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Date
Jun
06
2006

Providing a Healthier State to Life: The Impact of Conditional Cash Transfers on Infant Mortality

Presenter:

Tania Barham

Authors:

Tania Barham

Chair: James Burgess; Discussant: TBA Tue June 6, 2006 15:30-17:00 Room 213

Every year more than 10 million children die from preventable diseases such as malnutrition and intestinal infections in developing countries. The majority of these deaths take place during infancy. Consequently, finding effective policies to reduce mortality among infants is a key part of the development agenda. Conditional cash transfer programs are a popular type of social investment tool designed, amongst other goals, to improve the health of children, but which may also lead to important reductions in infant mortality. However, empirically establishing causality between the implementation of conditional cash transfers and infant mortality is difficult because the death of an infant is a relatively rare event. Even large household surveys commonly do not have a sufficient number of observations to examine infant mortality. In 1997, Mexico implemented one of the first, largest, and most innovative conditional income transfer programs, Progresa. Owing to its extensiveness, Progresa provides an opportunity to test the causality of conditional cash transfers on the infant mortality rate (IMR). In this paper, I use non-experimental methods tp examine if this new policy tool reduced the rural IMR in Mexico.

Previous research on Progresa has taken advantage of a randomized treatment and control evaluation database to investigate if the program improved various aspects of children’s health. This research has shown that the nutritional status of children improved and the number of days a mother reported her child ill decreased for treatment households as compared to those from similar families that did do not receive the transfer. These findings indicate that there are some important nutritional benefits of conditional cash transfers. This paper therefore focuses on infant mortality, which is a broader and more objective measure of children’s health.

Since the Progresa randomized treatment and control database is too small to accurately estimate the impact of the program on infant mortality, I construct municipal-level panel data from 1992 to 2001. I take advantage of the phasing-in of the program over time both between and within municipalities to identify the impact of the program. The econometric model employs municipality and time fixed effects, and includes variables associated with the program phase-in rule to control for program timing bias. The analysis also explicitly controls for changes in the supply of health care in rural areas. Additionally, the identification strategy takes advantage of the fact that Progresa was not provided in urban areas prior to 2000, and uses the urban IMR to test whether unobservable municipal time-variant variables are biasing the results. We find that Progresa led to an 11 percent decline in rural infant mortality among treated households. Given the relatively high incidence of infant mortality in rural areas, and that it fell by less than one percent a year over the five years before Progresa, this is an important decline. Reductions were even higher in communities where the population all spoke some Spanish and had better access to piped water.

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