Essays on explaining child health outcomes in Nigeria

This thesis contributes, through four essays, to the understanding of why Nigeria, an emerging economy with the strongest GDP in Africa, is a major global contributor to child mortality. Chapter 1 uses a quasi-experimental design—the interrupted time series (ITS) analysis—to investigate the effect of the Millennium Development Goals (MDGs) on child mortality outcomes. The results indicate the existence of a pre-MDG declining trend, and a dwindling gain in child survival post-MDG. The pattern of mortality change is consistent in the adjusted model with controls and suggests that the MDGs have an unclear causal effect on child mortality outcomes. Chapter 2 investigates the relationship between economic growth and child mortality and asks whether there is a structural break in the effect of growth on child mortality following the introduction of pro-poor growth policy. Results from the Arrelano and Bond system GMM indicate a growth elasticity of -0.42. Also, the study findings suggest that child mortality is still prevalent amongst the poor despite the pro-poor growth policy adopted. Chapter 3 addresses the question of whether public health spending in Nigeria, a source country with porous borders, has spill-over effects on neighbouring countries. The results from fixed effects regressions suggest that public health spending in Nigeria is associated with reduction in childhood mortality across West African countries. This implies a loss of efficiency gain in government health spending, which has consequences for child health outcomes. Chapter 4 examines the role of the domestic economy in explaining child health outcomes in Nigeria, using the demographic and health survey datasets. The findings from a propensity score matching technique indicate a lower child Anthropometric failure rate in households within which women have decision-making authority, compared to households within which men make decisions autonomously.