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Healthcare Reform and Gender Specific Child Investment in Developing Countries


  • Juergen Jung

    (Department of Economics, Towson University)

  • Vinish Shrestha

    (Department of Economics, Towson University)


We estimate to what extent a large scale health care reform disproportionately affects the mortality rate of boys in the context of a developing country with cultural preferences favoring boys. We use arguably exogenous variations due to a health care reform—the National Health Policy—which was implemented in Nepal in 1991 along with data from the Nepal Living Standard Survey 1996 and estimate that improved quality of primary health care facilities (by one standard deviation) can reduce the mortality rate of infant boys by 3.3 percentage points but does not affect the mortality rate of infant girls. We then construct a new cost measure for access to care in newly provisioned hospitals and find that higher access costs (by one standard deviation) increase the mortality rate of infant boys by 4 percentage points after the reform but, again, do not affect the mortality rate of girls. Our analysis points to societal gender preferences for sons and the consequent neglect of daughters' health as potential drivers of some of the observed differences in mortality between genders. Our research highlights the important role of cultural norms in shaping the outcomes of large scale health care reforms.

Suggested Citation

  • Juergen Jung & Vinish Shrestha, 2020. "Healthcare Reform and Gender Specific Child Investment in Developing Countries," Working Papers 2020-04, Towson University, Department of Economics, revised Aug 2021.
  • Handle: RePEc:tow:wpaper:2020-04

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    References listed on IDEAS

    1. Government of India, 2017. "National Health Policy 2017," Working Papers id:11664, eSocialSciences.
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    More about this item


    Infant and child mortality; gender specific health investment; health inequality by gender; access to health care in developing nation.;
    All these keywords.

    JEL classification:

    • C35 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions
    • I23 - Health, Education, and Welfare - - Education - - - Higher Education; Research Institutions
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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