摘要：Why do over 20% of children die in some poor countries, while in others only 2%
die? We examine this question using survey data covering 278,000 children in 45
low-income countries. We find that parents’ education and a mother’s propensity
to seek out modern healthcare are empirically important when explaining child
survival, while the prevalence of common diseases, along with infrastructure
such as improved water and sanitation, are not. Using a GINI coefficient we
construct for treatment services, we find that public and private health systems
are “equally unequal”, that is, both tend to favor children in relatively
well-off households, and neither appears superior at improving outcomes in very
poor communities. These facts contrast with a common view that a much-expanded
public health sector is necessary to reduce child mortality. Instead, we believe
the empirical evidence points to the essential role of parents as advocates for
their child’s health. If we can provide better health knowledge and general
education to parents, a private healthcare sector can arise to meet demand. We
provide evidence that this alternative route to low mortality is indeed a reason
behind the current success of many countries with low child mortality, including
Vietnam, Indonesia, Egypt, and the Indian state of Kerala. Finally, we calculate
a realistic package of interventions that target education, health knowledge and
treatment seeking could reduce child mortality by 32%.
