International Journal of Health Policy and Management

International Journal of Health Policy and Management

The Effect of Fiscal Decentralization on Under-five Mortality in Iran: A Panel Data Analysis

Document Type : Original Article

Authors
Ali Hussein Samadi 1
Ali Keshtkaran 2
Zahra Kavosi 2
Sajad Vahedi 2
1 Department of Economics, School of Economics, Management and Social Sciences, Shiraz University, Shiraz, Iran
2 School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
10.15171/ijhpm.2013.60
Abstract
Background
Fiscal Decentralization (FD) in many cases is encouraged as a strong means of improving the efficiency and equity in the provision of public goods, such as healthcare services. This issue has urged the researchers to experimentally examine the relationship between fiscal decentralization indicators and health outcomes. In this study we examine the effect of Fiscal Decentralization in Medical Universities (FDMU) and Fiscal Decentralization in Provincial Revenues (FDPR) on Under-Five Mortality Rate (U5M) in provinces of Iran over the period between 2007 and 2010.
 
Methods
We employed panel data methods in this article. The results of the Pesaran CD test demonstrated that most of the variables used in the analysis were cross-sectionally dependent. The Hausman test results suggested that fixed-effects were more appropriate to estimate our model. We estimated the fixed-effect model by using Driscoll-Kraay standard errors as a remedy for cross-sectional dependency.
 
Results
According to the findings of this research, fiscal decentralization in the health sector had a negative impact on U5M. On the other hand, fiscal decentralization in provincial revenues had a positive impact on U5M. In addition, U5M had a negative association with the density of physicians, hospital beds, and provincial GDP per capita, but a positive relationship with Gini coefficient and unemployment.
 
Conclusion
The findings of our study indicated that fiscal decentralization should be emphasized in the health sector. The results suggest the need for caution in the implementation of fiscal decentralization in provincial revenues.
Keywords
Fiscal Decentralization
Under-five Mortality
Panel Data
Fixed and Random Effects
Iran
Subjects

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  • Received Date 22 September 2013
  • Revised Date 27 November 2013
  • Accepted Date 14 November 2013
  • First Published Date 27 November 2013
  • Published Date 27 November 2013