| Popis: |
BackgroundSignificant levels of funding have been provided to low- and middle-income countries for development assistance for health, with most funds coming through direct bilateral investment led by the United States and the United Kingdom. Direct attribution of impact to large scale programs funded by donors remains elusive due the difficulty of knowing what would have happened without those programs, and the lack of detailed contextual information to support causal interpretation of changes. MethodsThis study uses the synthetic control analysis method to estimate the impact of one donor’s funding (United States Agency for International Development, USAID) on under-five mortality across several low- and middle-income countries that received above average levels of USAID funding for maternal and child health programs between 2000 and 2016. ResultsIn the study period (2000-16), countries with above average USAID funding had an under-fiver mortality rate lower than the synthetic control by an average of 29 deaths per 1,000 live births (year to year range of 2 – 38). This finding was stable across several sensitivity analyses. ConclusionsThe synthetic control method is a valuable addition to the range of approaches for quantifying the impact of large-scale health programs in low- and middle-income countries. The findings suggest that adequately funded donor programs (in this case USAID) help countries to reduce child mortality to significantly lower rates than would have occurred without those investments. |
