Excluding the Rural Population : The Impact of Public Expenditure on Child Malnutrition in Peru
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World Bank, Washington, DC
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Why is the urban-rural gap in child
malnutrition increasing in Peru despite government efforts
to improve the provision of public services? To answer this
question, the impact of regional public expenditure in Peru
on young children's nutritional outcomes is examined.
To account for policy endogeneity, public expenditures are
instrumented using unanticipated regional mining revenues.
Even after accounting for changes in expenditure composition
due to increases in mining revenues, public spending has a
significant and positive impact on children's outcomes
only in urban areas. However, even in urban areas, barriers
exist that diminish the effectiveness of public expenditure,
so indigenous and frailer children in these areas do not
benefit from public spending. These children face
constraints that limit their ability to use public services.
This result reveals the paramount importance of initial
conditions. In rural areas, possibly because of the lower
quantity and quality of public services, there is no
positive effect for any children.
Palabras clave
ABSENTEEISM, ACCESS TO HEALTH CARE, ACCESS TO HEALTH FACILITIES, ACCESS TO MARKETS, ACCOUNTING, ACUTE RESPIRATORY INFECTIONS, AGED, AGRICULTURAL PRODUCTIVITY, ANDEAN REGION, ANNUAL REPORTS, BUDGET CONSTRAINTS, BUDGETARY EXPENDITURE, CAPACITY BUILDING, CAPITAL INVESTMENT, CENTRAL GOVERNMENT, CHILD DEVELOPMENT, CHILD NUTRITION, CHRONIC ILLNESS, CHRONIC MALNUTRITION, CITIES, COMPOSITION OF EXPENDITURES, DEBT, DIETS, DIFFERENT REGION, DISADVANTAGED GROUPS, DRINKING WATER, ECONOMIC ANALYSIS, EFFECTIVENESS OF PUBLIC SPENDING, EXPENDITURE CATEGORIES, EXPENDITURE DATA, EXPENDITURES ON HEALTH, FAMILY PLANNING, FEASIBILITY STUDIES, FOOD AVAILABILITY, FOOD POLICY, FOOD SUPPLY, GEOGRAPHICAL REGIONS, GLOBAL POVERTY, GOVERNMENT EXPENDITURE, GOVERNMENT SPENDING, HEALTH CARE, HEALTH CENTERS, HEALTH EXPENDITURES, HEALTH OUTCOMES, HEALTH POLICY, HEALTH PROBLEMS, HEALTH PROMOTION, HEALTH SERVICES, HEALTH SPENDING, HEALTH WORKERS, HOUSEHOLD SIZE, HOUSEHOLD WELFARE, HOUSING, HUMAN CAPITAL, HUMAN CAPITAL FORMATION, IMMUNIZATION, INADEQUATE HEALTH, INCIDENCE OF PUBLIC SPENDING, INFECTIOUS DISEASES, INFRASTRUCTURE PROJECTS, INTERVENTION, IRON, LEVEL OF PUBLIC SPENDING, LIVING CONDITIONS, LOCAL GOVERNMENTS, MALNUTRITION, MARGINAL EFFECTS, MEDICAL PROFESSIONALS, MEDICINES, MIGRATION, NATIONAL ACCOUNTS, NET INCOME, NURSES, NUTRITION, NUTRITION OUTCOMES, NUTRITIONAL STATUS, OPPORTUNITY COST, PER CAPITA INCOME, PHYSICIANS, POLITICAL REGION, POLLUTION, POOR AREAS, POOR BENEFIT, POOR COUNTRIES, POOR HOUSEHOLDS, POOR PEOPLE, POORER GROUPS, POVERTY ALLEVIATION, POVERTY LEVELS, POVERTY LINE, PRIMARY SCHOOLS, PRIVATE GOODS, PRIVATE SECTOR, PRODUCTION FUNCTION, PROGRAMS, PROVINCIAL GOVERNMENTS, PUBLIC, PUBLIC ASSETS, PUBLIC BUDGET, PUBLIC ECONOMICS, PUBLIC EXPENDITURE, PUBLIC EXPENDITURES, PUBLIC FUNDS, PUBLIC GOODS, PUBLIC HEALTH, PUBLIC INTERVENTION, PUBLIC INVESTMENT, PUBLIC POLICY, PUBLIC PROGRAMS, PUBLIC PROVIDERS, PUBLIC SECTOR, PUBLIC SERVICE, PUBLIC SERVICES, PUBLIC SPENDING, QUALITY OF SERVICES, REGIONAL CHARACTERISTICS, REGIONAL DISTRIBUTION, REGIONAL GOVERNMENT, REGIONAL GOVERNMENTS, REGIONAL INCOME, REGIONAL LEVEL, REGIONAL MIGRATION, REGIONAL PARTICIPATION, REGIONAL PUBLIC EXPENDITURE, REGIONAL SPENDING, ROADS, RURAL AREAS, RURAL DIVIDE, RURAL GAP, RURAL POPULATION, SANITATION, SOCIAL PROGRAMS, SOCIAL SERVICES, TOTAL EXPENDITURE, TOTAL PUBLIC EXPENDITURE, TOTAL PUBLIC SPENDING, TOTAL SPENDING, URBAN AREAS, WATER POLLUTION, WORKERS