Excluding the Rural Population : The Impact of Public Expenditure on Child Malnutrition in Peru

Gajate-Garrido, Gissele

World Bank, Washington, DC

关键词: ABSENTEEISM;    ACCESS TO HEALTH CARE;    ACCESS TO HEALTH FACILITIES;    ACCESS TO MARKETS;    ACCOUNTING;   

DOI  :  10.1596/1813-9450-6666
RP-ID  :  WPS6666

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

Why is the urban-rural gap in childmalnutrition increasing in Peru despite government effortsto improve the provision of public services? To answer thisquestion, the impact of regional public expenditure in Peruon young children's nutritional outcomes is examined.To account for policy endogeneity, public expenditures areinstrumented using unanticipated regional mining revenues.Even after accounting for changes in expenditure compositiondue to increases in mining revenues, public spending has asignificant and positive impact on children's outcomesonly in urban areas. However, even in urban areas, barriersexist that diminish the effectiveness of public expenditure,so indigenous and frailer children in these areas do notbenefit from public spending. These children faceconstraints that limit their ability to use public services.This result reveals the paramount importance of initialconditions. In rural areas, possibly because of the lowerquantity and quality of public services, there is nopositive effect for any children.