Decentralization and Public Services : The Case of Immunization
The author studies the impact of political decentralization on childhood immunization, an essential public service provided in almost all countries. He examines the relationship empirically using a time-series data set of 140 low- and middle-income...
| Main Author: | |
|---|---|
| Format: | Policy Research Working Paper |
| Language: | English en_US |
| Published: |
World Bank, Washington, DC
2014
|
| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/2003/03/2183607/decentralization-public-services-case-immunization http://hdl.handle.net/10986/19159 |
| Summary: | The author studies the impact of
political decentralization on childhood immunization, an
essential public service provided in almost all countries.
He examines the relationship empirically using a time-series
data set of 140 low- and middle-income countries from 1980
to 1997. The author finds that decentralization has
different effects in low- and middle-income countries. In
the low-income group, decentralized countries have higher
coverage rates than centralized ones, with an average
difference of 8.5 percent for measles and DTP3 vaccines. In
the middle-income group, the reverse effect is observed:
decentralized countries have lower coverage rates than
centralized ones, with an average difference of 5.2 percent
for the same vaccines. Both results are significant at the
99 percent level. Modifiers of the
decentralization-immunization relationship also differ in
the two groups. In the low-income group, development
assistance reduces the gains from decentralization. In the
middle-income group, democratic government mitigates the
negative effects of decentralization, and decentralization
reverses the negative effects of ethnic tension and
ethno-linguistic fractionalization, but institutional
quality and literacy rates have no interactive effect either
way. Similar results are obtained whether decentralization
is measured with a dichotomous categorical variable or with
more specific measures of fiscal decentralization. The study
confirms predictions in the theoretical literature about the
negative impact of local political control on services that
have public goods characteristics and inter-jurisdictional
externalities. The author discusses reasons for the
difference between low- and middle-income countries. |
|---|