Child Mortality and Public Spending on Health: How Much Does Money Matter?

47 Pages Posted: 20 Apr 2016

See all articles by Deon Filmer

Deon Filmer

World Bank; World Bank - Development Research Group (DECRG)

Lant Pritchett

Harvard University - Harvard Kennedy School (HKS); Center for Global Development

Date Written: November 1999

Abstract

Roughly 95 percent of cross-national variation in child or infant mortality can be explained by a country's per capita income, the distribution of income, the extent of women's education, the level of ethnic fragmentation, and the predominant religion. Public spending on health has relatively little impact.

Filmer and Pritchett use cross-national data to examine the impact on child (under 5) and infant mortality of both nonhealth (economic, cultural, and educational) factors and public spending on health. They come up with two striking findings: ° Roughly 95 percent of cross-national variation in mortality can be explained by a country's per capita income, the distribution of income, the extent of women's education, the level of ethnic fragmentation, and the predominant religion. ° Public spending on health has relatively little impact, with a coefficient that is numerically small and statistically insignificant at conventional levels. Independent variations in public spending explain less than one-tenth of 1 percent of the observed differences in mortality across countries.

The estimates imply that for a developing country at average income levels, actual public spending per child death averted is $50,000 to $100,000. This contrasts markedly with a typical range of estimates for the cost-effectiveness of medical interventions to avert the main causes of child mortality of $10 to $4,000.

They outline three possible explanations for this divergence between the actual and apparent potential of public spending: the allocation of public spending, the net impact of additional public supply, and public sector efficacy.

This paper - a product of the Development Research Group - is part of a larger effort in the group to investigate the impact of health sector policies. The study was funded by the Bank's Research Support Budget under the research Project Primary Health Care: A Critical Evaluation (RPO 680-29). Deon Filmer may be contacted at dfilmer@worldbank.org.

Suggested Citation

Filmer, Deon and Pritchett, Lant, Child Mortality and Public Spending on Health: How Much Does Money Matter? (November 1999). World Bank Policy Research Working Paper No. 1864. Available at SSRN: https://ssrn.com/abstract=615010

Deon Filmer (Contact Author)

World Bank ( email )

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HOME PAGE: http://go.worldbank.org/MRWPOHRQJ0

World Bank - Development Research Group (DECRG)

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MSN3-311
Washington, DC 20433
United States

Lant Pritchett

Harvard University - Harvard Kennedy School (HKS) ( email )

79 John F. Kennedy Street
Cambridge, MA 02138
United States
617-496-4562 (Phone)
617-496-2554 (Fax)

HOME PAGE: http://ksghome.harvard.edu/~lpritch/

Center for Global Development

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5th floor
Washington, DC 20036
United States

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