Complementarities in the provision of public services: Evidence from Zambia

  • This study seeks to understand how the construction of new health facilities affects population health, focusing on health outcomes related to obstetric care and child mortality when the first facility is established in a local area.
  • Researchers built a new geo-referenced panel data set containing the universe of health facilities in Zambia by combining health facility censuses conducted by the Zambian Ministry of Health and its partner organisations.
  • The data set maps the rollout of new health facilities across space and time from 1990 to 2017, which saw a dramatic rise in the number of facilities, rising from 1,022 to 3,131.
  • The authors find that the establishment of a nearby health facility is associated with an increase in the deliveries via caesarean section. In addition, they obtain suggestive evidence for a decline in child mortality.
  • These findings may have significant implications for policymakers who hope to make inroads in reducing child mortality.