Political-Economic Origins of Demographic Trends: Political Liberalization and Within-Country Public Health Inequality in sub-Saharan Africa

Moshi O. Herman, Brown University

This paper examines the impact of the transition to competitive politics in four eastern Africa countries on population health, which we measure by infant survival indicators. Using more than two decades of Demographic and Health Surveys (DHS), we examine whether changes in institutional accountability and reconfiguration of political patronage after the introduction of competitive politics explain within-country variation in infant mortality across provinces in Kenya, Malawi, Tanzania, and Zambia from the mid 1980s to the late 1990s. Preliminary results show province-level pattern of varying infant mortality risk depending on the degree at which a given province supported the ruling regimes in the first multiparty elections. We interpret the statistical variations by comparing levels of salience of ethnic cleavages, switch of the presidential seat from an incumbent to an opposition political party, and disparity in access to maternal and postnatal care by voting behavior across the four countries.

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Presented in Session 140: Patterns and Determinants of Health and Mortality in the Developing World