Socio-economic determinants of efficiency in reducing child mortality in developing countries

Abstract

Efficiency issues in health investments have received increasing attention, mainly as a result of the growing amount of resources invested in developing countries and their mixed impacts on outcomes. The empirical literature has suggested that, although government spending on health care improves the health status of the population, society can potentially gain more through the more efficient assignment of health resources. In this context, this paper aims to: firstly, to analyse whether developing countries can further reduce child mortality by using the available resources more parsimoniously; and secondly, to identify the (non-discretionary) socio-economic factors that could be affecting this process. More specifically, this paper aims to explain why some countries are more efficient than others in converting inputs (physician density and relative total health expenditure) into a health outcome: the under-five mortality rate (U5MR). The database used in the estimations comprised 47 developing countries with data for the periods 2000- 2004, 2005-2009, and 2010-2012. The findings suggest that greater efficiency in the provision of immunization, better quality government, and lower income inequality are directly related to efficiency in the use of inputs to reduce the U5MR.