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72 Fighting the Diseases of Povertyhealth and education spending and urbanization are controlled for,but remains significant.In measuring the impact of corruption on the effectiveness ofhealth spending Rajkumar and Swaroop (2002) analyze data for1990 and 1997 controlling for GDP per capita, female educationalattainment, ethno-linguistic fractionalization, urbanization amongother factors, and find that the effectiveness of public healthspending in reducing child mortality hinges on the integrity rating(1–5 range based on level of perceived corruption), with higherintegrity associated with reduced mortality. Poor governance mayhelp to explain the inconclusive findings of Filmer and Pritchett(1999) on the lack of association between public health expendituresand infant and child mortality.Wagstaff and Claeson (2005) extend these analyses further anduse more recent data. They find that spending reduces under 5 mortality,but only where governance, as measured by the World Bank’sCPIA score (Country Policy and Institutional Assessment measurethat is scored between 1–5 depending on performance, part ofwhich regards corruption and governance), is sound (a CPIA above3.25). This study specifically explores the implications of additionalspending for reaching the MDGs, and concludes that more spendingin medium and low CPIA countries would not be expected to reducechild mortality, and that per capita income growth offers a betterinvestment if mortality declines are the objective.Because child mortality rates are measured with substantialerror, especially in the poorest countries, these results need to betaken with caution. The uncertainty of the direction of causalityintroduces further limitations in the interpretations of the results.Cross-country regressions are hard to interpret in any event, but asan aggregate assessment they provide general guidance on the relevanceof corruption and other factors in affecting health outcomesin developing countries. The inability of country level analysis toelucidate specific country problems leads to the subsequent sectionthat addresses these issues, complementing this introductory lookat the correlates of health outcomes.