Chris Blattman

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precisely because it has so many determinants, no one in government is willing to hold him or herself accountable for reducing child mortality.

That’s Shanta Devarajan, the World Bank’s Chief Economist for the Africa Region, on why so many countries are unlikely to meet their child mortality goals–a reduction by two-thirds–by 2015. He writes in his excellent new blog, AfricaCan.

Devarajan says that since politicians won’t take responsibility, informing parents is key.

The Bank has been on an information campaign for many years. I think it’s rooted in inclinations to microeconomic theory plus a few pieces of evidence like this brilliant corruption experiment in Uganda. The popular story is that corruption was slashed merely by publicly informing parents how much money was supposed to go where. While certainly true, a closer look suggests that the influence of information was small, and the popular wisdom somewhat exaggerated.

Readers: any good evidence on what drives down child mortality?

6 Responses

  1. Community monitoring (from Uganda also)

    http://www.iies.su.se/~svenssoj/PtP_QJE.pdf

    Abstract:

    This paper presents a randomized …field experiment on community-based monitoring of public primary health care providers in Uganda. Through two rounds of village meetings, localized NGOs encouraged communities to be more involved with the state of health service provision and strenghtened their capacity to hold their local health providers to account for performance. A year after the intervention, treatment communities are more involved in monitoring the provider and the health workers appear to exert higher e¤ort to serve the community. We document large increases in utilization and improved health outcomes, reduced child mortality and increased child weight that compare favorably to some of the more successful community-based intervention trials reported in the medical literature.

  2. Female literacy must be the one. It also correlates with fewer children per woman. So it gives fewer children, better cared for.

  3. I’ll agree with Texas. This question is related to some other work that I am doing anyway so I ran a couple of simple regressions using African household data – this points to education of the mother as being the only robustly significant factor – and piped water/sanitation as well is generally significant. But the reality is they don’t explain much – R2 is almost always less than 5%.

    I’m guessing this is why African leaders can avoid the question – no one really knows what they should be doing.

  4. Isn’t education of the mother the classic response? I have no data on that, but it makes intuitive sense. If a mother knows that polluted water causes cholera and a whole host of other problems, if she knows that a child needs a balanced diet to survive, and she knows that bednets reduce malaria risk, and if she knows that she’s at risk for HIV/AIDS and that she can get nevaripine, then her child should have a much better chance at surviving.

  5. Well, it’s very macro, anecdotal and lacking any sort of causal identification, but the halving of IMR in China (and near doubling of life expectancy) occurred after the introduction of barefoot doctors, coupled with sanitation programs. Interestingly there have not been many gains since the market reforms in the early 80s.

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