Achieving the Millennium Development Goals: the role of infrastructure

This paper provides an empirical analysis of the determinants of child health in order to make the case for the importance of combining interventions, including access to basic infrastructure services, in order to meet the Millennium Development Goals (MDGs).

Using data from Demographic and Health Surveys, the paper goes beyond traditional cross-country regressions by exploiting the variability in outcomes and explanatory variables observed within countries between asset quintiles.

Findings include:

• at the national level, GDP per capita, female illiteracy and ethno-linguistic fractionalization all affect infant and child mortality
• at the quintile level, the households’ asset levels, the prevalence of diseases and the level of access to piped water affect infant and child mortality
• the prevalence of malnutrition is associated with national GDP per capita and female illiteracy, and at the quintile level with diarrhoea prevalence, the mother’s nutritional status, delivery attendance at birth, the absence of sanitation and the presence of a dirt floor in the house
• female literacy and interventions that reduce the prevalence of diarrhoeal diseases and malnutrition are more important for analysing the determinants of health outcomes than GDP. This in turn includes a number of health and infrastructure interventions
• a substantial portion of the difference in health outcomes between rich and poor can be explained through the difference in water and sanitation service coverage
• for both child mortality and malnutrition, the impact of infrastructure seems to be conditioned by the level of education and the use of adequate health services