Do targeted intergovernmental fiscal transfers improve health outcomes in Kenya?
Author Information
Author(s): Bishnu Bahadur Thapa, Momotazur Rahman, Were Lawrence, Wamai Richard, Galárraga Omar
Primary Institution: Department of Health Services, Policy and Practice, School of Public Health, Brown University
Hypothesis
Additional financial resources from targeted intergovernmental fiscal transfers will lead to improved health outcomes in marginalized counties.
Conclusion
Targeted intergovernmental fiscal transfers may effectively reduce diarrhoea incidence but do not impact HIV incidence.
Supporting Evidence
- Counties receiving targeted fiscal transfers saw a statistically significant decline in diarrhoea incidence.
- The intervention had no significant effect on HIV incidence.
- Marginalized counties prioritized spending on health sectors that impact diarrhoea.
- Decentralization allowed for more integrated public health approaches for diarrhoea compared to HIV.
Takeaway
The study found that giving extra money to poorer counties in Kenya helped reduce the number of people getting sick from diarrhoea, but it didn't help with HIV.
Methodology
The study used the difference-in-differences technique and fixed effects models to analyze health outcomes before and after the implementation of fiscal transfers.
Potential Biases
Potential biases may arise from unobserved county-specific attributes and reverse causality.
Limitations
The study assumes equal distribution of funds among marginalized counties and may be biased due to unobserved confounding factors.
Participant Demographics
The intervention group consisted of 14 marginalized counties, which were poorer and less educated compared to the 33 nonmarginalized counties.
Statistical Information
P-Value
p<0.05
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website