Infant and child mortality in developing countries: Analysing the data for Robust determinants

Is development best achieved by going for growth, or does specific attention need to be paid to directly improving human welfare? In contrast to the Human Development Reports of the UNDP, the World Bank has stressed the growth approach. Recent work has reinforced this position by arguing that health spending is extremely ineffective in reducing infant or child mortality, which is mainly explained by a country's income per capita. This article contests this position through testing the robustness of determinants of infant and child mortality. We have estimated over 420,000 equations which show that, while income per capita is a robust determinant of infant and child mortality, so are indicators of health, education and gender inequality. Some health spending, such as immunisation, is thus shown to be cost effective way of saving lives. Our results are consistent with the view that much health spending in developing countries may be poorly targeted or otherwise ineffective, but do not support the position that public health strategies should not be given too great a role in pursuing improvements in human welfare.     

Aid,Remittances, Medical Brain Drain and Child Mortality: Evidence Using Inter and Intra-Country Data

This article analyses the respective impact of aid, remittances and medical brain drain (MBD) on child mortality using panel and cross-country quintile-level data on respectively 84 and 46 developing countries. Our results show that remittances reduce child mortality while MBD increases it. Health aid also significantly reduces child mortality but its impact is less robust than the impact of remittances. Remittances seem to be more effective in reducing mortality for children belonging to households from the upper classes, whereas neither a pro-poor nor anti-poor effect is found for health aid.     

Remittances,Regime Type,and Government Spending Priorities

Previous work suggests that remittances enable governments to reduce spending on public services and divert resources to serve their own interests. We argue this need not occur. Building on recent work which shows that the impact of remittances is contingent on the domestic environment in remittance-receiving countries, we hypothesize that (1) remittances are more likely to increase government spending on public services in democracies than in autocracies and (2) remittances are more likely to finance activities that deter political competition in autocracies than in democracies. Using a sample of 105 developing countries from 1985 through 2008, we find strong support for our hypotheses when examining the impact of remittances on public education, health, and military spending. We also provide suggestive evidence for the mechanism underpinning our results: micro-level evidence on remittance recipients’ preferences and political engagement.     

Does Health Aid Reduce Infant and Child Mortality from Diarrhoea in Sub-Saharan Africa?

Achieving sustained improvements in health outcomes remains a challenge for sub-Saharan Africa, where diarrhoea remains a leading cause of death in children under the age of five. This paper examines the impact of foreign aid to the health sector on diarrhoea mortality in children under five in 47 sub-Saharan African countries, using panel data on the sectoral allocation of official development assistance in conjunction with country-level data on health outcomes. After controlling for fixed effects and the potential endogeneity of health aid, we find that increased health aid and increased public health expenditure are associated with lower diarrhoea mortality in children under five. In addition, health aid increases government spending on health, suggesting that the overall impact of health aid on diarrheal death rates could exceed the direct effect. Furthermore, increased access to improved sources of water and sanitation are important in reducing child mortality from diarrhoea.     

The Impact of International Remittances on Child Outcomes and Household Expenditures in Nepal

Nepal has one of the highest ratios of international remittances to gross domestic product in the world. We examine whether the massive inflow of international remittances affects child schooling, child labour and household expenses. Controlling extensively for a host of observed characteristics of households and migrants, and using an instrumental variable approach, this research finds no effect of international remittances on child education or child labour in Nepal. However, it does find a significant increase in non-food expenditures, including education spending, due to international remittances. Despite increased expenditure on child education, educational outcomes are not improving because of international remittances.     

Child Schooling,Child Health,and Rainfall Shocks: Evidence from Rural Vietnam

Abstract

We study the effect of rainfall shocks on child schooling outcomes and on standardised height for age (a measure of child health) in rural Vietnam. We find that adverse rainfall shocks during pregnancy adversely affect children’s school entry delay and progress through school. Adverse rainfall shocks in the third year of life adversely affect both schooling and child health. These effects differ by region, as a result of constraints that reflect regional economic heterogeneity. We predict that policies that help rural families smooth income shocks will result in increases in human capital and in substantial cumulative returns over a worker’s working life.     

Disparities in Infant Mortality Rates Among Immigrant Caribbean Groups in New York City

SUMMARY

This study examined infant mortality rates (IMR) in New York City (NYC) to identify those groups reporting higher IMR concentrations in recent years and to determine what factors and explanations are associated with this new trend.

Analysis of data from NYC Department of Health (DOH) identified infant mortality patterns throughout the City by both maternal birthplace and NYC Health Districts. In addition, infant mortality rates for those NYC populations with the highest concentrations were compared to the most recently available IMR data from their countries of origin. Focus group sessions were conducted with women in the identified groups in New York City in an effort to obtain their perspectives on causality and other factors associated with the new trend.

Strong patterns emerged from this study pointing to a concentration of the City's highest IMR among groups from the circum-Caribbean region. Results of focus group sessions with women in the identified population groups yielded a list of specific barriers faced by this population in the utilization of perinatal care services. In addition, the study resulted in some clearly delineated program and policy approaches that can help to address the disparities in IMR.

Myriad causative factors contribute to the high rates of IMR among Caribbean immigrant groups. Expanding the availability of both successful program models and promising practices is critical to decreasing infant mortality in immigrant communities. Specific recommendations are for the development of a strategic set of interventions designed to eliminate this most serious challenge to the health of new immigrant groups in NYC.

Any references to comparisons between data from NYC and data from the countries of origin were merely to serve as a reference point as it is not often possible to determine the level of scientific rigor applied to the collection and analysis of data external to the United States (U.S.).

Implications for social work practice with immigrant populations include the need for delivery of culturally competent services in general and for cultural sensitivity to health beliefs surrounding maternal child health issues in particular.     

Political Trust,Ideology, and Public Support in the United States for Government Spending on Health Care

The U.S. health-care costs have increased at a rapid rate over the last several decades. How much responsibility the government should bear with the increase in health-care costs is one of the main questions that lack consensus among the American people. Utilizing the 2016 General Social Survey data, this study shows that over two-thirds of Americans want to see more or much more spending on health care by the government. An ordered logit regression model shows that political trust and ideology are significant correlates in predicting attitudes toward government spending on health care. The policy implications of the findings are discussed in the “Conclusion” section.     

Vital Democracy: A Theory of Democracy in Action

Scottish citizens benefit from 19 per cent more public spending per head than English citizens. The ‘Barnett formula’ is slowly reducing the gap, but very little is known about the countries' relative needs and hence about how far the present gap is defensible: the aim of this paper is to throw some light on the countries' relative needs. We begin with the complex formulae that the Westminster government uses to assess the spending needs of English local authorities, and we use these English formulae to assess the needs of Scottish local authorities for three major blocks of local services. These formulae suggest that Scotland needs 6.4 per cent more per head than England for environmental, protective and cultural services, 8.1 per cent more for highway maintenance, and between 24.3 per cent and 35.3 per cent more for fire services. We also combine these results with those of two other papers concerned with local education and social services to show that these English formulae put Scotland's per capita needs for local government services as a whole at about 6 per cent above England's. However, we then compare the relative needs of Scottish local authorities as assessed by the English formulae with their relative needs as assessed by the Scottish needs formulae that are currently used by Holyrood, and we find major differences. This suggests either that at least one country uses seriously flawed formulae to assess needs, or that the two countries have different conceptions of need.     

Remittances and Working Poverty

Abstract

This article shows that the level and the predictability of remittances reduce working poverty in receiving economies through their effects on labour market dynamics. It takes advantage of the new cross-country dataset (ILO, KILM 7th edition) containing information on the share of individuals working for less than US$2 per day. To identify the main impacts, the article proposes a novel approach to deal with the endogeneity of remittances and migration. In addition, the results are robust to the possible error in measuring working poverty, to the potential attrition bias, and to the presence of various control variables.     

Agricultural Production,Dietary Diversity and Climate Variability

Abstract

Nonseparable household modelsoutline the interlinkage between agricultural production and household consumption, yet empirical extensions to investigate the effect of production on dietary diversity and diet composition are limited. While a significant literature has investigated the calorie-income elasticity abstracting from production, this paper provides an empirical application of the nonseparable household model linking the effect of exogenous variation in planting season production decisions via climate variability on household dietary diversity. Using degree days, rainfall and agricultural capital stocks as instruments, the effect of production on household dietary diversity at harvest is estimated. The empirical specifications estimate production effects on dietary diversity using both agricultural revenue and crop production diversity. Significant effects of both agricultural revenue and crop production diversity on dietary diversity are estimated. The dietary diversity-production elasticities imply that a 10 per cent increase in agricultural revenue or crop diversity result in a 1.8 per cent or 2.4 per cent increase in dietary diversity respectively. These results illustrate that agricultural income growth or increased crop diversity may not be sufficient to ensure improved dietary diversity. Increases in agricultural revenue do change diet composition. Estimates of the effect of agricultural income on share of calories by food groups indicate relatively large changes in diet composition. On average, a 10 per cent increase in agricultural revenue makes households 7.2 per cent more likely to consume vegetables, 3.5 per cent more likely to consume fish, and increases the share of tubers consumed by 5.2 per cent.     

Volatility of Short-term Capital Flows and Private Investment in Emerging Markets

Using micro-level panel data, the paper analyses the impacts of short-term capital flow volatility on new fixed investment spending of publicly traded real sector firms in three major emerging markets – Argentina, Mexico and Turkey. The empirical results, including sensitivity tests, suggest that increasing volatility of capital inflows has an economically and statistically significant negative effect on new investment spending of private firms. Accordingly, a 10 per cent increase in capital flow volatility reduces fixed investment spending in the range of 1–1.7, 2.3–15, and 1 per cent in Argentina, Mexico and Turkey respectively.     

Remittances and Chain Migration: Longitudinal Evidence from Bosnia and Herzegovina

Abstract

Most of the literature on remittances focuses on their implications for the welfare of family members in the country of origin and disregards their role as facilitator of chain migration. We address this issue with the use of longitudinal data from Bosnia and Herzegovina, one of the primary exporters of migrants and recipients of remittances in the world. We find that remittances have a significant positive impact on the migration prospects of their recipients. Better-endowed people are most likely to migrate, which highlights a potential negative implication of migration and remittances.     

Collective Remittances and Transnational Coproduction: the 3 × 1 Program for Migrants and Household Access to Public Goods in Mexico

Migrant hometown associations (HTAs) are mobilizing collective remittances to improve social welfare in their countries of origin. This paper assesses the effect of transnational coproduction of public goods in migrants’ places of origin by studying the 3?×?1 Program for Migrants. The 3?×?1 Program is a national social spending program in which the Mexican local, state, and federal government matches HTAs’ collective remittances to improve public services through cross-border public–private partnerships. The statistical analysis across municipalities that do and do not participate in the 3?×?1 Program shows that coproduction improves citizens’ access to public sanitation, drainage, and water, although not electricity. Moreover, a negative and statistically significant interaction term between 3?×?1 Program expenditures and family remittances reveals a substitution effect: in the presence of transnational coproduction, migrant households are less likely to improve public goods using family remittance resources, but in the absence of 3?×?1 Program participation they continue to improve their hometowns with family remittances. This research offers a theoretical mechanism and supporting empirical evidence of an important kind of intermediary institution improving social welfare in migrant places of origin.     

Exchange Rate Pass-through to Import Prices,and Monetary Policy in South Africa

Abstract

Understanding how import prices adjust to exchange rates helps anticipate inflation effects and monetary policy responses. This article examines exchange rate pass-through to the monthly import price index in South Africa during 1980–2009. Short-horizon pass-through estimates are calculated using both single equation equilibrium correction models and systems (Johansen) models, controlling for both domestic and foreign costs. Average pass-through is incomplete at about 50 per cent within a year and 30 per cent in six months, and in the long-run, from the Johansen analysis including feedback effects, is about 55 per cent. There is evidence of slower pass-through under inflation targeting; pass-through is found to decline with recent exchange rate volatility and there is evidence for asymmetry, with greater pass-through occurring for small appreciations.     

Sharing Norm Pressures and Community Remittances: Evidence from a Natural Disaster in the Pacific Islands

Abstract

Migrants are often subject to social pressures to remit beyond their own households, to share the benefits of migration with the wider community in their home country; these are ‘community remittances’. We hypothesise that community sharing norm pressures are stronger in locations with more extensive home community networks. We also postulate that the responsiveness of remittances to sharing pressures is subject to diminishing returns, attributable to a donor fatigue effect. Using customised survey data from three Polynesian migrant groups in metropolitan and regional Australia, we estimate double-hurdle regression models of community remittances. To identify the effects of sharing norm pressures we exploit an exogenous (cyclone) shock to home country incomes affecting one sub-group. We find strong evidence in support of the postulated responsiveness of community remittances to location-related differences in sharing norm pressures, and the presence of a donor fatigue effect. The policy implications are discussed.     

Scientific Research on the Efficiency of Public Expenditures: How and Where is it Going?

ABSTRACT

Recent scientific research has advanced the measurement of the relative performance of organizations and the efficiency of public spending, based on analyzes of the services offered and results achieved. However, from the methodological point of view, there are several methods to analyze the performance and efficiency of spending in the private and public sectors. In this sense, the present study performs a systematic bibliometric review to analyze all scientific publications on the efficiency of public spending published in the last 20 years. The results show that most cost-efficiency analyzes have been limited to education and health expenditures and have used quantitative analysis, mainly through the application of data-involution analysis. The present review is a first step in mapping scientific publications on efficiency in public spending, which will support researchers and managers to make public spending more efficient.     

Institutional Arrangements and State and Local Financial Forecasting

Abstract

The articles in this symposium present various consequences that effectively result in changes from adopted budgets during the implementation phase, which derive from institutional structure. The institutional structures referred to include such attributes as internal policy, procedural methodology, longevity in office, and reward and incentive systems related to performance outcomes

For local governments, structural influences studied include changes in leadership in the executive and legislative branches, longevity in office of budget administrators, and differences related to mayor-council vs. council-manager forms of government. Internal policies reported on cover methodology used to forecast revenues such as quantitative methods versus informed judgment, budgetary controls and spending policy related to mandated spending beyond local government control, and procedures for benchmarking within the agency as well as with peer groups and professional standards.

Consortia of governments are referenced regarding performance evaluation as is the process for gaining consensus between the executive and legislative branches, including expert outside opinion. Other influences on performance outcomes reported on are those tied to the risk-reward system built in to the institutional structure, which includes risk tolerance of the individuals who make pension fund investments.     

The Effects of Heavily Indebted Poor Countries Initiative on the Millennium Development Goals for Health

The objective of this study is to investigate the impact of Heavily Indebted Poor Countries Initiative (HIPC) on the attainment of the health millennium development goals (MDGs) in Africa and identify other correlates of health MDGs. This way, the paper uses data from the World Bank and employs the difference in difference (DID) approach to estimate the impact of HIPC on health MDGs and to identify other determinants of health MDG attainment. The results show that the impact of HIPC on health MDGs is positive. Specifically, due to HIPC, the level of the following health MDG indicators decreased: mortality rate (infant); mortality rate (neonatal); incidence of tuberculosis; prevalence of HIV/AIDS, and mortality rate under five. However, the incidence of tuberculosis (all forms) registered an increase in Africa, even in treated groups. Our findings also indicate that MDGs for health will not be attained simultaneously because some variables that reduce mortality such as GDP per capita, natural resources and education cause HIV/AIDS.     

How do Migration and Remittances Affect Human Capital Investment? The Effects of Relaxing Information and Liquidity Constraints

Abstract

This article explores the heterogeneous effects of the migration–remittance process on the educational attainment of Nepalese children. The results suggest that when controlling for remittances, the children of more educated or informed parents suffer from parental absence, while the children of less informed parents gain from migration, implying that the migration experience helps less educated parents estimate the value of and returns to education more precisely. The results also suggest that remittances help severely credit-constrained households enrol their children in school and prevent dropouts. These remittances help households that face less severe liquidity constraints increase their investment in quality education.