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76 Fighting the Diseases of Poverty
affects immunizations, but not when other controls are added.
Reaching children appears to be more of an impediment due to dispersed
population or inadequate infrastructure. Per capita income
may not be as important to increasing immunization given the generosity
of donor funds, particularly for vertical programs like immunizations.
The variable for women’s education, a key input in
whether children get immunized, is best captured by average years
of schooling for females over age 15. However, the sample size
declines by 40 countries when this variable is used, so the completion
rate of females, the proportion of girls who are currently finishing
school, is used as a proxy because girls’ current achievements
are a reflection of their mothers’ support for education and their
ability to make household decisions about their children’s education.
Table 2 shows the OLS results for child mortality. The R2s are
almost 50 per cent higher than those for measles immunization
coverage, with income per capita and ethno-linguistic fractionalization
explaining most of the variation. Average years of female
schooling doesn’t have an effect, although girls’ completion rates
do. Average years of female education becomes significant, however,
when ethno-linguistic fragmentation is left out, suggesting either
some substitution between these factors, or when the loss for so
many observations affects the relationship. Governance is not significant,
but it matters when the education variable is female education
rather than completion. Road density and urbanization (not
shown) have no effect, and that pattern persists with other models.
The established inverse relationship between income and child mortality
makes these results unsurprising, but the lack of importance
of female education is odd given the strength of the relationship in
country level studies. These results provide the point of departure
for a more narrow focus on both the country level issues and the
factors that directly influence health care delivery.
The next section summarizes accumulated evidence on specific
components of governance and corruption, including: perceptions
of corruption and performance; management challenges in public