399, June.
    6. Edwards, Sebastian, 1998. "Openness, Productivity and Growth: What Do We Really Know?," Economic Journal, Royal Economic Society, vol. 108(447), pages 383-398, March.
    7. North, Douglass C. & Weingast, Barry R., 1989. "Constitutions and Commitment: The Evolution of Institutions Governing Public Choice in Seventeenth-Century England," The Journal of Economic History, Cambridge University Press, vol. 49(4), pages 803-832, December.
    8. Daron Acemoglu & Simon Johnson & James A. Robinson, 2001. "The Colonial Origins of Comparative Development: An Empirical Investigation," American Economic Review, American Economic Association, vol. 91(5), pages 1369-1401, December.
    9. Jeffrey D. Sachs & Andrew Warner, 1995. "Economic Reform and the Process of Global Integration," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 26(1, 25th A), pages 1-118.
    10. Hoff, Karla, 2008. "Joseph E. Stiglitz," Policy Research Working Paper Series 4478, The World Bank.
    11. Francisco Rodriguez & Dani Rodrik, 2001. "Trade Policy and Economic Growth: A Skeptic's Guide to the Cross-National Evidence," NBER Chapters, in: NBER Macroeconomics Annual 2000, Volume 15, pages 261-338, National Bureau of Economic Research, Inc.
    12. Dan Ben-David, 1993. "Equalizing Exchange: Trade Liberalization and Income Convergence," The Quarterly Journal of Economics, Oxford University Press, vol. 108(3), pages 653-679.
    13. Finger, J Michael, 1981. "Policy Research," Journal of Political Economy, University of Chicago Press, vol. 89(6), pages 1270-1271, December.
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    Cited by:

    1. Thomas Gries & Tim Krieger & Daniel Meierrieks, 2011. "Causal Linkages Between Domestic Terrorism and Economic Growth," Defence and Peace Economics, Taylor & Francis Journals, vol. 22(5), pages 493-508, June.
    2. Andrei A. Levchenko, 2013. "International Trade and Institutional Change," Journal of Law, Economics, and Organization, Oxford University Press, vol. 29(5), pages 1145-1181, October.
    3. Baliamoune-Lutz, Mina & Addison, Tony, 2007. "Economic reform when institutional quality is weak: The case of the Maghreb," Journal of Policy Modeling, Elsevier, vol. 29(1), pages 65-79.
    4. Thanh Le, 2009. "Trade, Remittances, Institutions, and Economic Growth," International Economic Journal, Taylor & Francis Journals, vol. 23(3), pages 391-408.
    5. Belloc, Marianna, 2005. "Cross-Cultural Trade and Internal Institutional Stability," Department of Economics, Working Paper Series qt1wj7v0sn, Department of Economics, Institute for Business and Economic Research, UC Berkeley.
    6. Martinez, Sebastian & Bernal, Pedro, 2020. "In-Kind Incentives and Health Worker Performance: Experimental Evidence from El Salvador," IDB Publications (Working Papers) 45, Inter-American Development Bank.
    7. Pierre‐Guillaume Méon & Khalid Sekkat, 2008. "Institutional Quality And Trade: Which Institutions? Which Trade?," Economic Inquiry, Western Economic Association International, vol. 46(2), pages 227-240, April.
    8. David Dollar & Aart Kraay, 2004. "Trade, Growth, and Poverty," Economic Journal, Royal Economic Society, vol. 114(493), pages 22-49, February.
    9. Chahir Zaki & Fida Karam, 2017. "Why Don’t MENA Countries Trade More? The Curse of Bad Institutions," Working Papers 1148, Economic Research Forum, revised 10 2003.
    10. Christine Mutz & Thomas Ziesemer, 2008. "Simultaneous estimation of income and price elasticities of export demand, scale economies and total factor productivity growth for Brazil," Applied Economics, Taylor & Francis Journals, vol. 40(22), pages 2921-2937.
    11. Subhayu Bandyopadhyay & Suryadipta Roy, 2006. "Corruption and Trade Protection: Evidence from Panel Data," Working Papers 06-11 Classification- JEL, Department of Economics, West Virginia University.
    12. Dang, D Anh, 2010. "Trade Liberalization and Institutional Quality: Evidence from Vietnam," MPRA Paper 26346, University Library of Munich, Germany, revised 31 Aug 2010.
    13. Fenske, James, 2010. "Institutions in African history and development: A review essay," MPRA Paper 23120, University Library of Munich, Germany.
    14. Dollar, David & Kraay, Aart, 2003. "Institutions, trade, and growth," Journal of Monetary Economics, Elsevier, vol. 50(1), pages 133-162, January.
    15. Marschall, Paul, 2018. "Evidence-oriented approaches in development cooperation: experiences, potential and key issues," Discussion Papers 8/2018, German Development Institute / Deutsches Institut für Entwicklungspolitik (DIE).

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