Can Institutional Deliveries Reduce Newborn Mortality? Evidence from Rwanda

47 Pages Posted: 27 Jun 2016

See all articles by A.V. Chari

A.V. Chari

University of Sussex - School of Business, Management and Economics

Edward N. Okeke

RAND Corporation

Date Written: December 18, 2014

Abstract

Current global health policies emphasize institutional deliveries as a pathway to achieving reductions in newborn mortality in developing countries. There is however remarkably little evidence regarding a causal relationship between institutional deliveries and newborn mortality. In this paper we take advantage of a shock to institutional deliveries provided by the randomized rollout of a government performance-based financing (PBF) program in Rwanda, to provide the first estimates of this causal effect. Using a combination of difference-in-differences and regression discontinuity approaches, we find that program-induced increases in the rate of institutional delivery have not been successful in reducing the rate of newborn mortality. The findings suggest that attempts to increase institutional deliveries without addressing supply-side constraints are unlikely to result in the large reductions in mortality that policy makers expect.

Keywords: health production, infant mortality, institutional births

JEL Classification: C93, D01, D03, I12

Suggested Citation

Chari, Amalavoyal and Okeke, Edward N., Can Institutional Deliveries Reduce Newborn Mortality? Evidence from Rwanda (December 18, 2014). RAND Working Paper Series WR- 1072. Available at SSRN: https://ssrn.com/abstract=2800311 or http://dx.doi.org/10.2139/ssrn.2800311

Amalavoyal Chari (Contact Author)

University of Sussex - School of Business, Management and Economics ( email )

Falmer, Brighton BN1 9SL
United Kingdom

Edward N. Okeke

RAND Corporation ( email )

1776 Main Street
P.O. Box 2138
Santa Monica, CA 90407-2138
United States

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