When a Doctor Falls from the Sky: The Impact of Easing Doctor Supply Constraints on Mortality

• 成果类型: Article
• 署名作者: Okeke, Edward N.
• 署名单位: RAND Corporation; Rand Health
• 刊物名称: AMERICAN ECONOMIC REVIEW
• ISSN/ISSBN: 0002-8282
• DOI: 10.1257/aer.20210701
• 发表日期: 2023
• 页码: 585-627
• 关键词: PRIMARY-HEALTH-CARE; Sub-Saharan Africa; prenatal-care; systematic analysis; UNDER-5 MORTALITY; perinatal-mortality; neonatal-mortality; infant-mortality; child-mortality; Birth outcomes

摘要

This paper describes the results of a policy experiment conducted in coordination with the Nigerian government. In this experiment, some communities were randomly selected to receive a new doctor. These doctors were posted to the local public health center. Prior to their arrival, health care was provided by midlevel health-care providers (MLP). To separate the effect of (ostensibly higher) quality from that of quantity, another group of communities was provided with an additional midlevel provider. A third group of communities received no additional workers. No other inputs were provided. I find a measurable decrease in mortality in communities assigned a doc-tor but not in communities assigned an MLP, suggesting that quality in the health-care sector is a significant constraint. (JEL I11, I12, O15, O18)