An empirical analysis of the efficiency in reducing child mortality (Millennium Development Goal 4)

Abstract

The main aim of this article is to analyse, at the macro-level, why some countries are more efficient in converting inputs (physicians density and relative total health expenditure) into both a specific health-output (immunization against measles) and a health-outcome (under-five mortality rate). With this aim, a two-step Data Envelopment Analysis / Tobit analysis is applied on cross-section data for 43 developing countries in 2000, 2005 and 2010. Research findings suggest that countries with lower income inequality have achieved better efficiency levels in attaining health targets. Some other control variables are also shown to matter, including government effectiveness and the poverty gap ratio. Thus, enhancing the quality of institutions and reducing poverty are key factors which could promote efficiency in the use of resources employed in the production of basic health outputs, like children immunization programs. These two factors may explain, for example, why some developing countries are achieving higher rates of immunization against measles using the same health-input level in the period 2006-2010.