2004年-世界发展银行全球_Child_Health_and_the_1988-92____________Economic_Crisis_in_Peru_28页_302kb

Summary of "Child Health and the 1988-1992 Economic Crisis in Peru"

Core Content

This paper investigates the impact of the 1988-1992 economic crisis in Peru on child health, specifically focusing on infant mortality and nutritional status. The study uses data from the Demographic and Health Surveys (DHS) conducted in 1986, 1992, 1996, and 2000, along with public health expenditure data, GDP per capita, and wage income data to assess the effects of the crisis on children.

Main Findings

• Infant Mortality Increase: The infant mortality rate increased by approximately 2.5 percentage points for children born in late 1989 and 1990, resulting in about 17,000 additional deaths compared to what would have occurred without the crisis.
• Crises and Mortality: The mortality spike appears in all three surveys (1992, 1996, and 2000), suggesting it is not due to sampling error. The inverse relationship between infant mortality and per capita GDP is strong, with an elasticity of -0.973.
• Regional Impact: The increase in infant mortality was observed in all regions except the jungle region, where data were noisy due to small sample sizes. This supports the idea that the crisis had a widespread effect on child health.
• Maternal Education and Urbanization: These factors explain about 0.5 percentage points of the overall decline in infant mortality from 1978 to 1998, but do not account for the sharp spike in 1990.
• Differential Impact by Education: The increase in infant mortality was most pronounced among children born to mothers with less education. For example, the infant mortality rate for uneducated mothers increased from 9.4% in 1988 to 12.8% in 1990, while for those with 10 years of schooling, it increased from 2.7% to 3.8%.
• Fertility Response: The paper finds that fertility rates declined during the crisis, especially among less-educated women, but this decline does not seem to have contributed to the mortality spike.
• Nutritional Status: Children under the age of 6 who were exposed to the crisis in 1992 were shorter than same-aged children in 1996 and 2000. This suggests a long-term negative impact on child nutrition, likely due to economic hardship.
• No Significant Impact on Schooling: Despite a decline in public education spending, the crisis did not have a significant negative impact on schooling outcomes, indicating that education may be more resilient to economic shocks than health.
• Economic Context: The crisis was marked by severe GDP contraction (almost 30% between 1988 and 1992), hyperinflation, and a large cholera epidemic in 1991. The 1982-83 crisis, though smaller, also had a negative impact on child health, though less clear due to limited data.

Key Information

• Data Sources: The study relies on DHS data, which provide nationally representative samples of women aged 15-49, and additional macroeconomic data.
• Methodology: The paper uses probit regressions to analyze the relationship between the economic crisis and child health outcomes. It also employs kernel smoothing to interpret anthropometric data.
• Limitations: The lack of pre-crisis child height data makes it difficult to distinguish between the effects of the crisis and secular trends. Recall errors and small sample sizes in certain regions also pose challenges.
• Conclusion: The economic crisis in Peru had a significant negative impact on child health, particularly infant mortality and nutritional status. The effects were more pronounced among less-educated and poorer households, highlighting the vulnerability of these groups during economic downturns.

Main Points

• The 1988-1992 economic crisis in Peru led to a sharp increase in infant mortality.
• Children exposed to the crisis were shorter in 1992 than those in 1996 and 2000, indicating long-term nutritional impacts.
• The crisis had a more severe impact on child health than on schooling outcomes.
• The effect of the crisis on child health varied by education level, with less-educated mothers and their children being most affected.
• The study suggests that both household income decline and reduced public health spending contributed to the deterioration in child health during the crisis.