Public Financial Management, Health Financing and Under-Five Mortality A Comparative Empirical Analysis
- Moritz Piatti-Fünfkirchen, Lodewijk Smets
- Feb 2019
- The World Bank Group (WBG), Inter-American Development Bank (IDB)
- International
This paper examines the relationship between public financial management (PFM), the financing of health interventions and health outcomes. Specifically, the paper econometrically tests whether the effect of PFM on under-five (U5) mortality depends on public sector health financing. Employing ordinary least squares (OLS) on a sample of 215 observations indicates that a one-unit increase in PFM quality is associated with a reduction in the U5 mortality rate by about 14 deaths per 1,000 live births. For countries that channel at least 75 percent of health expenditures through the government system, this rate increases to 17 deaths per 1,000 child births. Furthermore, the paper provides a comparative analysis for Latin America and Caribbean (LAC), a region that remains mostly overlooked in the literature. The findings for LAC are broadly consistent with the global sample, though less pronounced and without a differential effect for countries across the financing threshold. Overall, the evidence indicates that the pursuit of universal health coverage and the progress toward related SDGs will be costlier if enabling systems are not in place.
