Achieving the Millennium Development Goals
The Role of Infrastructure
Danny Leipziger, Marianne Fay, Quentin Wodon and Tito Yepes1
This paper provides an empirical analysis of the determinants of three child health outcomes related to the Millennium Development Goals: the infant mortality rate, the child mortality rate, and the prevalence of malnutrition. Using data fromDemographic 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. The paper shows the relationships existing between the prevalence of diseases (diarrhea and malnutrition) and mortality. The findings suggest that apart from traditional variables (income,assets, education and direct health interventions), better access to basic infrastructure services has an important role to play in improving child health outcomes. The analysis of interaction effects between interventions also suggests the importance of combining interventions in order to meet the Millenium Development Goals. JEL categories: I12, O10, H42 Keywords: Millennium Development Goals, Infantmortality, Malnutrition, Infrastructure
World Bank Policy Research Working Paper 3163, November 2003
The Policy Research Working Paper Series disseminates the findings of work in progress to encourage the exchange of ideas about development issues. An objective of the series is to get the findings out quickly, even if the presentations are less than fully polished. The papers carry the namesof the authors and should be cited accordingly. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the view of the World Bank, its Executive Directors, or the countries they represent. Policy Research Working Papers are available online at http://econ.worldbank.org. Corresponding author: Marianne Fay WorldBank, 1818 H Street Washington, DC 20433 Email: email@example.com This paper was prepared in the Finance, Private Sector and Infrastructure Department of the Latin America and the Caribbean Vice Presidency at the World Bank as part of a research program on MDGs and Infrastructure.
1 1. Introduction In September 2000, the 189 member states of the United Nations unanimously adopted theMillennium Declaration. The Declaration outlines key development challenges, proposes a response to these challenges and defines a series of targets and progress measures. There are eight broad goals (the so-called Millennium Development Goals, or MDGs hereafter), with 15 targets that are to be monitored through a set of 48 indicators.2 The aim is to achieve these targets by 2015. The setting of humandevelopment goals is not new to the development literature. Many in the early 1980s viewed the development challenge through the optic of basic human needs, a series of necessities that the donor community was to commit itself to provide the poor3. Today, the development challenge is no less daunting than it was two decades ago. In the intervening years, global growth has surged, a few primarilyAsian countries have broken through the poverty barrier, and some significant progress in trade opening has occurred. These developments notwithstanding, and despite some gains in reducing the demographic explosion, the number of poor people has increased dramatically. Hence the attraction to the MDGs as a way to re-ignite development efforts. To many, the goals encapsulate some of the key developmentchallenges facing governments and international donors. To others, goals 2 through 8 seem superfluous as long as the first – eradication of extreme poverty and hunger– is tackled. capita income, they argue, why bother with specific aims in health and education? The answer to this first question is that economic growth should help, but will not be sufficient to achieve the MDGs.4 Performance in...