Does Fiscal Decentralization Improve Health Outcomes? Evidence from a Cross-Country Analysis

By David A. Robalino, Oscar F. Picazo, A. Voetberg. 2001

176 citations recorded by the source corpus.

Decentralization of fiscal responsibilities has emerged as a primary objective on the agendas of national governments, and international organizations alike. Yet there is little empirical evidence on the potential benefits of this intervention. The authors fill in some quantitative evidence. Using panel data on infant mortality rates, GDP per capita, and the share of public expenditures managed by local governments, they find greater fiscal decentralization is consistently associated with lower mortality rates. The results suggest that the benefits of fiscal decentralization are particularly important for poor countries. They suggest also that the positive effects of fiscal decentralization on infant mortality, are greater in institutional environments that promote political rights. Fiscal decentralization also appears to be a mechanism for improving health outcomes in environments with a high level of ethno-linguistic fractionalization, however, the benefits from fiscal decentralization tend to be smaller.

Subfields: Economics and Econometrics, General Health Professions, Political Science and International Relations

View Paper: https://www.semanticscholar.org/paper/47ed74062bc140153b30aae99d29dff260703bed

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In Economics and Econometrics

1. Matthaios D. Delis
2. Antonis Adam
3. Pantelis Kammas
4. Bambang Suharnoko Sjahrir
5. Krisztina Kis‐Katos

In Political Science and International Relations

1. Antonis Adam
2. Pantelis Kammas
3. Matthaios D. Delis
4. Bambang Suharnoko Sjahrir
5. Krisztina Kis‐Katos

Citations in the corpus

• Decentralization and Political Institutions (2007, unknown): “Robalino et al. (2001) found negative cross-country relationship between decentralization and infant mortality.”
• Fiscal decentralization and public sector efficiency: evidence from OECD countries (2013, background): “Robalino et al. (2001) and Khalegian (2003) in cross-country studies, also find support that fiscal decentralization is associated with lower infant mortality rates and immunization rates (taken as measures of the quality of governance).”
• The Impact of Fiscal and Political Decentralization on Local Public Investments in Indonesia (2017, background): “Cross-country analyses also show various outcomes to be improving with fiscal decentralization (see e.g., Robalino et al. 2001, Khalegian 2004, and Jiménez-Rubio 2011 for health or Fisman and Gatti 2002 and de Mello and Barenstein 2001 for corruption).”
• The Impact of Fiscal Decentralization: A Survey (2015, unknown): “Robalino et al. (2001) find that countries where local governments manage a higher share of public expenditures tended to have lower mortality rates.”