Has democratization reduced infant mortality in sub- Saharan Africa? Evidence from micro data

Does democracy help babies survive in sub-Saharan Africa? By using retrospective fertility surveys conducted in 28 African countries, I compare the survival of infants born to the same mother before and after democratization to identify the effect of democracy. In measuring democracy, I adopt a theoretically motivated definition of democracy: universal suffrage and contested elections for executive office. I find that infant mortality falls by 1.8 percentage points, 18 percent of the sample mean, after democratization. The size of the reduction is larger for babies born to mothers from disadvantaged groups. I also find that the replacement of a chief executive by democratization is the driving force behind these results. Additional evidence suggests that improvements in public health service delivery, not an increase in affluence, are the key mechanism in which democratization has reduced infant mortality. ∗I thank Maitreesh Ghatak and Tim Besley for their continuous support and valuable comments, and Robin Burgess and Oriana Bandiera for helpful comments at various stages of this research. I am also grateful to Fernando Aragon, Yutaka Arimoto, Dave Donaldson, Ray Fisman, Hiro Ishise, Hisaki Kono, Rocco Macchiavello, Torsten Persson, Steve Pischke, Jim Snyder, and seminar participants at the 4th Development Economics PhD Seminar held in University of Namur, at University of Warwick, and at London School of Economics for helpful suggestions and discussions. Sylvia Meek kindly guided me through the public health literature. Data appendices to this paper are available on my website: http://personal.lse.ac.uk/kudamats/research.htm †Email address: [email protected]