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首页> 外文期刊>International Journal of Social Economics >Relation between levels of infant-,child- and maternal-mortality and their rates of decline: Evidence from a large cross-country data set
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Relation between levels of infant-,child- and maternal-mortality and their rates of decline: Evidence from a large cross-country data set

机译：婴儿，儿童和孕产妇死亡率水平与下降速度之间的关系：来自大型跨国数据集的证据

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Purpose - The purpose of this paper is to study the cross-country relation between initial levels of infant-, child- and maternal-mortality and their rates of decline so as to see whether the so-called Matthew effect or the inverse-care principle operates relative to these three important health indicators.rnDesign/methodology/approach - Data on the three variables for a large number of countries covering several periods between 1950 and 2007 are considered. Signs and significance of correlations between initial levels and the rates of decline over the period, and of coefficients of initial levels in regressions of rates of decline on the initial level, are studied.rnFindings - First, in a broad global context, higher initial levels of mortality are associated with significantly lower rates of decline in each of the three indicators for every period, thus providing strong support to the operation of the inverse-care principle and the Matthew effect. Second, the high-income countries (and transition economies) deviate from the global pattern. Third, following Hart's suggestion, the parametric contrast between the high income and the developing groups may be interpreted as indicative of stronger government intervention in the healthcare sector in high-income countries. Fourth, the contrast may thus indicate the desirability of greater government intervention in provision of healthcare in developing countries. Fifth, operation of the inverse-care principle and the Matthew effect is observed even in the absence of high-HIV prevalence. Sixth, the observed negative covariation between initial mortality and its rate of decline implies cross-country divergence in these core indicators of health.rnOriginality/value - First, this is the only study to investigate the operation of the inverse-care principle relative to infant mortality for such a large number of countries and such a long period. Second, it is also the only study to extend the investigation to child-mortality and maternal-mortality, which are heavily emphasized in the millennium development goals. Third, the patterns are studied not only merely for the entire set of countries, but also for several subgroups. Fourth, the observed parametric contrasts are interpreted as possibly reflecting the importance of government intervention in the healthcare sector in mitigating the operation of the inverse-care phenomenon. Fifth, an effort is made to factor out the role of HIV so as to show that the pattern is not significantly altered by high prevalence of HIV in poor countries. Sixth, the implied cross-country divergence in these important health variables is suggestive of the need for caution in interpreting the conclusions stated by some scholars about convergence in several quality-of-life indicators. Last, contrary to what some scholars have suggested, not merely does it not seem to be the case that the inverse-care proposition relative to infant mortality is observed only in exceptional cases, but the reported evidence suggests that the proposition holds globally over long periods even for child- and maternal-mortality.
机译：目的-本文的目的是研究婴儿，儿童和孕产妇死亡率的初始水平与其下降速度之间的跨国关系，以便了解所谓的马修效应还是逆保健原则设计/方法/方法-考虑了涵盖1950年至2007年多个时期的许多国家的三个变量的数据。研究了初始水平与该期间的下降速度之间的相关性的符号和意义，以及在初始水平的下降速度回归中初始水平的系数。rn发现-首先，在广泛的全球背景下，较高的初始水平死亡率的降低与每个时期三个指标中每个指标的下降率显着降低有关，从而为逆保健原则的运作和马修效应提供了有力的支持。第二，高收入国家（和转型经济体）背离了全球格局。第三，根据哈特的建议，高收入人群和发展中国家人群之间的参数对比可能被解释为表明政府对高收入国家医疗部门的干预力度加大。第四，因此，这种对比可能表明希望在发展中国家提供更多的政府干预以提供医疗服务。第五，即使在艾滋病毒高流行的情况下，也可以观察到逆向护理原则的运作和马修效应。第六，观察到的初始死亡率及其下降速度之间的负协方差意味着这些核心健康指标之间存在跨国差异。rn原创性/价值-首先，这是唯一一项研究逆向护理原则相对于婴儿的操作的研究如此众多的国家和如此长的时期内的死亡率。其次，这也是将调查范围扩大到儿童死亡率和孕产妇死亡率的唯一研究，这在千年发展目标中得到了极大的强调。第三，不仅针对整个国家，而且针对几个亚组研究模式。第四，观察到的参数对比被解释为可能反映出政府干预医疗部门在减轻逆向护理现象的运行中的重要性。第五，努力排除艾滋病毒的作用，以表明在贫穷国家，艾滋病毒的高流行没有明显改变这种模式。第六，在这些重要的健康变量中所隐含的跨国差异表明，在解释一些学者关于几种生活质量指标趋同的结论时，需要谨慎行事。最后，与一些学者的建议相反，不仅似乎并非仅在特殊情况下观察到了与婴儿死亡率有关的逆向护理方案，而且据报道的证据表明，该方案在全球范围内长期存在即使是儿童和母亲死亡率。

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