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Unpublished Paper
Can Institutional Deliveries Reduce Newborn Mortality? Evidence from Rwanda
  • Edward Okeke, Rand Corporation
  • A.V. Chari, University of Sussex

Current global health policies emphasize institutional deliveries as a pathway to achieving reductions in newborn mortality in developing countries. There is however remarkably little evidence regarding a causal relationship between institutional deliveries and newborn mortality. In this paper we take advantage of a shock to institutional deliveries provided by the randomized rollout of a government performance-based financing program in Rwanda, to provide the first estimates of this causal effect. We construct an instrumental variables estimator that combines interrupted time-series and difference-in-differences approaches. We do not find any statistically significant effect of an institutional birth on either 7- or 30-day mortality in any of our specifications. We conclude that attempting to increase institutional deliveries without addressing supply-side constraints is unlikely to result in the large reductions in mortality that policy makers expect.

  • institutional births,
  • infant mortality,
  • health production
Publication Date
Citation Information
Edward Okeke and A.V. Chari. "Can Institutional Deliveries Reduce Newborn Mortality? Evidence from Rwanda" (2014)
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