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Does Contracting-Out Primary Care Services Work?: The Case of Rural Guatemala

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Listed:
  • Cristia, Julian P.
  • Evans, William N.
  • Beomsoo, Kim

Abstract

This paper estimates the impact of a large-scale contracting-out program in Guatemala, using two waves of living standard measurement surveys which collected data before and after the expansion of the program and exploiting variation in the timing of the program to estimate treatment effects. Results indicate large program impacts on immunization rates for children and prenatal care provider choices. The program increases substantially the role of physician and nurses as prenatal care providers at the expense of traditional midwives. There is no evidence of effects in family planning outcomes. Taken together these results suggest a potential effective role of contracting-out in the provision of health care.

Suggested Citation

  • Cristia, Julian P. & Evans, William N. & Beomsoo, Kim, 2011. "Does Contracting-Out Primary Care Services Work?: The Case of Rural Guatemala," IDB Publications (Working Papers) 3803, Inter-American Development Bank.
    • Handle: RePEc:idb:brikps:3803
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    References listed on IDEAS

    as
    1. A. Colin Cameron & Jonah B. Gelbach & Douglas L. Miller, 2008. "Bootstrap-Based Improvements for Inference with Clustered Errors," The Review of Economics and Statistics, MIT Press, vol. 90(3), pages 414-427, August.
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    3. Filmer, Deon & Pritchett, Lant, 1999. "The impact of public spending on health: does money matter?," Social Science & Medicine, Elsevier, vol. 49(10), pages 1309-1323, November.
    4. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    5. Filmer, Deon & Hammer, Jeffrey S & Pritchett, Lant H, 2000. "Weak Links in the Chain: A Diagnosis of Health Policy in Poor Countries," The World Bank Research Observer, World Bank, vol. 15(2), pages 199-224, August.
    6. Basinga, Paulin & Gertler, Paul J. & Binagwaho, Agnes & Soucat, Agnes L.B. & Sturdy, Jennifer R. & Vermeersch, Christel M.J., 2010. "Paying primary health care centers for performance in Rwanda," Policy Research Working Paper Series 5190, The World Bank.
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    Cited by:

    1. Busso, Matias & Cristia, Julian & Humpage, Sarah, 2015. "Did you get your shots? Experimental evidence on the role of reminders," Journal of Health Economics, Elsevier, vol. 44(C), pages 226-237.
    2. Busso, Matias & Cristia, Julian & Humpage, Sarah, 2015. "Did you get your shots? Experimental evidence on the role of reminders," Journal of Health Economics, Elsevier, vol. 44(C), pages 226-237.
    3. Cristia, Julian & Prado, Ariadna García & Peluffo, Cecilia, 2015. "The Impact of Contracting in and Contracting out Basic Health Services: The Guatemalan Experience," World Development, Elsevier, vol. 70(C), pages 215-227.

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    More about this item

    Keywords

    IDB-WP-273; Child health services; Infant health services; Immunization of children; Contracting-out; Health care provision; Guatemala;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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