Has Democratization Reduced Infant Mortality in Sub-Saharan Africa? Evidence from Micro Data

Does democracy help babies survive in sub-Saharan Africa? By using retrospective fertility surveys conducted in 28 African countries, I compare the survival of infants born to the same mother before and after democratization to identify the effect of democracy. In measuring democracy, I adopt a theoretically motivated definition of democracy: universal suffrage and contested elections for executive office. I find that infant mortality falls by 1.8 percentage points, 18 percent of the sample mean, after democratization. The size of the reduction is larger for babies born to mothers from disadvantaged groups. I also find that the replacement of a chief executive by democratization is the driving force behind these results. Additional evidence suggests that improvements in public health service delivery, not an increase in affluence, are the key mechanism in which democratization has reduced infant mortality.

Political economy of development: health as a development outcome, micro evidence, and heterogeneity of democracies and autocracies

The thesis explores whether and how democratic and autocratic political institutions affect the welfare of people in developing countries. First, we empirically investigate whether democracy improves people's health, by using time-series country-level aggregate statistics. We find that there is a robust cross-sectional correlation between democracy and life expectancy at birth. Country fixed effects estimation, on the other hand, does not yield a statistically significant correlation between the two. This empirical approach, however, does not disentangle the effect of democracy from country-level confounding factors. To overcome this, I empirically examine whether democratization has reduced infant mortality in sub-Saharan Africa in the 1990s, by using micro data on child survival. Mother fixed effects estimation shows that mothers see their infants more likely to survive after democratization than before. This result may suggest that African dictatorships are particularly bad compared to those in other regions. To shed some light on this possibility, we theoretically investigate under what condition autocracy yields good policy outcomes. We show that such a condition is that those enfranchised in autocracy can retain the right of leadership selection after overthrowing a dictator for his bad performance. We also show that such a successful autocracy outperforms a democracy if distributional issues are so important that voters in democracy cannot discipline policy-makers in the general interest policy outcomes. What affects the salience of distributional issues, therefore, needs to be understood. One such factor may be ethnic favoritism by the government, which has rarely been empirically investigated in a systematic way. By using micro data on infant mortality and by exploiting one-time unexpected change in the president's ethnicity in Guinea, I provide evidence on whether the ethnicity of those in power affects infant mortality for each ethnic group under an autocratic rule

Child mortality, commodity price volatility and the resource curse

Given many developing economies depend on primary commodities, the fluctuations of commodity prices may imply significant effects for the wellbeing of children. To investigate, this paper examines the relationship between child mortality and commodity price movements as reflected by country-specific commodity terms-of-trade. Employing a panel of 69 low and lower-middle income countries over the period 1970-2010, we show that commodity terms-of-trade volatility increases child mortality in highly commodity-dependent importers suggesting a type of 'scarce' resource curse. Strikingly however, good institutions appear able to mitigate the negative impact of volatility. The paper concludes by highlighting this tripartite relationship between child mortality, volatility and good institutions and posits that an effective approach to improving child wellbeing in low to lower-middle income countries will combine hedging, import diversification and improvement of institutional quality

Women, weather, and woes: The triangular dynamics of female-headed households, economic vulnerability, and climate variability in South Africa

Existing gender inequality is believed to be heightened as a result of weather events and climate-related disasters that are likely to become more common in the future. We show that an already marginalized group—female-headed households in South Africa—is differentially affected by relatively modest levels of variation in rainfall, which households experience on a year-to-year basis. Data from three waves of the National Income Dynamics Survey in South Africa allow us to follow incomes of 4,162 households from 2006 to 2012. By observing how household income is affected by variation in rainfall relative to what is normally experienced during the rainy season in each district, our study employs a series of naturally occurring experiments that allow us to identify causal effects. We find that households where a single head can be identified based on residency or work status are more vulnerable to climate variability than households headed by two adults. Single male-headed households are more vulnerable because of lower initial earnings and, to a lesser extent, other household characteristics that contribute to economic disadvantages. However, this can only explain some of the differential vulnerability of female-headed households. This suggests that there are traits specific to female-headed households, such as limited access to protective social networks or other coping strategies, which makes this an important dimension of marginalization to consider for further research and policy in South Africa and other national contexts. Households headed by widows, never-married women, and women with a non-resident spouse (e.g., “left-behind” migrant households) are particularly vulnerable. We find vulnerable households only in districts where rainfall has a large effect on agricultural yields, and female-headed households remain vulnerable when accounting for dynamic impacts of rainfall on income

Violence, Selection and Infant Mortality in Congo

This paper documents the effects of the recent civil war in the Democratic Republic of Congo on mortality both in utero and during the first year of life. It instruments for conflict intensity using a mineral price index, which exploits the exogenous variation in the potential value of mineral resources generated by changes in world mineral prices to predict the geographic distribution of the conflict. Using estimates of civil war exposure on mortality across male and female newborn to assess their relative health, it provides evidence of culling effect (in utero selection) as a consequence of in utero shocks

Health and democracy

In spite of the inexorable march of democracy around the globe, just how democratic institutions a¤ect human well-being is open to debate. The evidence that democracy promotes prosperity is neither strong nor robust. Moreover which aspects of policy making and human well-being are promoted b

Making autocracy work

One of the key goals of political economy is to understand how institutional arrangements shape policy outcomes. This paper studies a comparatively neglected aspect of this - the forces that shape heterogeneous performance of autocracies. The paper develops a simple theoretical model of accountability in the absence of regularized elections. Leadership turnover is managed by a selectorate - a group of individuals on whom the leader depends to hold onto power. Good policy is institutionalized when the selectorate removes poorly performing leaders from office. This requires that the selectorate’s hold on power is not too dependent on a specific leader being in office. The paper looks empirically at spells of autocracy to establish cases where it has been successful according to various objective criteria. We use these case studies to identify the selectorate in specific instances of successful autocracy. We also show that, consistent with the theory, leadership turnover in successful autocracies is higher than in unsuccessful autocracies. Finally, we show by exploiting leadership deaths from natural causes that successful autocracies appear to have found ways for selectorates to nominate successors without losing power - a feature which is also consistent with the theoretical approach