International financial organisations and global child mortality rates

Economic policy reforms mandated by the International Monetary Fund (IMF) are known to be socially disruptive and associated with declining health, yet their causal effect on children’s life chances is understudied. This paper employs two-way fixed effects panel regressions with instrumental variables to examine the impact of IMF programmes on mortality rates amongst children under the age of 5 per 1,000 live births in 176 countries between 1990 and 2017. IMF programmes are shown to cause up to 90 excess under-5 deaths per 1,000 live births (95% CI: 50–130). This aggregate effect appears to be driven by large-scale privatisation reforms, which cause up to 132 excess child deaths per 1,000 live births (72–191). These parameter estimates are robust to a range of sensitivity checks. IMF-mandated policies, as currently implemented, are harmful to children’s health and must be revised in order to prevent avoidable child deaths. The role of international financial organisations in shaping global health outcomes must be taken seriously by researchers and policy-makers alike.