Democracy and child health in developing countries

Burroway, Rebekah

doi:10.1177/0020715216676514

Cited by 29 publications

(25 citation statements)

References 108 publications

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“…48 Gauri and Khaleghian find that democracies tend to have lower immunization rates than autocracies due to a more autonomous and efficient bureaucracy. 42 Using a multilevel modeling strategy, Burroway does not find any statistically significant relationship between democracy and 2 specific child health indicators, malnutrition and diarrhea, 49 which fits well with my assumption that political regime might be losing its relevance for explaining many modern causes of infant mortality.…”

Section: Literature Reviewmentioning

confidence: 53%

Political Economy of Infant Mortality Rate: Role of Democracy Versus Good Governance

Rosenberg

2018

Int J Health Serv

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Despite numerous studies on whether democracy reduces the infant mortality rate (IMR), the empirical results remain mixed at best. In this article, I perform several theoretical and empirical exercises that help explain why and under what conditions we should expect politics to matter most for a decrease in IMR. First, I capitalize on the epidemiological view that IMR - the most commonly used indicator of health in social sciences - is better suited to reflect public health micromanagement than overall social development. Second, I theorize that autocrats have incentives to invest in health up to a certain point, which could lead to a reduction in IMR. Third, I introduce an omitted variable - good governance - that trumps the importance of a political regime for IMR: (1) it directly affects public health micromanagement, and (2) many autocrats made inroads in achieving good governance. Finally, for the first time in such research, I use a disaggregated IMR approach to corroborate my hypotheses.

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Section: Literature Reviewmentioning

confidence: 53%

Political Economy of Infant Mortality Rate: Role of Democracy Versus Good Governance

Rosenberg

2018

Int J Health Serv

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“…I also control for GDP per capita, to capture country-level economic development, which I expect to be negatively associated with infant mortality. I also utilize a measure for the level of democracy as different types of political regimes have been associated with infant mortality and access to healthcare [ 18 ], though the relationship is complex [ 7 ]. As indicators of globalization I include net Foreign Direct Investment (FDI) and trade volume, the sum of imports and exports, as a percent of GDP.…”

Section: Methodsmentioning

confidence: 99%

For the children? A mixed methods analysis of World Bank structural adjustment loans, health projects, and infant mortality in Latin America

Noy

2021

Global Health

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Background The World Bank wields immense financial and normative power in health in the developing world. During the 1980s and 1990s, in the face of intense criticism of its structural adjustment policies, the World Bank purportedly turned its attention to “pro-growth and pro-poor” policies and new lending instruments. One focus has been an investment in maternal and infant health. My analysis uses a mixed methods approach to examine the relationship between traditional structural adjustment and health loans and projects and infant mortality in Latin America and the Caribbean from 2000 to 2015. Results My answer to whether the World Bank’s projects in Latin America worked “for the children” is: somewhat. The results are heartening in that quantitatively, health projects are associated with lower infant mortality rates, net of controls, whereas traditional structural adjustment loans do not appear to be negatively associated with infant mortality, though examined across a short time horizon. Qualitative data suggest that infants, children, and mothers are considered in World Bank loans and projects in the context of an economic logic: focusing on productivity, economic growth, and human capital, rather than human rights. Conclusion Taken together, my results suggest that the World Bank appears to, at least partially, have amended its approach and its recent work in the region is associated with reductions in infant mortality. However, the World Bank’s economistic approach risks compartmentalizing healthcare and reducing people to their economic potential. As such, there remains work to do, in Latin America and beyond, if health interventions are to be effective at sustainably and holistically protecting vulnerable groups.

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“…Four studies (6%) involved measurement at the individual level [35][36][37][38], while the remaining 63 were ecological. The collective period of data collection across studies was 1950-2014.…”

Section: Study Profilementioning

confidence: 99%

Linking political exposures to child and maternal health outcomes: a realist review

et al. 2021

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Background Conceptual and theoretical links between politics and public health are longstanding. Internationally comparative systematic review evidence has shown links between four key political exposures – the welfare state, political tradition, democracy and globalisation – on population health outcomes. However, the pathways through which these influences may operate have not been systematically appraised. Therefore, focusing on child and maternal health outcomes, we present a realist re-analysis of the dataset from a recent systematic review. Methods The database from a recent systematic review on the political determinants of health was used as the data source for this realist review. Included studies from the systematic review were re-evaluated and those relating to child and/or maternal health outcomes were included in the realist synthesis. Initial programme theories were generated through realist engagement with the prior systematic review. These programme theories were adjudicated and refined through detailed engagement with the evidence base using a realist re-synthesis involving two independent reviewers. The revised theories that best corresponded to the evidence base formed the final programme theories. Results Out of the 176 included studies from the systematic review, a total of 67 included child and/or maternal health outcomes and were included in the realist re-analysis. Sixty-three of these studies were ecological and data were collected between 1950 and 2014. Six initial programme theories were generated. Following theory adjudication, three theories in revised form were supported and formed the final programme theories. These related to a more generous welfare state leading to better child and maternal health especially in developed countries through progressive social welfare policies, left-of-centre political tradition leading to lower child mortality and low birth weight especially in developed countries through greater focus on welfare measures, and increased globalisation leading to greater child and infant mortality and youth smoking rates in LMECs through greater influence of multinational corporations and neoliberal trade organisations. Conclusion We present a realist re-analysis of a large systematically identified body of evidence on how four key political exposures – the welfare state, democracy, political tradition and globalisation – relate to child and maternal health outcomes. Three final programme theories were supported.

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Democracy and child health in developing countries

Cited by 29 publications

References 108 publications

Political Economy of Infant Mortality Rate: Role of Democracy Versus Good Governance

Political Economy of Infant Mortality Rate: Role of Democracy Versus Good Governance

For the children? A mixed methods analysis of World Bank structural adjustment loans, health projects, and infant mortality in Latin America

Linking political exposures to child and maternal health outcomes: a realist review

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