Can Institutional Deliveries Reduce Newborn Mortality? Evidence from Rwanda
47 Pages Posted: 27 Jun 2016
Date Written: December 18, 2014
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: Suggested Citation