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Research article
Estimating the impact of donor programs on child mortality in low- and middle-income countries: a synthetic control analysis of child health programs funded by the United States Agency for International Development
William M. Weiss
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
Background Significant levels of funding have been provided to low- and middle-income countries for development assistance for health, with most funds coming through direct bilateral investment led by the United States and the United Kingdom. Direct attribution of impact to large scale programs funded by donors remains elusive due the difficulty of knowing what would have happened without those programs, and the lack of detailed contextual information to support causal interpretation of changes.
Methods This study uses the synthetic control analysis method to estimate the impact of one donor’s funding (United States Agency for International Development, USAID) on under-five mortality across several low- and middle-income countries that received above average levels of USAID funding for maternal and child health programs between 2000 and 2016.
Results In the study period (2000-16), countries with above average USAID funding had an under-fiver mortality rate lower than the synthetic control by an average of 29 deaths per 1,000 live births (year to year range of 2 – 38). This finding was stable across several sensitivity analyses.
Conclusions The synthetic control method is a valuable addition to the range of approaches for quantifying the impact of large-scale health programs in low- and middle-income countries. The findings suggest that adequately funded donor programs (in this case USAID) help countries to reduce child mortality to significantly lower rates than would have occurred without those investments.
Keywords
Synthetic control analysis, Integrated Management of Childhood Illness (IMCI), Low- and middle-income countries (LMICs), United States Agency for International Development (USAID), Child mortality, Quasi-experimental methods, Maternal and child health (MCH), Impact evaluation, Donor assistance
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This is a list of supplementary files associated with this preprint. Click to download.
- FigureS1288Ghana.tif
- SupplementaryMaterialBMCPopHlthMetricsClean20200216.pdf
- FigureS2450Madagascar.tif
- FigureS3454Malawi.tif
- FigureS4466Mali.tif
- FigureS5508Mozambique.tif
- FigureS6686Senegal.tif
- FigureS7800Uganda.tif
- FigureS8894Zambia.tif
- FigureS9treatmentunitand47placebosNoChad.tif
- FigureS10ATreatmentQuadrant3.tif
- FigureS10BtreatmentandplacebosQuadrant3.tif
- FigureS11ATreatmentQuadrant1NonNested.tif
- FigureS11BtreatmentandplacebosQuad1NonNested.tif
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This is a preprint. It has not completed peer review.
Research article
Estimating the impact of donor programs on child mortality in low- and middle-income countries: a synthetic control analysis of child health programs funded by the United States Agency for International Development
William M. Weiss
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 09 Jun, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background Significant levels of funding have been provided to low- and middle-income countries for development assistance for health, with most funds coming through direct bilateral investment led by the United States and the United Kingdom. Direct attribution of impact to large scale programs funded by donors remains elusive due the difficulty of knowing what would have happened without those programs, and the lack of detailed contextual information to support causal interpretation of changes.
Methods This study uses the synthetic control analysis method to estimate the impact of one donor’s funding (United States Agency for International Development, USAID) on under-five mortality across several low- and middle-income countries that received above average levels of USAID funding for maternal and child health programs between 2000 and 2016.
Results In the study period (2000-16), countries with above average USAID funding had an under-fiver mortality rate lower than the synthetic control by an average of 29 deaths per 1,000 live births (year to year range of 2 – 38). This finding was stable across several sensitivity analyses.
Conclusions The synthetic control method is a valuable addition to the range of approaches for quantifying the impact of large-scale health programs in low- and middle-income countries. The findings suggest that adequately funded donor programs (in this case USAID) help countries to reduce child mortality to significantly lower rates than would have occurred without those investments.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5