The impact of IMF conditionality on government health expenditure: A cross-national analysis of 16 West African nations

Stubbs, Thomas; Kentikelenis, Alexander; Stuckler, David; McKee, Martin; King, Lawrence

doi:10.1016/j.socscimed.2016.12.016

Cited by 142 publications

(99 citation statements)

References 49 publications

(41 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, this gap shrinks under programs. We offer some potential explanations of these observations by highlighting the broader relationship between IMF programs and the societal effects of austerity (5,7,13,32,(38)(39)(40). Our study raises four main questions.…”

Section: Discussionmentioning

confidence: 89%

Impact of International Monetary Fund programs on child health

Daoud

Nosrati

Reinsberg

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

Parental education is located at the center of global efforts to improve child health. In a developing-country context, the International Monetary Fund (IMF) plays a crucial role in determining how governments allocate scarce resources to education and public health interventions. Under reforms mandated by IMF structural adjustment programs, it may become harder for parents to reap the benefits of their education due to wage contraction, welfare retrenchment, and generalized social insecurity. This study assesses how the protective effect of education changes under IMF programs, and thus how parents' ability to guard their children's health is affected by structural adjustment. We combine cross-sectional stratified data (countries, 67; children, 1,941,734) from the Demographic and Health Surveys and the Multiple Indicator Cluster Surveys. The sample represents ∼2.8 billion (about 50%) of the world's population in year 2000. Based on multilevel models, our findings reveal that programs reduce the protective effect of parental education on child health, especially in rural areas. For instance, in the absence of IMF programs, living in an household with educated parents reduces the odds of child malnourishment by 38% [odds ratio (OR), 0.62; 95% CI, 0.66-0.58]; in the presence of programs, this drops to 21% (OR, 0.79; 95% CI,. In other words, the presence of IMF conditionality decreases the protective effect of parents' education on child malnourishment by no less than 17%. We observe similar adverse effects in sanitation, shelter, and health care access (including immunization), but a beneficial effect in countering water deprivation.International Monetary Fund | education | child health | development | structural adjustment

show abstract

Section: Discussionmentioning

confidence: 89%

Impact of International Monetary Fund programs on child health

Daoud

Nosrati

Reinsberg

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

show abstract

“…To promote domestic markets, the IMF will aim to reduce the state's interventions in the economy. This can comprise the privatization of health care and education (Rowden 2011;Stubbs et al 2017). Researchers have devoted considerable effort to evaluate the impact of IMF on populations, yet mainly using aggregated country-level data.…”

Section: Macro Moderators: the Political Economy Of Economic Shocks Amentioning

confidence: 99%

Estimating Treatment Heterogeneity of International Monetary Fund Programs on Child Poverty with Generalized Random Forest

Daoud¹,

Johansson²

2019

Preprint

View full text Add to dashboard Cite

A flourishing group of scholars of family sociology study how macroeconomic shockwaves propagate via households dynamics and landing a blow on children’s living conditions; simultaneously, scholars of political economy unravel impacts of such shockwaves on population outcomes. Since these two strands of literature have evolved independently, little is know about the relative importance of societal and family features moderating this impact on children’s material living conditions. In this article, we synthesize insights from these two strands by examining the effect of economic austerity following International Monetary Fund programs—a type of economic shock—on child poverty across a sample representative of about half the world’s population of mainly the Global South. This article addresses the following fundamental sociological questions: to what extent do the pathways of economic austerity propagate through families’ living conditions and societies’ structural and political characteristics. To capture these multiple non-linear heterogeneous relationships between macro and micro traits, we deploy machine learning in the service of policy evaluation. First, our analysis identifies an adverse average treatment effect (ATE) following the implementation of IMF programs on children’s probability of falling into poverty: 0.14, 95% CI 0.03- 0.24. Second, our algorithms identify substantial impact heterogeneity distributed about this ATE. Macro constellation moderate about half of the impact variation on children, and families’ capabilities moderate the other half of this variation. We named this finding the 50-50 impact-moderation rule of thumb. Our algorithm identified family wealth closely followed by governments’ education spending as the critical moderating factors. IMF program affects children residing in the middle of the social stratification more than compared to their peers residing in both the top and bottom of this stratification; for those children residing in societies that have selected into IMF programs and have historically spent most on education, are at a higher risk of falling into poverty. These findings identify the value of combining family sociology and political economy perspectives. Scholars will likely cross-fertilize this research further by testing this 50-50 rule of thumb to other types of economic shocks.

show abstract

“…The analysis presented by Stubbs and Kentikelenis () and Stubbs et al. () suggests that overall levels of government spending on health tended to decline with the presence of an IMF arrangement. Likewise, Robinson and Pfeiffer () note that, in the run‐up to the Ebola outbreak of 2015, Liberia and Sierra Leone had had to limit their recruitment of health workers and cap levels of pay to meet the expenditure limits within their IMF loan programmes.…”

Section: The Imf and Social Protection: The Ieo's Headline Findingsmentioning

confidence: 99%

The IMF Record on Social Protection: Pro‐poor or Poor?

Clegg¹

2019

Development and Change

View full text Add to dashboard Cite

The impact of IMF conditionality on government health expenditure: A cross-national analysis of 16 West African nations

Cited by 142 publications

References 49 publications

Impact of International Monetary Fund programs on child health

Impact of International Monetary Fund programs on child health

Estimating Treatment Heterogeneity of International Monetary Fund Programs on Child Poverty with Generalized Random Forest

The IMF Record on Social Protection: Pro‐poor or Poor?

Contact Info

Product

Resources

About