nep-dev New Economics Papers
on Development
Issue of 2014‒12‒19
twenty papers chosen by
Jacob A. Jordaan
Universitiet Utrecht

  1. Economic Development and the Effectiveness of Foreign Aid: A Historical Perspective By Sebastian Edwards
  2. (Measured) Profit is Not Welfare: Evidence from an Experiment on Bundling Microcredit and Insurance By Abhijit Banerjee; Esther Duflo; Richard Hornbeck
  3. Does malaria control impact education? A study of the Global Fund in Africa By Maria Kuecken; Josselin Thuilliez; Marie-Anne Valfort
  4. Poverty and the spatial distribution of rural population By Barbier, Edward B.; Hochard, Jacob P.
  5. Do Remittances Alter Household Nutrition? Evidence from Rural Kilimanjaro in Tanzania By Isoto, Rosemary; Kraybill, David
  6. Remittance Responses to Temporary Discounts: A Field Experiment among Central American Migrants By Kate Ambler; Diego Aycinena; Dean Yang
  7. Agricultural Technology Adoption and Child Nutrition: Improved Maize Varieties in Rural Ethiopia By Zeng, Di; Alwang, Jeffrey; Norton, George; Shiferaw, Bekele; Jaleta, Moti; Yirga, Chilot
  8. Is There More than Milk? The Impact of Heifer International’s Livestock Donation Program on Rural Livelihoods: Preliminary Findings from a Field Experiment in Zambia By Kafle, Kashi R.
  9. The impact of food transfers for people living with HIV/AIDS: Evidence from Zambia By Tirivayi J.N.; Groot W.N.J.
  10. Does Development Reduce Migration? By Clemens, Michael A.
  11. Market Power & Economic Consequences of Post-Harvest Losses in Rwandan Dry Bean Markets By Jones, Michael S.; Alexander, Corinne E.; Smith, Bruce
  12. Public Health Effects of Natural Resource Degradation: Evidence from Indonesia By Garg, Teevrat
  13. Determinants of Land Allocation in a Multi-Crop Farming System: An Application of the Fractional Multinomial Logit Model to Agricultural Households in Mali By Allen, James E. IV
  14. Credit Quality in Developing Economies: Remittances to the Rescue? By Christian Ebeke; Boileau Loko; Arina Viseth
  15. Gender-preferential intergenerational patterns in primary education attainment : a quantitative analysis of a case of rural Mindanao, the Philippines By Okabe, Masayoshi
  16. Do input subsidies crowd in or crowd out other soil fertility management practices? Evidence from Zambia By Levine, Kendra; Mason, Nicole M.
  17. Social Networks and Health Knowledge in India: Who You Know or Who You Are? By Niels-Hugo Blunch; Nabanita Datta Gupta
  18. The Impact of a One Laptop per Child Program on Learning: Evidence from Uruguay By De Melo, Gioia; Machado, Alina; Miranda, Alfonso
  19. The role of social networks in an imperfect market for agricultural technology products: Evidence on Bt cotton adoption in Pakistan By Ma, Xingliang; Spielman, David J.; Nazli, Hina; Zambrano, Patricia; Zaidi, Fatima; Kouser, Shahzad
  20. The Relative (in)Efficiency of South African Municipalities in Providing Public Health Care By Josue Mbonigaba and Saidou Baba Oumar

  1. By: Sebastian Edwards
    Abstract: In this paper I discuss the effectiveness of foreign aid from a historical perspective. I show that foreign aid is a relatively new concept in economics, and I emphasize the role of exchange rate policies in the foreign aid controversies of the 1970s through 1990s. I show that in the early 1980s there were major changes in views regarding aid and agriculture. I emphasize the role of “ownership” of aid programs by the recipient countries as a way of increasing effectiveness. I argue that there is little hope of making progress in these debates if the economics profession continues to rely, almost exclusively, on cross section regressions. In order to move forward, these analyses need to be supplemented by in depth case studies that follow a country’s history for many decades.
    JEL: B20 F31 O10 O13 O19 O40 O43
    Date: 2014–11
  2. By: Abhijit Banerjee; Esther Duflo; Richard Hornbeck
    Abstract: We analyze a randomized trial in which microfinance loans were bundled with an unpopular (but cheap) health insurance policy. In randomly assigned treatment villages, purchase of the insurance policy was made mandatory at the time of loan renewal. This requirement led to a 22 percentage point (or 31%) decline in loan renewal in treatment villages, compared to control villages where the insurance policy was not introduced. The insurance policy itself turned out to be useless, partly due to administrative failures in implementation. Therefore, non-renewing clients' valuation of microfinance is approximated by the modest fee to purchase the insurance; in the presence of any expected gains, the fee represents an upper bound. Comparing client businesses in treatment and control villages, however, the decline in loan renewal had negative impacts that were both economically substantial and statistically significant. Clients' decision to incur these losses, rather than pay the modest insurance premium, implies the substantial financial gains from microfinance are mostly dissipated by unmeasured costs of operating the small businesses. This result potentially reconciles the seemingly large returns to capital for microenterprises with the lack of growth and frequent business closure.
    JEL: O12 O16 O19
    Date: 2014–09
  3. By: Maria Kuecken (CES - Centre d'économie de la Sorbonne - CNRS : UMR8174 - Université Paris I - Panthéon-Sorbonne); Josselin Thuilliez (CES - Centre d'économie de la Sorbonne - CNRS : UMR8174 - Université Paris I - Panthéon-Sorbonne); Marie-Anne Valfort (CES - Centre d'économie de la Sorbonne - CNRS : UMR8174 - Université Paris I - Panthéon-Sorbonne, EEP-PSE - Ecole d'Économie de Paris - Paris School of Economics - Ecole d'Économie de Paris)
    Abstract: We examine the middle-run effects of the Global Fund's malaria control programs on the educational attainment of primary schoolchildren in Sub-Saharan Africa. Using a quasi-experimental approach, we exploit geographic variation in pre-campaign malaria prevalence (malaria ecology) and variation in exogenous exposure to the timing and expenditure of malaria control campaigns, based on individuals' years of birth and year surveyed. In a large majority of countries (14 of 22), we find that the program led to substantial increases in years of schooling and grade level as well as reductions in schooling delay. Moreover, although by and large positive, we find that the marginal returns of the Global Fund disbursements in terms of educational outcomes are decreasing. Our findings, which are robust to both the instrumentation of ecology and use of alternative ecology measures, have important policy implications on the value for money of malaria control efforts.
    Keywords: Malaria; Sub-Saharan Africa; education; quasi-experimental; Global Fund
    Date: 2013–10
  4. By: Barbier, Edward B.; Hochard, Jacob P.
    Abstract: According to global spatial data sets in 2000 more than one-third of the rural population in developing countries was located on less favored agricultural land and areas. Less favored agricultural lands are susceptible to low productivity and degradation, because their agricultural potential is constrained biophysically by terrain, poor soil quality, or limited rainfall. Less favored agricultural areas include less favored agricultural lands plus favorable agricultural land that is remote, that is, land in rural areas with high agricultural potential but with limited access. The paper presents tests of whether these spatial distributions of rural population influence poverty directly or indirectly via income growth in 83 developing countries from 2000 to 2012. The analysis finds no evidence of a direct impact on poverty, but there is a significant indirect impact via the elasticity of poverty reduction with respect to growth. Reducing poverty requires targeting rural populations in less favored lands and remote areas, in addition to encouraging out-migration in some areas.
    Keywords: Rural Poverty Reduction,Regional Economic Development,Population Policies,Achieving Shared Growth
    Date: 2014–11–01
  5. By: Isoto, Rosemary; Kraybill, David
    Abstract: There is growing interest in the role of remittances on livelihoods of households in developing countries including those in Sub-Saharan Africa. We estimate the remittance elasticity for a number of macro- and micronutrients using a sample of rural households in Tanzania. Due to endogeneity of net income and remittances, special focus is placed on econometric analysis. One major finding is that remittances seem to be used as an investment in higher quality nutrients like proteins, vitamin A, vitamin C and calcium that lead to better development of especially the young population while net income is used for mere consumption. Remittances do not have any significant effect on calories, carbohydrates, and fats.
    Keywords: Remittances, Macronutrients, Micronutrients, Sub-Saharan Africa, Agricultural and Food Policy, Food Consumption/Nutrition/Food Safety, Food Security and Poverty, International Development, O15, D1,
    Date: 2014
  6. By: Kate Ambler; Diego Aycinena; Dean Yang
    Abstract: We study the impacts on remittances of offering migrants temporary discounts on remittance transaction fees. We randomly assigned migrants from El Salvador and Guatemala 10-week remittance transaction fee discounts, and assess impacts using administrative transaction data and a post-experiment survey. Temporary discounts lead to substantial increases in the number of transactions and total amount remitted during the discount period. Surprisingly, these increases persist up to 20 weeks after expiration of the discount. We find no evidence that the discounts cause migrants to shift remittances from other remittance channels, or to send remittances on behalf of other migrants. These findings are consistent with naïveté on the part of migrants regarding remittance recipients' reference-dependent preferences.
    JEL: F24 J61 O15
    Date: 2014–09
  7. By: Zeng, Di; Alwang, Jeffrey; Norton, George; Shiferaw, Bekele; Jaleta, Moti; Yirga, Chilot
    Abstract: Adoption of agricultural technology can lead to multiple benefits to farm households, including increased productivity, incomes and food consumption. However, specific causal linkages between agricultural technology adoption and child nutrition outcomes are rarely explored in the literature. This paper helps bridge this gap through an impact assessment of the adoption of improved maize varieties on child nutrition outcomes using a recent household survey in rural Ethiopia. The conceptual linkage between adoption of improved maize varieties and child nutrition is first established using an agricultural household model. Instrumental variable (IV) estimation suggests the overall impacts of adoption on child height-for-age and weight-for-age z-scores to be positive and significant. Quantile IV regressions further reveal that such impacts are largest among children with poorest nutritional outcomes. By combining a decomposition procedure with system of equations estimation, it is found that the increase in own-produced maize consumption is the major channel through which adoption of improved maize varieties affects child nutrition.
    Keywords: child nutrition, impact, improved maize varieties, Ethiopia, Food Consumption/Nutrition/Food Safety, Food Security and Poverty, Health Economics and Policy, International Development,
    Date: 2014
  8. By: Kafle, Kashi R.
    Abstract: This study evaluates the impact of Heifer International’s livestock donation program in the Copperbelt Province in Zambia. Using a panel data of 300 households and 4 survey rounds, this analysis assesses the impact of dairy cow, meat goat, and draft cattle donation programs on poverty and food security measures. The impact on consumption expenditures and livestock revenue are estimated with a difference-in-difference method, and the impact on dairy/meat consumption frequency is estimated with a pooled poisson regression. A probit model is used to estimate the effects on subjective measures of poverty and food security. Results show that the impact of the program has increased significantly over time and animal recipients are relatively feeling better. By the fourth round, all animal recipients have seen a significant increase in consumption expenditure, livestock revenue, and frequency of dairy/meat consumption. However, no significant impact exists on household asset ownership and growth. Although all the animal recipients have increased milk consumption, meat consumption has gone up among the goat beneficiaries only. While all three animal species contribute to increase consumption expenditures among animal recipients, only the draft cattle and dairy cow programs help increase revenue from livestock products. Likewise, the meat goat and dairy cow programs have contributed to food security through improved dietary diversity.
    Keywords: livestock donation, poverty, dietary diversity, milk consumption, consumption expenditure, food security, Agricultural and Food Policy, Food Consumption/Nutrition/Food Safety, Food Security and Poverty, International Development, Livestock Production/Industries,
    Date: 2014–07–25
  9. By: Tirivayi J.N.; Groot W.N.J. (UNU-MERIT)
    Abstract: We estimate the impact of food transfers on diet and consumption expenditures in food insecure households with HIV positive members on antiretroviral therapy. We use primary data collected from 199 beneficiary and 179 non-beneficiary households in Lusaka, Zambia. Propensity score matching estimates show that the food transfers significantly increase dietary diversity and food consumption expenditures. Our results also show that the food transfers increased the proportion of households with optimal dietary diversity and consuming at least five food groups. The results are robust to variation in the propensity score model and matching technique. Sensitivity analysis demonstrates that our results are largely robust to substantial amounts of unobserved selection bias. We discuss the implications of our findings in the context of the growing number of HIV/AIDS treatment, care and support programmes providing food assistance in resource poor settings.
    Keywords: Microeconomic Behavior: Underlying Principles; Consumer Economics: Empirical Analysis; General Welfare; Welfare and Poverty: Government Programs; Provision and Effects of Welfare Programs;
    JEL: D01 D12 I31 I38
    Date: 2014
  10. By: Clemens, Michael A. (Center for Global Development)
    Abstract: The most basic economic theory suggests that rising incomes in developing countries will deter emigration from those countries, an idea that captivates policymakers in international aid and trade diplomacy. A lengthy literature and recent data suggest something quite different: that over the course of a "mobility transition", emigration generally rises with economic development until countries reach upper-middle income, and only thereafter falls. This note quantifies the shape of the mobility transition in every decade since 1960. It then briefly surveys 45 years of research, which has yielded six classes of theory to explain the mobility transition and numerous tests of its existence and characteristics in both macro- and micro-level data. The note concludes by suggesting five questions that require further study.
    Keywords: emigration, migration, mobility, development, growth, transition, hump, lifecycle, inequality, poverty, aid, demand, pressure
    JEL: F22 J61 O15
    Date: 2014–10
  11. By: Jones, Michael S.; Alexander, Corinne E.; Smith, Bruce
    Abstract: To date there is extremely limited knowledge of the economic consequences of post-harvest losses for smallholders in sub-Saharan Africa. Major contributors to economic losses are price penalties for poor quality marketed grain. This study investigates farm-gate level discounts demanded by rural Rwandan bean traders for insect-damaged dry beans. We use a simplified contingent evaluation methodology with physical grain samples to elicit seasonal damage discount schedules, gathering data from 270 trader interviews in 25 regionally-diverse rural markets, in periods of both grain abundance and grain scarcity. We find that while levels of 5-10% grain damage can generally be sold with a moderate discount, grain with 20-30% damage is largely unmarketable. We additionally use a two-stage model to investigate physical and non-physical drivers of buying insect-damaged grain and, if so, the demanded discount intensity. Results indicate that while grain damage levels play a central role, large volume traders penalize damage less while traders in the seed market, storing before re-sale, or purchasing heavily from farmers (vs. other traders) penalize damage significantly more. Findings have helped develop more evidence-based extension programming for the Post-Harvest Task Force of the Rwandan Ministry of Agriculture. Additionally, derived discount coefficients help evaluate the cost-effectiveness of technologies throughout the region which prevent post-harvest damage.
    Keywords: post-harvest losses, crop storage, storage technology, food security, Rwanda, sub-Saharan Africa, Food Security and Poverty, Research and Development/Tech Change/Emerging Technologies,
  12. By: Garg, Teevrat
    Abstract: Despite growing concern about the effect of environmental degradation on human health, little effort has been made to quantify the effect of ecosystem damage on public health indicators such as the incidence and burden of infectious diseases. Using village-level panel data and satellite data on forest cover, I find that the average within-sample deforestation results in a 2-4.5\% increase in the probability of malarial outbreak in each village in that district, translating to 360,000 - 880,000 additional infected individuals during the course of this study. The evidence is consistent with an ecological response and the effect of deforestation on malaria cannot be explained by post-deforestation land use change, anti-malarial programs or migration. The effect is specific to malaria, with deforestation having no discernible effect on other diseases (measles, respiratory infections, dengue and diarrhea) whose disease ecology differs from that of malaria. These large effects underscore that forest conservation can have local health benefits in addition to global carbon benefits.
    Keywords: Deforestation, Malaria, Public Health, Environmental Economics and Policy, Health Economics and Policy, International Development, Land Economics/Use, Public Economics,
    Date: 2014
  13. By: Allen, James E. IV
    Abstract: Effective food security work in developing countries, such as Mali, relies on a thorough understanding of the rural farming system. A common approach is to study land allocation decisions to specific crops. In accomplishing this, one challenge is to model all production outcomes in a multi-crop system. This paper attempts to overcome this challenge to study the determinants of household allocation to cotton, maize, sorghum, millet, and secondary crops. First, a reduced form of the agricultural household model helps to identify factors that explain land allocation to various crops. This framework is applied to survey data from six villages in Mali’s Koutiala Cercle. A fractional multinomial logit econometric model is used to estimate the effect of household and production attributes on shares of cotton, maize, sorghum, millet, and secondary crops simultaneously, the results of which are presented as average marginal effects. Among other results, the analysis shows that ethnic groups not native to the Koutiala Cercle are associated with significantly smaller shares of maize, and that villages with better market access are correlated with much higher shares of secondary crops and smaller shares of cotton. These results provide insights for policymakers on the role of cotton in farming system, the need to promote and develop better markets for coarse grains and secondary crops, and the importance of understanding the dynamic farming system in Mali’s Koutiala Cercle.
    Keywords: Mali, Land Allocation, Agricultural Household, Econometrics, Fractional Multinomial Logit, Farming Systems Research, Food Security and Poverty, International Development, Research Methods/ Statistical Methods,
    Date: 2014–05
  14. By: Christian Ebeke; Boileau Loko; Arina Viseth
    Abstract: This paper analyzes the link between remittances inflows and nonperforming loans (NPLs) in a large sample of developing countries. Theoretical transmission channels include risk coping, exchange rate and growth impacts. Panel data estimates uncover the significant role of remittance inflows in reducing the size of NPLs in recipient economies. Econometric results also indicate a stronger marginal impact of remittances in a context of high macroeconomic instability, suggesting a significant effect of remittances on the likelihood of the private sector’s credit default during shocks. These results hold even after factoring in: (i) the endogeneity of remittance inflows and, (ii) the use of an alternative estimator (panel fractional logit) aimed at dealing with bounded dependent variables.
    Keywords: Remittances;Capital inflows;Bank credit;Private sector;Non-performing loans;Developing countries;Econometric models;remittances; nonperforming loans; macroeconomic volatility; financial stability
    Date: 2014–08–08
  15. By: Okabe, Masayoshi
    Abstract: The Philippines has achieved a relatively high standard of education. Previous researches, most of which deal with Luzon Island, have indicated that rural poverty alleviation began partly due to the increased investment in education. However, the suburban areas beyond Luzon Island have rarely been studied. This study examines a case from rural Mindanao, and investigates the determinants and factors associated with children's education, with a special focus on delays in schooling, which may be a cause of dropout and holdover incidences, as well as exploring gender-specific differential patterns. The result shows that after controlling other socioeconomic attributes, (1) delays in schooling, as well as years completed, are more favorable for girls than boys; (2) the level of maternal education is equally associated with the child(ren)’s education level regardless of their gender; and (3) paternal education is preferentially and favorably influential to the same-gender child(ren), i.e., son(s). To reduce the boy-unfriendly gender bias in primary education, this study suggests two future tasks, i.e., providing boy-specific interventions to enhance the magnitude of the father-son educational virtuous circle, and comparing the magnitude of gender-equal maternal education influence and boy-preferential paternal education influence to specify which effect is larger.
    Keywords: Philippines, Elementary education, Gender, Poverty, Rural societies, Delays in years of schooling, Gender-preferential and intergenerational effect, Primary education, Limited dependent variable regression, Rural Mindanao
    JEL: I20 I21 I29 O53 I24 I25
    Date: 2014–09
  16. By: Levine, Kendra; Mason, Nicole M.
    Abstract: It is recognized that inorganic fertilizer, as is commonly distributed in large-­‐scale input subsidy programs, must be used along with soil fertility management (SFM) practices in order to maximize its efficacy. We use nationally representative data with 8,839 household observations to assess the impact of the Zambian input subsidy program on the use of five SFM practices: (i) manure and/or compost application, (ii) soil erosion preventative measures, (iii) minimum tillage, (iv) rotations between cereals and legumes, and (v) leaving land fallow. We estimate at the household level the effect of subsidized fertilizer on probability of adoption of each practice using a maximum likelihood probit model and the effect on number of hectares under each practice with a maximum likelihood Tobit model. The endogeneity of fertilizer distribution is tested and controlled for using the control function approach. We find a small but positive statistically significant crowding in effect of receiving subsidized fertilizer on all SFM practices except for fallow land, where we report a statistically significant crowding out effect of larger magnitude than estimated for the other practices (a decrease in hectares equal to 11.3% of the unconditional mean hectares of fallow land per household).
    Keywords: Fertilizer, Input subsidies, Zambia, Sub-Saharan Africa, Soil fertility management, Agricultural and Food Policy, Community/Rural/Urban Development, International Development, H2, Q180, Q010,
    Date: 2014
  17. By: Niels-Hugo Blunch (Washington and Lee University & IZA); Nabanita Datta Gupta (Department of Economics and Business, Aarhus University, Denmark)
    Abstract: Addressing several methodological shortcomings of the previous literature, this paper explores the relationship among health knowledge and caste and religion and a number of important mediating factors in India, estimating causal impacts through a combination of instrumental variables and matching methods. The results indicate the presence of a substantively large caste and religion health knowledge gap in the context of proper treatment of diarrhea in children favoring high caste women relative to low caste and Muslim women. We also provide evidence that while observed individual characteristics such as education and access to social networks explain part of the gap, a substantial part of the health knowledge gap is left unexplained. All groups have greater health knowledge in urban than in rural areas, but the gap is even wider in urban than in rural areas. Additionally, high caste women benefit more in terms of health knowledge from having health networks than women from other groups; except if the health person is of the same caste/religion, in which case low caste and Muslim women sometimes benefit by as much as double that of high caste women, or even more. It may therefore not be enough to give individuals access to high quality networks if caste and religion-related gaps in health knowledge are to be reduced; such networks also have to be homophilous, to have the maximum effect. Improved treatment from and confidence in the medical profession is found to be part of the mechanism linking health social network formation with improved health knowledge about the treatment of diarrhea in children.
    Keywords: Health knowledge, caste, religion, social networks, India
    JEL: I12 I14 I15
    Date: 2014–10–27
  18. By: De Melo, Gioia (Banco de México); Machado, Alina (IECON, Universidad de la República); Miranda, Alfonso (CIDE, Mexico City)
    Abstract: We present evidence on the impact on students' math and reading scores of one of the largest deployments of an OLPC program and the only one implemented at a national scale: Plan Ceibal in Uruguay. Unlike previous work in the field, we have unique data that allow us to know the exact date of laptop delivery for every student in the sample. This gives us the ability to use a continuous treatment, where days of exposure are used as a treatment intensity measure. We use a panel data framework including fixed effects at the individual level. Given that there is some variation in the date of laptop delivery across individuals within the same school, we can identify the effect of the program net of potential heterogeneity in the rate schools gain improvements on student's achievement over time in the absence of the OLPC program across the country (i.e. we allow each school to follow a different learning growth curve over time due to unobservable time-varying heterogeneity). We also run an alternative specification where we allow for different learning growth curves over time between schools located in Montevideo and the rest of Uruguay. Our results suggest that in the first two years of its implementation the program had no effects on math and reading scores. The zero effect could be explained by the fact that laptops in class are mainly used to search for information on the internet.
    Keywords: impact evaluation, education, technology
    JEL: I21 I28
    Date: 2014–09
  19. By: Ma, Xingliang; Spielman, David J.; Nazli, Hina; Zambrano, Patricia; Zaidi, Fatima; Kouser, Shahzad
    Abstract: Social networks play an important role in generating learning externalities that can drive the diffusion of innovative, and potentially poverty-reducing, technologies. This is particularly the case in developing countries where rural education, extension, and agricultural information services are underprovided. The recent introduction of genetically modified insect-resistant Bt (Bacillus thuringiensis) cotton in Pakistan represents an example where imperfect markets, weak extension services, and information asymmetries limit the ability of farmers to make informed decisions on how to take best advantage of the technology. This study explores the role of social networks and learning externalities in the adoption of Bt cotton in Pakistan. We model how information from social network members influences farmers’ adoption decisions, controlling for farmers’ characteristics, cotton growing conditions, and other possible information sources. We apply our model to a representative sample of 728 cotton-growing households randomly selected in 2012-13 from 52 villages across Punjab and Sindh. We also assess the role of input dealers, progressive farmers, public extension agents, and farmers’ individual characteristics in the uptake of the technology. Results suggest that communication within social networks helps disseminate information about Bt cotton cultivation and has encouraged its adoption.
    Keywords: social networks, Bt cotton, Pakistan, technology adoption, Agricultural and Food Policy, Community/Rural/Urban Development, Institutional and Behavioral Economics, International Development, Research and Development/Tech Change/Emerging Technologies,
    Date: 2014
  20. By: Josue Mbonigaba and Saidou Baba Oumar
    Abstract: Previous studies in South Africa have not dis-aggregated efficiency analysis across municipalities which are health system components of the broader national health system. The purpose of this paper is therefore to assess whether the relative efficiency of South African municipalities in primary health care and hospital care is different and whether South African municipalities can learn from each other to improve on their efficiency. The paper employs efficiency scores, estimated with Data Envelopment Analysis (DEA) using data from the District Health Barometer of the Health Systems Trust to rank South African municipalities across primary health care and hospital health care. The finding is that that the ranking of municipalities is not the same across both types of health care when efficiency scores and efficiency score growth are contemplated. These results imply that municipalities in South Africa are generally inefficient, but with the possibility of learning from each other’s practice in order to increase their technical efficiency. The health system authority should monitor service-specific best practices among municipalities so that they can use them as practice guidelines for other municipalities.
    Keywords: Municipalities, DEA, public, health care, technical efficiency, South Africa
    JEL: I12
    Date: 2014

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