[go: up one dir, main page]

IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v174y2017icp220-227.html
   My bibliography  Save this article

The impact of IMF conditionality on government health expenditure: A cross-national analysis of 16 West African nations

Author

Listed:
  • Stubbs, Thomas
  • Kentikelenis, Alexander
  • Stuckler, David
  • McKee, Martin
  • King, Lawrence
Abstract
How do International Monetary Fund (IMF) policy reforms—so-called ‘conditionalities’—affect government health expenditures? We collected archival documents on IMF programmes from 1995 to 2014 to identify the pathways and impact of conditionality on government health spending in 16 West African countries. Based on a qualitative analysis of the data, we find that IMF policy reforms reduce fiscal space for investment in health, limit staff expansion of doctors and nurses, and lead to budget execution challenges in health systems. Further, we use cross-national fixed effects models to evaluate the relationship between IMF-mandated policy reforms and government health spending, adjusting for confounding economic and demographic factors and for selection bias. Each additional binding IMF policy reform reduces government health expenditure per capita by 0.248 percent (95% CI −0.435 to −0.060). Overall, our findings suggest that IMF conditionality impedes progress toward the attainment of universal health coverage.

Suggested Citation

  • Stubbs, Thomas & Kentikelenis, Alexander & Stuckler, David & McKee, Martin & King, Lawrence, 2017. "The impact of IMF conditionality on government health expenditure: A cross-national analysis of 16 West African nations," Social Science & Medicine, Elsevier, vol. 174(C), pages 220-227.
  • Handle: RePEc:eee:socmed:v:174:y:2017:i:c:p:220-227
    DOI: 10.1016/j.socscimed.2016.12.016
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953616306876
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.socscimed.2016.12.016?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Vreeland,James Raymond, 2003. "The IMF and Economic Development," Cambridge Books, Cambridge University Press, number 9780521016957, September.
    2. Ghobarah, Hazem Adam & Huth, Paul & Russett, Bruce, 2003. "Civil Wars Kill and Maim People—Long After the Shooting Stops," American Political Science Review, Cambridge University Press, vol. 97(2), pages 189-202, May.
    3. World Bank, 2015. "World Development Indicators 2015," World Bank Publications - Books, The World Bank Group, number 21634.
    4. Dreher, Axel, 2006. "IMF and economic growth: The effects of programs, loans, and compliance with conditionality," World Development, Elsevier, vol. 34(5), pages 769-788, May.
    5. Im, Kyung So & Pesaran, M. Hashem & Shin, Yongcheol, 2003. "Testing for unit roots in heterogeneous panels," Journal of Econometrics, Elsevier, vol. 115(1), pages 53-74, July.
    6. Jan‐Egbert Sturm & Helge Berger & Jakob De Haan, 2005. "Which Variables Explain Decisions On Imf Credit? An Extreme Bounds Analysis," Economics and Politics, Wiley Blackwell, vol. 17(2), pages 177-213, July.
    7. Benedict Clements & Sanjeev Gupta & Masahiro Nozaki, 2013. "What happens to social spending in IMF-supported programmes?," Applied Economics, Taylor & Francis Journals, vol. 45(28), pages 4022-4033, October.
    8. Przeworski, Adam & Vreeland, James Raymond, 2000. "The effect of IMF programs on economic growth," Journal of Development Economics, Elsevier, vol. 62(2), pages 385-421, August.
    9. Barro, Robert J. & Lee, Jong-Wha, 2005. "IMF programs: Who is chosen and what are the effects?," Journal of Monetary Economics, Elsevier, vol. 52(7), pages 1245-1269, October.
    10. Heckman, James, 2013. "Sample selection bias as a specification error," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 31(3), pages 129-137.
    11. Dreher, Axel & Walter, Stefanie, 2010. "Does the IMF Help or Hurt? The Effect of IMF Programs on the Likelihood and Outcome of Currency Crises," World Development, Elsevier, vol. 38(1), pages 1-18, January.
    12. Oberdabernig, Doris A., 2013. "Revisiting the Effects of IMF Programs on Poverty and Inequality," World Development, Elsevier, vol. 46(C), pages 113-142.
    13. Brady, David & Lee, Hang Young, 2014. "The rise and fall of government spending in affluent democracies, 1971-2008," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 24(1), pages 56-79.
    14. Abouharb,M. Rodwan & Cingranelli,David, 2007. "Human Rights and Structural Adjustment," Cambridge Books, Cambridge University Press, number 9780521676717, September.
    15. Ruger, J.P., 2005. "The changing role of the World Bank in global health," American Journal of Public Health, American Public Health Association, vol. 95(1), pages 60-70.
    16. Abouharb,M. Rodwan & Cingranelli,David, 2007. "Human Rights and Structural Adjustment," Cambridge Books, Cambridge University Press, number 9780521859332, September.
    17. Valerie Mercer-Blackman & Anna Unigovskaya, 2004. "Compliance with IMF Program Indicators and Growth in Transition Economies," Emerging Markets Finance and Trade, Taylor & Francis Journals, vol. 40(3), pages 55-83, May.
    18. Helge Berger & Jakob de Haan & Jan-Egbert Sturm, 2005. "Which Variables Explain Decisions on IMF Credit? An Extreme Bounds Analysis�," TWI Research Paper Series 13, Thurgauer Wirtschaftsinstitut, Universität Konstanz.
    19. Arpac, Ozlem & Bird, Graham & Mandilaras, Alex, 2008. "Stop Interrupting: An Empirical Analysis of the Implementation of IMF Programs," World Development, Elsevier, vol. 36(9), pages 1493-1513, September.
    20. Wei, Shang-Jin & Zhang, Zhiwei, 2010. "Do external interventions work? The case of trade reform conditions in IMF supported programs," Journal of Development Economics, Elsevier, vol. 92(1), pages 71-81, May.
    21. Stubbs, Thomas H. & Kentikelenis, Alexander E. & King, Lawrence P., 2016. "Catalyzing Aid? The IMF and Donor Behavior in Aid Allocation," World Development, Elsevier, vol. 78(C), pages 511-528.
    22. repec:bla:ecopol:v:17:y:2005:i::p:177-213 is not listed on IDEAS
    23. Nooruddin, Irfan & Simmons, Joel W., 2006. "The Politics of Hard Choices: IMF Programs and Government Spending," International Organization, Cambridge University Press, vol. 60(4), pages 1001-1033, October.
    24. Kentikelenis, Alexander E. & Stubbs, Thomas H. & King, Lawrence P., 2015. "Structural adjustment and public spending on health: Evidence from IMF programs in low-income countries," Social Science & Medicine, Elsevier, vol. 126(C), pages 169-176.
    25. Gupta, Sanjeev, 2000. "Social issues in IMF: supported programs," Sede de la CEPAL en Santiago (Estudios e Investigaciones) 34725, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
    26. Benson, John S., 2001. "The impact of privatization on access in Tanzania," Social Science & Medicine, Elsevier, vol. 52(12), pages 1903-1915, June.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Bernhard Reinsberg & Daniel O Shaw & Louis Bujnoch, 2024. "Revisiting the security–development nexus: Human security and the effects of IMF adjustment programmes," Conflict Management and Peace Science, Peace Science Society (International), vol. 41(1), pages 72-95, January.
    2. Flynn, Matthew B., 2021. "Global capitalism as a societal determinant of health: A conceptual framework," Social Science & Medicine, Elsevier, vol. 268(C).
    3. Bernhard Reinsberg & Thomas Stubbs & Alexander Kentikelenis & Lawrence King, 2020. "Bad governance: How privatization increases corruption in the developing world," Regulation & Governance, John Wiley & Sons, vol. 14(4), pages 698-717, October.
    4. Thomas Stubbs & Bernhard Reinsberg & Alexander Kentikelenis & Lawrence King, 2020. "How to evaluate the effects of IMF conditionality," The Review of International Organizations, Springer, vol. 15(1), pages 29-73, January.
    5. Mr. Sanjeev Gupta & Michela Schena & Mr. Seyed Reza Yousefi, 2018. "Expenditure Conditionality in IMF-supported Programs," IMF Working Papers 2018/255, International Monetary Fund.
    6. Stubbs, Thomas & Kring, William & Laskaridis, Christina & Kentikelenis, Alexander & Gallagher, Kevin, 2021. "Whatever it takes? The global financial safety net, Covid-19, and developing countries," World Development, Elsevier, vol. 137(C).
    7. Jagrič, Timotej & Brown, Christine & Boyce, Tammy & Jagrič, Vita, 2021. "The impact of the health-care sector on national economies in selected European countries," Health Policy, Elsevier, vol. 125(1), pages 90-97.
    8. Daoud, Adel & Reinsberg, Bernhard & Kentikelenis, Alexander E. & Stubbs, Thomas H. & King, Lawrence P., 2019. "The International Monetary Fund’s interventions in food and agriculture: An analysis of loans and conditions," Food Policy, Elsevier, vol. 83(C), pages 204-218.
    9. Alexander Kentikelenis & Thomas Stubbs, 2022. "Austerity Redux: The Post‐pandemic Wave of Budget Cuts and the Future of Global Public Health," Global Policy, London School of Economics and Political Science, vol. 13(1), pages 5-17, February.
    10. Jackson, Emerson Abraham, 2019. "Systemic health care failure as a symptom of Market Failure in Sierra Leone," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, issue Forthcomi.
    11. Chletsos, Michael & Sintos, Andreas, 2021. "Hide and seek: IMF intervention and the shadow economy," Structural Change and Economic Dynamics, Elsevier, vol. 59(C), pages 292-319.
    12. Barlow, Pepita, 2020. "Global disparities in health-systems financing: A cross-national analysis of the impact of tariff reductions and state capacity on public health expenditure in 65 low- and middle-income countries, 199," LSE Research Online Documents on Economics 104107, London School of Economics and Political Science, LSE Library.
    13. Dumitriu Ramona & Stefanescu Razvan, 2020. "Improving IMF’s Reputation in the Context of COVID-19," Risk in Contemporary Economy, "Dunarea de Jos" University of Galati, Faculty of Economics and Business Administration, pages 230-238.
    14. Forster, Timon & Kentikelenis, Alexander E. & Stubbs, Thomas H. & King, Lawrence P., 2020. "Globalization and health equity: The impact of structural adjustment programs on developing countries," Social Science & Medicine, Elsevier, vol. 267(C).
    15. Bozorgmehr, Kayvan & Samuilova, Mariya & Petrova-Benedict, Roumyana & Girardi, Enrico & Piselli, Pierluca & Kentikelenis, Alexander, 2019. "Infectious disease health services for refugees and asylum seekers during a time of crisis: A scoping study of six European Union countries," Health Policy, Elsevier, vol. 123(9), pages 882-887.
    16. Kentikelenis, Alexander E., 2017. "Structural adjustment and health: A conceptual framework and evidence on pathways," Social Science & Medicine, Elsevier, vol. 187(C), pages 296-305.
    17. Hugo Oriola & Jamel Saadaoui, 2024. "How do geopolitical interests affect financial markets reaction to international institution projects?," Working Papers of BETA 2024-25, Bureau d'Economie Théorique et Appliquée, UDS, Strasbourg.
    18. Iasmin Goes, 2023. "Examining the effect of IMF conditionality on natural resource policy," Economics and Politics, Wiley Blackwell, vol. 35(1), pages 227-285, March.
    19. Bhumika Muchhala, 2022. "The Structural Power of the State-Finance Nexus: Systemic Delinking for the Right to Development," Development, Palgrave Macmillan;Society for International Deveopment, vol. 65(2), pages 124-135, December.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Thomas Stubbs & Bernhard Reinsberg & Alexander Kentikelenis & Lawrence King, 2020. "How to evaluate the effects of IMF conditionality," The Review of International Organizations, Springer, vol. 15(1), pages 29-73, January.
    2. Chletsos, Michael & Sintos, Andreas, 2023. "The effects of IMF conditional programs on the unemployment rate," European Journal of Political Economy, Elsevier, vol. 76(C).
    3. Valentin Lang, 2021. "The economics of the democratic deficit: The effect of IMF programs on inequality," The Review of International Organizations, Springer, vol. 16(3), pages 599-623, July.
    4. Marijana Andrijić & Tajana Barbić, 2021. "When the Going Gets Tough … the Effect of Economic Reform Programmes on National Well-Being," Sustainability, MDPI, vol. 13(20), pages 1-19, October.
    5. Oberdabernig, Doris A., 2013. "Revisiting the Effects of IMF Programs on Poverty and Inequality," World Development, Elsevier, vol. 46(C), pages 113-142.
    6. Stephanie J. Rickard & Teri L. Caraway, 2019. "International demands for austerity: Examining the impact of the IMF on the public sector," The Review of International Organizations, Springer, vol. 14(1), pages 35-57, March.
    7. Chletsos, Michael & Sintos, Andreas, 2021. "Hide and seek: IMF intervention and the shadow economy," Structural Change and Economic Dynamics, Elsevier, vol. 59(C), pages 292-319.
    8. Brendan Skip Mark & Huei-Jyun Ye & Andrew Foote & Tiffani Crippin, 2021. "It’s a Hard-Knock Life: Child Labor Practices and Compliance with IMF Agreements," Social Sciences, MDPI, vol. 10(5), pages 1-21, May.
    9. Rickard, Stephanie J. & Caraway, Teri L., 2019. "International demands for austerity: examining the impact of the IMF on the public sector," LSE Research Online Documents on Economics 86636, London School of Economics and Political Science, LSE Library.
    10. Stephen C. Nelson & Geoffrey P. R. Wallace, 2017. "Are IMF lending programs good or bad for democracy?," The Review of International Organizations, Springer, vol. 12(4), pages 523-558, December.
    11. Martin Steinwand & Randall Stone, 2008. "The International Monetary Fund: A review of the recent evidence," The Review of International Organizations, Springer, vol. 3(2), pages 123-149, June.
    12. Daoud, Adel & Herlitz, Anders & Subramanian, S.V., 2022. "IMF fairness: Calibrating the policies of the International Monetary Fund based on distributive justice," World Development, Elsevier, vol. 157(C).
    13. Bal Gündüz, Yasemin, 2016. "The Economic Impact of Short-term IMF Engagement in Low-Income Countries," World Development, Elsevier, vol. 87(C), pages 30-49.
    14. Christoph Moser & Jan-Egbert Sturm, 2011. "Explaining IMF lending decisions after the Cold War," The Review of International Organizations, Springer, vol. 6(3), pages 307-340, September.
    15. Dreher, Axel, 2006. "IMF and economic growth: The effects of programs, loans, and compliance with conditionality," World Development, Elsevier, vol. 34(5), pages 769-788, May.
    16. Bomprezzi, Pietro & Marchesi, Silvia, 2023. "A firm level approach on the effects of IMF programs," Journal of International Money and Finance, Elsevier, vol. 132(C).
    17. Kentikelenis, Alexander E., 2017. "Structural adjustment and health: A conceptual framework and evidence on pathways," Social Science & Medicine, Elsevier, vol. 187(C), pages 296-305.
    18. Mr. Calixte Ahokpossi & Laurence Allain & Giovanna Bua, 2014. "A Constrained Choice? Impact of Concessionality Requirements on Borrowing Behavior," IMF Working Papers 2014/176, International Monetary Fund.
    19. Presbitero, Andrea F. & Zazzaro, Alberto, 2012. "IMF Lending in Times of Crisis: Political Influences and Crisis Prevention," World Development, Elsevier, vol. 40(10), pages 1944-1969.
    20. Ifrah Siddique & Muhammad Azmat Hayat & Muhammad Zahid Naeem & Abdullah Ejaz & Cristi Spulbar & Ramona Birau & Toni Calugaru, 2021. "Why Do Countries Request Assistance from International Monetary Fund? An Empirical Analysis," JRFM, MDPI, vol. 14(3), pages 1-19, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:174:y:2017:i:c:p:220-227. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.