The Failures of Privatization: A Comparative Investigation of Tuberculosis Rates and the Structure of Healthcare in Less-Developed Nations, 1995–2010

Austin, Kelly; DeScisciolo, Cristina; Samuelsen, Lene

doi:10.1016/j.worlddev.2015.10.027

Cited by 61 publications

(14 citation statements)

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“…Descisciolo and Samuelsen (2016) point to the limits of privatisation in sectors with public goods characteristics. Examining the privatisation of healthcare in 99 less-developed nations over the 1995-2000 period, they employ two-way fixed effects ordinary least squares regression models.…”

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confidence: 99%

Privatization in Developing Countries: What Are the Lessons of Recent Experience?

Estrin

Pelletier

2018

The World Bank Research Observer

114

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This document is the author's final accepted version of the journal article. There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it. breakdown for developed countries. We are not aware of an alternative database providing such information. This was also confirmed by several academic and practitioner experts on privatisation whom we contacted during the course of this research. iv Which includes transportation, water and sewerage, telecommunications, natural gas transmission and distribution, and electricity generation, transmission, and distribution. v Which includes agribusiness, cement, chemicals, construction, steel, hotels, tourism, airlines, maritime services and other sub-sectors that are not infrastructure or finance related. vi Which includes banks, insurance, real estate, and other financial services. vii Which includes the exploration, extraction, and refinement of hydrocarbons, oil, and natural gas. viii Which includes the extraction, refinement and sale of primary minerals and metals such as coal and iron ore. ix The ownership pattern resulting from privatisation often depends on the mode of privatisation chosen. Thus, private sale usually leads to concentrated strategic owners while mass privatisation usually generates widespread ownership at least initially. The impact of mode of privatisation on national economic performance in transition economies is explored in Bennett, Estrin and Urga (2007). x Note however that in the utilities sector, water in particular, the technology and the nature of the product restrict the possibility of competition in the market and therefore the efficiency gains following privatisation. In this case, competition for the market (to win the contract or concession agreement) has to be organized. Given the ambiguous results of privatisation in noncompetitive markets in terms of improving economic performance (Megginson and Netter 2001), regulation may prove to be more effective (Kirkpatrick et al., 2006). xi Because the performance of privatised banks in the seven countries of the West African Economic and Monetary Union from 1990 to 1997 improved in the first year after privatisation but not after that. xii Improvements in performance in Nigeria were observed in fully divested banks but not in the ones where the government retained minority shareholdings. xiii Whereas competition is feasible in telecommunications markets, it is usually cost inefficient in the market for water services given the scale of the investment in network assets required to deliver the product. xiv Privatisation is also not associated with the profitability and efficiency of government-owned firms. xv Note however that this method may suffer from a trade-off with competition objectives since foreign firms may seek local monopoly power. Such sales may be accompanied by conditions with respect to technology transfer, domestic content of inputs, employment, environment etc.

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confidence: 99%

Privatization in Developing Countries: What Are the Lessons of Recent Experience?

Estrin

Pelletier

2018

The World Bank Research Observer

114

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“…For instance, for some diseases, such as HIV, the presence of international nongovernmental organizations (INGO) or other external health resources (such as provisions for antiretroviral drugs) may act as mediating factors to consider. Previous studies such as Austin et al (2016) have shown that public health spending ameliorated tuberculosis but private health spending had no effect, thus, demonstrating that each health outcome is potentially driven by different mechanisms and that all types of health expenditures are not equal.…”

Section: Resultsmentioning

confidence: 89%

“…This method has been shown to be superior to certain types of multiple imputation, and pairwise and listwise deletion for dealing with missing data. In addition, it is recommended for use in SEMs over multiple imputation (Asparouhov and Muthén 2010) and, in simulations, was shown to produce lower bias for estimates and standard errors when there were common amounts of missing data (Schlomer, Bauman, and Card 2010). Direct ML is not utilized in regression analyses because it is not a typical feature of multiple regression commands but is in software packages designed to model SEMs (e.g., Amos and Mplus).…”

Section: Robustness Checksmentioning

confidence: 99%

Democracy and Infant Mortality in Less-Developed Nations: Dismantling Differences in Direct and Indirect Effects Modeling

Noble

2019

Sociological Perspectives

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In recent years, many studies have focused on examining the relationship between democracy and health outcomes in developing nations. However, the overwhelming majority of this research utilizes direct-effect modeling approaches, assuming that increases in democracy are going to directly translate into improvements in well-being. Drawing on a sample of 136 less-developed nations, I first conduct a basic regression, where I find no significant impact of democracy on infant mortality. I then utilize structural equation modeling (SEM) to show significant indirect effects of democracy on infant deaths through public health spending. The results help place in context previous studies that have found inconsistent effects of democracy on health outcomes. The regression and SEM analyses demonstrate how erroneous findings can result from solely utilizing direct-effect approaches, which incorrectly treat key mediating mechanisms as competing predictors.

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“…We expect higher levels of public health expenditures to be associated with decreased maternal mortality within sub‐Saharan African nations. This is because government investment in hospitals and primary care (e.g., immunizations, family planning, prenatal care, postnatal care, and nutrition counseling) should improve maternal mortality (Austin, DeScisciolo, and Samuelsen ).…”

Section: Methodsmentioning

confidence: 99%

The World Bank, Organized Hypocrisy, and Women's Health: A Cross‐National Analysis of Maternal Mortality in Sub‐Saharan Africa

et al. 2016

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The theory of organized hypocrisy asserts that an organization depends upon its external environment for both financial support and conferred legitimacy, which can lead to conflicting policy agendas. We apply the theory of organized hypocrisy to World Bank structural adjustment and investment lending for reproductive health, hypothesizing these two lending policies should have differential effects on maternal mortality. We estimate a two-way fixed effects regression model with robust standard errors clustered by country to examine the effect of World Bank reproductive health lending on maternal mortality within sub-Saharan African nations over the period 1990-2010. We find that in every model the coefficients for World Bank structural adjustment lending in the health sector are positive and significant while the coefficients for World Bank investment lending in the reproductive health sector are negative and significant. The findings lend support to the theory that the World Bank is pursuing contradictory agendas, embodied by its lending policies, which can have differential effects on maternal mortality.

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The Failures of Privatization: A Comparative Investigation of Tuberculosis Rates and the Structure of Healthcare in Less-Developed Nations, 1995–2010

Cited by 61 publications

References 50 publications

Privatization in Developing Countries: What Are the Lessons of Recent Experience?

Privatization in Developing Countries: What Are the Lessons of Recent Experience?

Democracy and Infant Mortality in Less-Developed Nations: Dismantling Differences in Direct and Indirect Effects Modeling

The World Bank, Organized Hypocrisy, and Women's Health: A Cross‐National Analysis of Maternal Mortality in Sub‐Saharan Africa

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