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1. Pay for Performance for Prenatal Care and Newborn Health: Evidence from a Developing Country

Author:
Maria Laura Alzúa and Noemi Katzkowicz
Publication Date:
12-2020
Content Type:
Working Paper
Institution:
Center for Distributive, Labor and Social Studies (CEDLAS)
Abstract:
Empirical literature analyzing the effect of pay-for-performance programs (P4P) for healthcare providers on maternal care and newborn health outcomes is scarce. In 2008, Uruguay’s Ministry of Public Health implemented a P4P called Metas Asistenciales (Healthcare Goals), a country-wide program that grants healthcare providers an economic incentive for complying with certain maternal and newborn healthcare goals. Health organizations use these funds to provide maternal and child health services. Using administrative records and a difference-in-difference methodology, we evaluate the effect of the Metas Asistenciales program on maternal and newborn health outcomes. We find that in the institutions affected by the program, 10 percentage points more women received an adequate number of prenatal checkups and pregnancy detection in the first trimester improved by 5 percentage points. We also found better results among newborns for indicators related to birth weight, premature births, and stillbirths. In sum, the program had a positive, significant impact on the rate of pregnant women’s utilization of health services and on newborn health outcomes. This study thus provides evidence supporting the idea that economic incentives are a promising tool for incentivizing healthcare providers to achieve better health services in developing countries.
Topic:
Health, Health Care Policy, Children, and Birthing
Political Geography:
South America and Uruguay

2. China’s Declining Birth Rate and Changes in CCP Population Policies

Author:
Linda Zhang
Publication Date:
02-2020
Content Type:
Journal Article
Journal:
China Brief
Institution:
The Jamestown Foundation
Abstract:
Demography may not be destiny, but China has always been conscious of rearing the next generation. One of the three unfilial acts, according to the ancient Chinese philosopher Mencius, is the failure to bear a son. The Chinese have traditionally viewed offspring as a form of wealth, and have placed immense value on fecundity. [1] Despite such traditional beliefs, in the years after the Cultural Revolution senior officials of the Chinese Communist Party (CCP) feared that overpopulation would exhaust the country’s scarce resources. In 1980, the CCP formally implemented the One Child Policy (独生子女政策, Dusheng Zi Nu Zhengce), or OCP, a national family planning policy that limited parents to only one child (Xinhua, November 16, 2015). However, after over three decades of efforts to reduce population growth, People’s Republic of China (PRC) officials are now concerned about a shrinking workforce and an aging population. The CCP leadership repealed OCP in 2015, but the fertility rate in China is nowhere near pre-OCP levels. Furthermore, the PRC has seen a significant decline in birth rate in recent years (see discussion below). The true extent of the decline is impossible to verify, but the downward trend in birth numbers is worrisome. This article examines both official PRC statistics on total birth numbers for recent years, as well as discussions among Chinese netizens using unconfirmed statistics, to analyze the deep uncertainties surrounding China’s demographic and political future.
Topic:
Population, Domestic Policy, Birthing, and Birth Rates
Political Geography:
China and Asia