Decentralization and child health outcomes in Brazil
DOI:
https://doi.org/10.1590/0101-41615033dncaKeywords:
Decentralization, Child health, Regional development, BrazilAbstract
Over the past decade, Brazil experienced a sharp increase in the decentralization of public health services. Given the possibility of heterogeneous responses and distributional consequences, it was sought to verify the general and regional effects of the decentralization of public health services on child health outcomes across Brazilian states during the period 2000-2013. For this, I constructed a measure of fiscal decentralization of the health sector does not explored in national literature and the two-way fixed effects model approach was applied with state-specific trends and robust standard errors. The results showed that the fiscal decentralization of actions and public health services had, during the period in analysis, a substantial statistically impact on reducing the infant and child mortality rates in Brazil. However, the effects of decentralization are different given the regional development level, with superior impacts in more developed regions (South region, -0.598). Meanwhile, the institutional capacity of health sector management of states and municipalities in the Northern region of Brazil (null effect) needs to be reexamined.
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Atualizado em 14/08/2025