IDEAS home Printed from https://ideas.repec.org/a/oup/jafrec/v21y2012i2p192-227.html
   My bibliography  Save this article

Wealthiest Is Not Always Healthiest: What Explains Differences in Child Mortality in West Africa?

Author

Listed:
  • Amy Ickowitz

Abstract

Ghana has the lowest under-five mortality rate in West Africa. Understanding why Ghana's child mortality rate is lower than in neighbouring countries may offer useful insights for other developing countries that are trying to improve child health. This paper explores whether Ghana's lower mortality rate is mostly a result of greater household wealth, better implementation of national health policies, or more favourable geography. The paper uses micro level data for children under five to examine relative child mortality risk between Ghana and each of its three immediate neighbours—Burkina Faso, the Ivory Coast and Togo. A Cox proportional hazards model is used to test which of the three ‘contenders’—health policy, wealth or geography—best explains Ghana's mortality advantage. The results of the analysis indicate that wealth variables are not able to explain any of the child mortality variation between Ghana and its neighbours. Geography and health policy variables each explain about 40% of the mortality gap between Ghana and Burkina Faso. Health policy differences alone are able to explain about 70% of the child mortality gap between Ghana and the Ivory Coast. These results suggest that even poor countries that have been ‘cursed’ by bad geography can potentially improve development outcomes and save children's lives. Copyright 2012 , Oxford University Press.

Suggested Citation

  • Amy Ickowitz, 2012. "Wealthiest Is Not Always Healthiest: What Explains Differences in Child Mortality in West Africa?," Journal of African Economies, Centre for the Study of African Economies, vol. 21(2), pages 192-227, March.
    • Handle: RePEc:oup:jafrec:v:21:y:2012:i:2:p:192-227
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1093/jae/ejr035
    Download Restriction: Access to full text is restricted to subscribers.
    ---><---

    As the access to this document is restricted, you may want to look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. Brunnschweiler, Christa N. & Bulte, Erwin H., 2008. "The resource curse revisited and revised: A tale of paradoxes and red herrings," Journal of Environmental Economics and Management, Elsevier, vol. 55(3), pages 248-264, May.
    2. Masters, William A & McMillan, Margaret S, 2001. "Climate and Scale in Economic Growth," Journal of Economic Growth, Springer, vol. 6(3), pages 167-186, September.
    3. Rodrigo R. Soares, 2007. "On the Determinants of Mortality Reductions in the Developing World," Population and Development Review, The Population Council, Inc., vol. 33(2), pages 247-287, June.
    4. Lant Pritchett & Lawrence H. Summers, 1996. "Wealthier is Healthier," Journal of Human Resources, University of Wisconsin Press, vol. 31(4), pages 841-868.
    5. Angus Deaton, 2006. "Global Patterns of Income and Health: Facts, Interpretations, and Policies," NBER Working Papers 12735, National Bureau of Economic Research, Inc.
    6. Daron Acemoglu & Simon Johnson & James A. Robinson, 2001. "The Colonial Origins of Comparative Development: An Empirical Investigation," American Economic Review, American Economic Association, vol. 91(5), pages 1369-1401, December.
    7. Dani Rodrik & Arvind Subramanian & Francesco Trebbi, 2004. "Institutions Rule: The Primacy of Institutions Over Geography and Integration in Economic Development," Journal of Economic Growth, Springer, vol. 9(2), pages 131-165, June.
    8. Kai Carstensen & Erich Gundlach, 2006. "The Primacy of Institutions Reconsidered: Direct Income Effects of Malaria Prevalence," The World Bank Economic Review, World Bank, vol. 20(3), pages 309-339.
    9. 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.
    10. Wilmoth, Teresa A. & Elder, John P., 1995. "An assessment of research on breastfeeding promotion strategies in developing countries," Social Science & Medicine, Elsevier, vol. 41(4), pages 579-594, August.
    11. Lucia Breierova & Esther Duflo, 2003. "The Impact of Education on Fertility and Child Mortality: Do Fathers Really Matter Less Than Mothers?," OECD Development Centre Working Papers 217, OECD Publishing.
    12. Ellen van de Poel & Owen O'Donnell & Eddy van Doorslaer, 2007. "Are Urban Children really healthier?," Tinbergen Institute Discussion Papers 07-035/3, Tinbergen Institute.
    13. Christiaensen, Luc & Alderman, Harold, 2004. "Child Malnutrition in Ethiopia: Can Maternal Knowledge Augment the Role of Income?," Economic Development and Cultural Change, University of Chicago Press, vol. 52(2), pages 287-312, January.
    14. Penders, Christopher L. & Staatz, John M., 2001. "The Impact Of Household-Level Determinants Of Child Health And Nutrition: Cross-Country Evidence From West Africa," 2001 Annual meeting, August 5-8, Chicago, IL 20586, American Agricultural Economics Association (New Name 2008: Agricultural and Applied Economics Association).
    15. Deon Filmer & Kinnon Scott, 2012. "Assessing Asset Indices," Demography, Springer;Population Association of America (PAA), vol. 49(1), pages 359-392, February.
    16. Easterlin, Richard A., 1999. "How beneficent is the market? A look at the modern history of mortality," European Review of Economic History, Cambridge University Press, vol. 3(3), pages 257-294, December.
    17. Adam Wagstaff & Naoko Watanabe, 2003. "What difference does the choice of SES make in health inequality measurement?," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 885-890, October.
    18. Ravallion, Martin, 1997. "Good and bad growth: The human development reports," World Development, Elsevier, vol. 25(5), pages 631-638, May.
    19. 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.
    20. Jeffrey D. Sachs, 2003. "Institutions Don't Rule: Direct Effects of Geography on Per Capita Income," NBER Working Papers 9490, National Bureau of Economic Research, Inc.
    21. Steven A. Block, 2007. "Maternal nutrition knowledge versus schooling as determinants of child micronutrient status," Oxford Economic Papers, Oxford University Press, vol. 59(2), pages 330-353, April.
    22. repec:pri:cheawb:deaton_wider_final_annual_lecture_all is not listed on IDEAS
    23. Paul Glewwe, 1999. "Why Does Mother's Schooling Raise Child Health in Developing Countries? Evidence from Morocco," Journal of Human Resources, University of Wisconsin Press, vol. 34(1), pages 124-159.
    24. John W. McArthur & Jeffrey D. Sachs, 2001. "Institutions and Geography: Comment on Acemoglu, Johnson and Robinson (2000)," NBER Working Papers 8114, National Bureau of Economic Research, Inc.
    25. Filmer, Deon & Pritchett, Lant, 1998. "The effect of household wealth on educational attainment : demographic and health survey evidence," Policy Research Working Paper Series 1980, The World Bank.
    26. Jeffrey D. Sachs, 2001. "Tropical Underdevelopment," NBER Working Papers 8119, National Bureau of Economic Research, Inc.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Pérez-Moreno, Salvador & Blanco-Arana, María C. & Bárcena-Martín, Elena, 2016. "Economic cycles and child mortality: A cross-national study of the least developed countries," Economics & Human Biology, Elsevier, vol. 22(C), pages 14-23.
    2. Lilipramawanty Kewok Liwin & Brian Houle, 2019. "The effects of household and community context on mortality among children under five in Sierra Leone: Evidence from the 2013 Demographic and Health Survey," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 40(11), pages 279-306.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. 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.
    2. Ickowitz, Amy & Powell, Bronwen & Salim, Mohammad & Sunderland, Terry, 2013. "Dietary quality and tree cover in Africa," MPRA Paper 52906, University Library of Munich, Germany.
    3. Dalton Conley & Gordon C. McCord & Jeffrey D. Sachs, 2007. "Africa's Lagging Demographic Transition: Evidence from Exogenous Impacts of Malaria Ecology and Agricultural Technology," NBER Working Papers 12892, National Bureau of Economic Research, Inc.
    4. Ola Olsson, 2005. "Geography and institutions: Plausible and implausible linkages," Journal of Economics, Springer, vol. 10(1), pages 167-194, December.
    5. Carstensen, Kai & Gundlach, Erich, 2005. "The primacy of institutions reconsidered: The effects of malaria prevalence in the empirics of development," Kiel Working Papers 1210, Kiel Institute for the World Economy (IfW Kiel).
    6. Tobias D. Ketterer & Andrés Rodríguez‐Pose, 2018. "Institutions vs. ‘first‐nature’ geography: What drives economic growth in Europe's regions?," Papers in Regional Science, Wiley Blackwell, vol. 97(S1), pages 25-62, March.
    7. Alan Martina, 2009. "On the Constrained Contribution of Advances in Medical Knowledge to the Economic Growth of Developing Countries," ANU Working Papers in Economics and Econometrics 2009-504, Australian National University, College of Business and Economics, School of Economics.
    8. Casabonne, Ursula & Kenny, Charles, 2012. "The Best Things in Life are (Nearly) Free: Technology, Knowledge, and Global Health," World Development, Elsevier, vol. 40(1), pages 21-35.
    9. Rodríguez-Pose, Andrés & Ketterer, Tobias, 2016. "Institutions vs. ‘First-Nature’ Geography – What Drives Economic Growth in Europe’s Regions?," CEPR Discussion Papers 11322, C.E.P.R. Discussion Papers.
    10. Mauricio Cárdenas, 2007. "Economic Growth in Colombia : a reversal of "fortune"?," Revista ESPE - Ensayos sobre Política Económica, Banco de la Republica de Colombia, vol. 25(53), pages 220-259, January.
    11. Adolfo Meisel-Roca & Juliana Jaramillo-Echeverri & María Teresa Ramírez-Giraldo, 2018. "Más de cien años de avances en el nivel de vida: El caso de Colombia," Cuadernos de Historia Económica 46, Banco de la Republica de Colombia.
    12. W. A. Naudé, 2004. "The effects of policy, institutions and geography on economic growth in Africa: an econometric study based on cross-section and panel data," Journal of International Development, John Wiley & Sons, Ltd., vol. 16(6), pages 821-849.
    13. Capolupo, Rosa, 2009. "The New Growth Theories and Their Empirics after Twenty Years," Economics - The Open-Access, Open-Assessment E-Journal (2007-2020), Kiel Institute for the World Economy (IfW Kiel), vol. 3, pages 1-72.
    14. Bodea, Cristina & Elbadawi, Ibrahim A., 2008. "Political violence and economic growth," Policy Research Working Paper Series 4692, The World Bank.
    15. Sambit Bhattacharyya, 2009. "Root Causes of African Underdevelopment," Journal of African Economies, Centre for the Study of African Economies, vol. 18(5), pages 745-780, November.
    16. Casey Brown & Upmanu Lall, 2006. "Water and economic development: The role of variability and a framework for resilience," Natural Resources Forum, Blackwell Publishing, vol. 30(4), pages 306-317, November.
    17. Lubna Hasan, 2007. "Myths and Realities of Long-run Development: A Look at Deeper Determinants," The Pakistan Development Review, Pakistan Institute of Development Economics, vol. 46(1), pages 19-44.
    18. Bennett, Daniel L. & Faria, Hugo J. & Gwartney, James D. & Morales, Daniel R., 2017. "Economic Institutions and Comparative Economic Development: A Post-Colonial Perspective," World Development, Elsevier, vol. 96(C), pages 503-519.
    19. Sambit Bhattacharyya, 2011. "Growth Miracles and Growth Debacles," Books, Edward Elgar Publishing, number 13609.
    20. Holger Strulik, 2004. "Economic growth and stagnation with endogenous health and fertility," Journal of Population Economics, Springer;European Society for Population Economics, vol. 17(3), pages 433-453, August.

    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O10 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - General
    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development
    • O55 - Economic Development, Innovation, Technological Change, and Growth - - Economywide Country Studies - - - Africa

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:oup:jafrec:v:21:y:2012:i:2:p:192-227. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Oxford University Press (email available below). General contact details of provider: https://edirc.repec.org/data/csaoxuk.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.