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Determinants of efficiency in reducing child mortality in developing countries. The role of inequality and government effectiveness

Author

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  • Bienvenido Ortega

    (Universidad de Málaga)

  • Jesús Sanjuán

    (Universidad de Málaga)

  • Antonio Casquero

    (Universidad de Málaga)

Abstract

The main aim of this article was to analyze the relationship of income inequality and government effectiveness with differences in efficiency in the use of health inputs to improve the under-five survival rate (U5SR) in developing countries. Robust Data Envelopment Analysis (DEA) and regression analysis were conducted using data for 47 developing countries for the periods 2000–2004, 2005–2009, and 2010–2012. The estimations show that countries with a more equal income distribution and better government effectiveness (i.e. a more competent bureaucracy and good quality public service delivery) may need fewer health inputs to achieve a specific level of the U5SR than other countries with higher inequality and worse government effectiveness.

Suggested Citation

  • Bienvenido Ortega & Jesús Sanjuán & Antonio Casquero, 2017. "Determinants of efficiency in reducing child mortality in developing countries. The role of inequality and government effectiveness," Health Care Management Science, Springer, vol. 20(4), pages 500-516, December.
    • Handle: RePEc:kap:hcarem:v:20:y:2017:i:4:d:10.1007_s10729-016-9367-1
    DOI: 10.1007/s10729-016-9367-1
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    1. Jeroen Klomp & Jakob De Haan, 2008. "Effects of Governance on Health: a Cross‐National Analysis of 101 Countries," Kyklos, Wiley Blackwell, vol. 61(4), pages 599-614, November.
    2. Nazmul Chaudhury & Jeffrey Hammer & Michael Kremer & Karthik Muralidharan & F. Halsey Rogers, 2006. "Missing in Action: Teacher and Health Worker Absence in Developing Countries," Journal of Economic Perspectives, American Economic Association, vol. 20(1), pages 91-116, Winter.
    3. Tanzi, Vito & Schuknecht, Ludger, 1997. "Reconsidering the Fiscal Role of Government: The International Perspective," American Economic Review, American Economic Association, vol. 87(2), pages 164-168, May.
    4. Dobson, Stephen & Ramlogan-Dobson, Carlyn, 2012. "Why is Corruption Less Harmful to Income Inequality in Latin America?," World Development, Elsevier, vol. 40(8), pages 1534-1545.
    5. Bingjie Hu & Ronald U. Mendoza, 2013. "Public Health Spending, Governance and Child Health Outcomes: Revisiting the Links," Journal of Human Development and Capabilities, Taylor & Francis Journals, vol. 14(2), pages 285-311, May.
    6. Wilkinson, Richard G & Pickett, Kate E., 2006. "Income inequality and population health: A review and explanation of the evidence," Social Science & Medicine, Elsevier, vol. 62(7), pages 1768-1784, April.
    7. Sanjeev Gupta & Marijn Verhoeven & Erwin R. Tiongson, 2003. "Public spending on health care and the poor," Health Economics, John Wiley & Sons, Ltd., vol. 12(8), pages 685-696, August.
    8. Harold Fried & Shelton Schmidt & Suthathip Yaisawarng, 1999. "Incorporating the Operating Environment Into a Nonparametric Measure of Technical Efficiency," Journal of Productivity Analysis, Springer, vol. 12(3), pages 249-267, November.
    9. Tandon, Ajay, 2005. "Measuring Efficiency of Macro Systems: An Application to Millennium Development Goal Attainment," Asian Development Review, Asian Development Bank, vol. 22(2), pages 108-125.
    10. David Cutler & Angus Deaton & Adriana Lleras-Muney, 2006. "The Determinants of Mortality," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 97-120, Summer.
    11. Filmer, Deon & Hammer, Jeffrey & Pritchett, Lant, 1998. "Health policy in poor countries : weak links in the chain," Policy Research Working Paper Series 1874, The World Bank.
    12. Gisselquist, Rachel M., 2012. "Good Governance as a Concept, and Why This Matters for Development Policy," WIDER Working Paper Series 030, World Institute for Development Economic Research (UNU-WIDER).
    13. Charnes, A. & Cooper, W. W. & Rhodes, E., 1978. "Measuring the efficiency of decision making units," European Journal of Operational Research, Elsevier, vol. 2(6), pages 429-444, November.
    14. Adler, Nicole & Yazhemsky, Ekaterina & Tarverdyan, Ruzanana, 2010. "A framework to measure the relative socio-economic performance of developing countries," Socio-Economic Planning Sciences, Elsevier, vol. 44(2), pages 73-88, June.
    15. Farasat A. S. Bokhari & Yunwei Gai & Pablo Gottret, 2007. "Government health expenditures and health outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 257-273, March.
    16. Rajkumar, Andrew Sunil & Swaroop, Vinaya, 2008. "Public spending and outcomes: Does governance matter?," Journal of Development Economics, Elsevier, vol. 86(1), pages 96-111, April.
    17. Simar, Leopold & Wilson, Paul W., 2007. "Estimation and inference in two-stage, semi-parametric models of production processes," Journal of Econometrics, Elsevier, vol. 136(1), pages 31-64, January.
    18. Tanzi,Vito & Schuknecht,Ludger, 2000. "Public Spending in the 20th Century," Cambridge Books, Cambridge University Press, number 9780521662918, September.
    19. Léopold Simar & Paul W. Wilson, 1998. "Sensitivity Analysis of Efficiency Scores: How to Bootstrap in Nonparametric Frontier Models," Management Science, INFORMS, vol. 44(1), pages 49-61, January.
    20. Bloom, Gerald, 2001. "Equity in health in unequal societies: meeting health needs in contexts of social change," Health Policy, Elsevier, vol. 57(3), pages 205-224, September.
    21. Brown, T.M. & Cueto, M. & Fee, E., 2006. "The World Health Organization and the transition from international to global public health," American Journal of Public Health, American Public Health Association, vol. 96(1), pages 62-72.
    22. Mansour Farahani & S. V. Subramanian & David Canning, 2010. "Effects of state‐level public spending on health on the mortality probability in India," Health Economics, John Wiley & Sons, Ltd., vol. 19(11), pages 1361-1376, November.
    23. Dietrich, Simone, 2011. "The Politics of Public Health Aid: Why Corrupt Governments Have Incentives to Implement Aid Effectively," World Development, Elsevier, vol. 39(1), pages 55-63, January.
    24. Sudhir Anand & Martin Ravallion, 1993. "Human Development in Poor Countries: On the Role of Private Incomes and Public Services," Journal of Economic Perspectives, American Economic Association, vol. 7(1), pages 133-150, Winter.
    25. Bidani, Benu & Ravallion, Martin, 1997. "Decomposing social indicators using distributional data," Journal of Econometrics, Elsevier, vol. 77(1), pages 125-139, March.
    26. Stephen Knowles & P. Dorian Owen, 2010. "Which Institutions are Good for Your Health? The Deep Determinants of Comparative Cross-country Health Status," Journal of Development Studies, Taylor & Francis Journals, vol. 46(4), pages 701-723.
    27. Marwa Farag & A. Nandakumar & Stanley Wallack & Dominic Hodgkin & Gary Gaumer & Can Erbil, 2013. "Health expenditures, health outcomes and the role of good governance," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 33-52, March.
    28. Adam Wagstaff & Mariam Claeson, 2004. "The Millennium Development Goals for Health : Rising to the Challenges," World Bank Publications - Books, The World Bank Group, number 14954.
    29. 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.
    30. R. D. Banker & A. Charnes & W. W. Cooper, 1984. "Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis," Management Science, INFORMS, vol. 30(9), pages 1078-1092, September.
    31. Sonia Bhalotra, 2007. "Spending to save? State health expenditure and infant mortality in India," Health Economics, John Wiley & Sons, Ltd., vol. 16(9), pages 911-928, September.
    32. Gupta, Sanjeev & Verhoeven, Marijn & Tiongson, Erwin R., 2002. "The effectiveness of government spending on education and health care in developing and transition economies," European Journal of Political Economy, Elsevier, vol. 18(4), pages 717-737, November.
    33. Filmer, Deon & Pritchett, Lant, 1997. "Child mortality and public spending on health : how much does money matter?," Policy Research Working Paper Series 1864, The World Bank.
    34. repec:unu:wpaper:wp2012-30 is not listed on IDEAS
    35. McGuire, James W., 2006. "Basic health care provision and under-5 mortality: A Cross-National study of developing Countries," World Development, Elsevier, vol. 34(3), pages 405-425, March.
    36. Gauri, Varun & Khaleghian, Peyvand, 2002. "Immunization in Developing Countries: Its Political and Organizational Determinants," World Development, Elsevier, vol. 30(12), pages 2109-2132, December.
    37. Ruggiero, John, 2004. "Performance evaluation when non-discretionary factors correlate with technical efficiency," European Journal of Operational Research, Elsevier, vol. 159(1), pages 250-257, November.
    38. Rachel M. Gisselquist, 2012. "Good Governance as a Concept, and Why This Matters for Development Policy," WIDER Working Paper Series wp-2012-030, World Institute for Development Economic Research (UNU-WIDER).
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    4. Gan, Tian & Zhang, Mingxin & Zhang, Zhiqiang, 2023. "The impact of digital government policy on entrepreneurial activity in China," Economic Analysis and Policy, Elsevier, vol. 79(C), pages 479-496.
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