Decentralization and public services : the case of immunization
The author studies the impact of political decentralization on childhood immunization, an essential public service provided in almost all countries. He examines the relationship empirically using a time-series data set of 140 low- and middle-income countries from 1980 to 1997. The author finds that decentralization has different effects in low- and middle-income countries. In the low-income group, decentralized countries have higher coverage rates than centralized ones, with an average difference of 8.5 percent for measles and DTP3 vaccines. In the middle-income group, the reverse effect is observed: decentralized countries have lower coverage rates than centralized ones, with an average difference of 5.2 percent for the same vaccines. Both results are significant at the 99 percent level. Modifiers of the decentralization-immunization relationship also differ in the two groups. In the low-income group, development assistance reduces the gains from decentralization. In the middle-income group, democratic government mitigates the negative effects of decentralization, and decentralization reverses the negative effects of ethnic tension and ethno-linguistic fractionalization, but institutional quality and literacy rates have no interactive effect either way. Similar results are obtained whether decentralization is measured with a dichotomous categorical variable or with more specific measures of fiscal decentralization. The study confirms predictions in the theoretical literature about the negative impact of local political control on services that have public goods characteristics and inter-jurisdictional externalities. The author discusses reasons for the difference between low- and middle-income countries.
|Date of creation:||31 Mar 2003|
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- Gauri, Varun & Khaleghian, Peyvand, 2002.
"Immunization in Developing Countries: Its Political and Organizational Determinants,"
Elsevier, vol. 30(12), pages 2109-2132, December.
- Gauri, Varun & Khaleghian, Peyvand, 2002. "Immunization in developing countries : its political and organizational determinants," Policy Research Working Paper Series 2769, The World Bank.
- Dilip Mookherjee, 2001. "Combating the Crisis in Government Accountability: A Review of Recent International Experience," Boston University - Department of Economics - The Institute for Economic Development Working Papers Series dp-117, Boston University - Department of Economics.
- Rafael LaPorta & Florencio Lopez-de-Silanes & Andrei Shleifer & Robert Vishny, .
"The Quality of Government,"
19452, Harvard University OpenScholar.
- Andrei Shleifer & Robert W. Vishny, 1998. "The Quality of Government," Harvard Institute of Economic Research Working Papers 1847, Harvard - Institute of Economic Research.
- Rafael La Porta & Florencio Lopez-de-Silanes & Andrei Shleifer & Robert Vishny, 1998. "The Quality of Goverment," NBER Working Papers 6727, National Bureau of Economic Research, Inc.
- Brinkerhoff, Derick W., 2000. "Democratic Governance and Sectoral Policy Reform: Tracing Linkages and Exploring Synergies," World Development, Elsevier, vol. 28(4), pages 601-615, April.
- Tendler, Judith & Freedheim, Sara, 1994. "Trust in a rent-seeking world: Health and government transformed in Northeast Brazil," World Development, Elsevier, vol. 22(12), pages 1771-1791, December.
- Gilson, Lucy & Mills, Anne, 1995. "Health sector reforms in sub-Saharan Africa: lessons of the last 10 years," Health Policy, Elsevier, vol. 32(1-3), pages 215-243.
- Prud'homme, Remy, 1995. "The Dangers of Decentralization," World Bank Research Observer, World Bank Group, vol. 10(2), pages 201-20, August.
- Robalino, David A. & Picazo, Oscar F. & Voetberg, Albertus, 2001. "Does fiscal decentralization improve health outcomes? - evidence from a cross-country analysis," Policy Research Working Paper Series 2565, The World Bank.
- Collins, Charles & Araujo, Jose & Barbosa, Jarbas, 2000. "Decentralising the health sector: issues in Brazil," Health Policy, Elsevier, vol. 52(2), pages 113-127, June.
- Ebel, Robert D. & Yilmaz, Serdar, 2002. "On the measurement and impact of fiscal decentralization," Policy Research Working Paper Series 2809, The World Bank.
- Jonathan Isham & Satu Kahkonen, 2002. "Institutional Determinants of the Impact Community-Based Water Services: Evidence from Sri Lanka and India," Middlebury College Working Paper Series 0220, Middlebury College, Department of Economics.
- Campos-Outcalt, Doug & Kewa, Kelly & Thomason, Jane, 1995. "Decentralization of health services in Western Highlands Province, Papua New Guinea: An attempt to administer health service at the subdistrict level," Social Science & Medicine, Elsevier, vol. 40(8), pages 1091-1098, April.
- Pranab Bardhan & Dilip Mookherjee, 1998. "Expenditure Decentralization and the Delivery of Public Services in Developing Countries," Boston University - Institute for Economic Development 90, Boston University, Institute for Economic Development.
- John Akin & Paul Hutchinson & Koleman Strumpf, 2005. "Decentralisation and government provision of public goods: The public health sector in Uganda," Journal of Development Studies, Taylor & Francis Journals, vol. 41(8), pages 1417-1443.
- Beck, Thorsten & Clarke, George & Groff, Alberto & Keefer, Philip & Walsh, Patrick, 2000. "New tools and new tests in comparative political economy - the database of political institutions," Policy Research Working Paper Series 2283, The World Bank.
- Faguet, Jean-Paul, 2001. "Does decentralization increase responsiveness to local needs? - evidence from Bolivia," Policy Research Working Paper Series 2516, The World Bank.
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