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Poverty, Health Infrastructure and the Nutrition of Peruvian Children


  • Martin Valdivia


After the Peruvian economic crisis of the late 1980s, the 1990s witnessed a significant pro-poor expansion of the country`s health infrastructure that was instrumental in increasing preventive and primary health care expenditures. Using empirical evidence, this paper discusses the effect of this expansion in health infrastructure on child nutrition in Peru, as measured by the height-for-age z-score. Using a pooled sample from the 1992, 1996 and 2000 rounds of the Peruvian DHS, this analysis controls for biases in the allocation of public investments by using a district fixed effects model. The econometric analysis finds a positive albeit small effect of the expansion of the last decade. After desegregating by type of location, however, the effect was found to be significant only in urban areas. Furthermore, the effect is highly nonlinear and has a pro-poor bias. The estimated coefficient for health infrastructure in less endowed districts is 10 times higher than that in the better-endowed districts. The pro-poor bias refers to the fact that the estimated effect is larger for children of less educated mothers. In this sense, this policy seems to have had a pro-poor bias within urban areas, while at the same time excluding the rural population, a traditionally marginalized population group in Peru. These findings support the idea that reducing distance and waiting time barriers may be necessary, but that more explicitly inclusive policies are required to improve the health of the rural poor, especially indigenous groups, so that they can escape this kind of poverty trap.

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  • Martin Valdivia, 2004. "Poverty, Health Infrastructure and the Nutrition of Peruvian Children," Research Department Publications 3193, Inter-American Development Bank, Research Department.
  • Handle: RePEc:idb:wpaper:3193

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    References listed on IDEAS

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    2. Martín Valdivia, 2002. "Acerca de la magnitud de la inequidad en salud en el Perú," Documentos de Investigación dt37, Grupo de Análisis para el Desarrollo (GRADE).
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    7. Behrman, Jere R. & Deolalikar, Anil B., 1988. "Health and nutrition," Handbook of Development Economics,in: Hollis Chenery & T.N. Srinivasan (ed.), Handbook of Development Economics, edition 1, volume 1, chapter 14, pages 631-711 Elsevier.
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    Cited by:

    1. Ramirez, N.F. & Gamboa, L.F. & Bedi, A.S. & Sparrow, R.A., 2012. "Child malnutrition and antenatal care: Evidence from three Latin American countries," ISS Working Papers - General Series 536, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
    2. César P. Bouillon & Luis Tejerina, 2006. "Do We Know What Works?: A Systematic Review of Impact Evaluations of Social Programs in Latin America and the Caribbean," IDB Publications (Working Papers) 2801, Inter-American Development Bank.
    3. Behrman, Jere R. & Skoufias, Emmanuel, 2004. "Correlates and determinants of child anthropometrics in Latin America: background and overview of the symposium," Economics & Human Biology, Elsevier, vol. 2(3), pages 335-351, December.
    4. Steckel, Richard H., 2009. "Heights and human welfare: Recent developments and new directions," Explorations in Economic History, Elsevier, vol. 46(1), pages 1-23, January.
    5. Inter-American Development Bank (IDB), 2005. "The Millennium Development Goals in Latin America and the Caribbean: Progress, Priorities and IDB Support for their Implementation," IDB Publications (Books), Inter-American Development Bank, number 53698, February.
    6. Krause, Brooke Laura, 2013. "Childhood Malnutrition and Educational Attainment: An Analysis using Oxford's Young Lives Longitudinal Study in Peru," 2013 Annual Meeting, August 4-6, 2013, Washington, D.C. 150598, Agricultural and Applied Economics Association.
    7. Krause, Brooke Laura, 2012. "Childhood Malnutrition and Educational Attainment: An Analysis using Oxford’s Young Lives Longitudinal Study in Peru," Master's Theses 146072, University of Minnesota, Department of Applied Economics.
    8. Kuang-Yao Pan, William & Erlien, Christine & Bilsborrow, Richard E., 2010. "Morbidity and mortality disparities among colonist and indigenous populations in the Ecuadorian Amazon," Social Science & Medicine, Elsevier, vol. 70(3), pages 401-411, February.
    9. Ahmet Caliskan & Abdulkadir Civan & Mehmet Karakuyu, 2011. "Where Should We Spend Government's Money? The Effect of Public Sector Investments on Socioeconomic Development in Turkey," European Journal of Economic and Political Studies, Fatih University, vol. 4(1), pages 1-11.
    10. -, 2008. "Millennium development goals: progress towards the right to health in Latin america and the Caribbean," Libros y Documentos Institucionales, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL), number 2919 edited by Eclac.
    11. César P. Bouillon & Luis Tejerina, 2006. "Do We Know What Works?: A Systematic Review of Impact Evaluations of Social Programs in Latin America and the Caribbean," IDB Publications (Working Papers) 80443, Inter-American Development Bank.
    12. Paraje, Guillermo, 2009. "Child stunting and and socio-economic inequality in Latin America and the Caribbean," Revista CEPAL, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL), December.
    13. Djimeu, Eric W., 2014. "The impact of social action funds on child health in a conflict affected country: Evidence from Angola," Social Science & Medicine, Elsevier, vol. 106(C), pages 35-42.

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