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. 2016 Jul:48:16-25.
doi: 10.1016/j.jhealeco.2016.03.002. Epub 2016 Mar 16.

Why has under-5 mortality decreased at such different rates in different countries?

Dean T Jamison  1 , Shane M Murphy  2 , Martin E Sandbu  3
Affiliations

Why has under-5 mortality decreased at such different rates in different countries?

Dean T Jamison et al. J Health Econ. 2016 Jul.

Abstract

Controlling for socioeconomic and geographic factors, under-5 mortality (5q0) in developing countries has been declining at about 2.7% per year, a high rate of 'technical progress'. This paper adduces theoretical and empirical reasons for rejecting the usual specification of homogeneous technical progress across countries and uses a panel of 95 developing countries for the period 1970-2000 to explore the consequences of heterogeneity. Allowing country-specific rates of technical progress sharply reduces the estimated income elasticity of 5q0 and points to country variation in technical progress as the principal source of the (large) cross-country variation in 5q0 decline. Education levels and physician coverage also contribute and are less affected than income of allowing country variation in technical progress. The paper concludes by decomposing 1970-2000 5q0 decline into its different sources for each country.

Keywords: Hierarchical model; Technical progress; Under-5 mortality; Varying coefficients model.

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Figures

Fig. 1
Fig. 1
Rates of decline in under-5 mortality, 95 countries, 1970–2000. Note: Values are grouped in 1% increments above and below 4.3%, the rate required to reach MDG-4.
Fig. 2
Fig. 2
Factors accounting for decline in under-5 mortality, all low- and middle-income countries, 1970–2000. Note: Under-5 mortality (5q0) averaged across all countries declined from 143 per thousand in 1970 to 62 per thousand in 2000. The average country-specific rate of decline was 3.4% per year. This graph shows the contribution of selected policy-elated determinants of this decline. Decline associated with technical progress is broken down into geographic, DPT3 immunization coverage, and unexplained country effects in Web appendix D.
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