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Corruption in public health 73Figure 1 demonstrates the relationship between governanceindices and measures of health performance and outcomes. Measlesimmunization coverage provides a robust measure of public serviceperformance as it reflects government’s ability to perform a criticaland basic health service. Measles immunization by itself is particularlyimportant since when administered in infancy it sharplyreduces all causes of mortality in childhood (Koenig et al., 1991;Aaby 1995). It is also easily measured. Child mortality is a standardvariable for measuring health outcomes, is influenced by a widerange of factors beyond the quality and extent of health careservices, but has the advantage that it is available for a largenumber of countries.The six panels in Figure 1 show the scatter plots for both indicatorsand each of the three components of the KKM governanceindex: government effectiveness, control of corruption, and voiceand accountability. Of the three measures, and compared to theaggregate governance indicator (not shown), government effectivenessbest correlates with poor outcomes and performance in healthcare based on the smaller variation conveyed in the adjust R2. 1 Voicehas the least explanatory power and it is especially limited forimmunization coverage. The panel on voice and accountabilitysuggests why. The highly variable relationship especially among thecountries with the lowest governance scores makes any effort toexplain variation unconvincing. In higher performing countriesmore convergence occurs for government effectiveness and controlof corruption but much less so for voice. Immunization programsare typically the responsibility of central governments because it isa preventive measure for which demand tends to be low among allbut the most educated. 2 The dispersion in the voice and accountabilitypanel is consistent with that fact.Table 1 provides OLS results showing the strength of governancemeasures on measles immunization coverage controlling forother relevant factors. Of the various governance indices, governmenteffectiveness explains more of the differences in measlesimmunization and has a slightly stronger effect than the overall
74 Fighting the Diseases of PovertyFigure 1 Relationship between corruption indices and healthoutcomesImmunizationChild mortality120300100200R 2 = 0.3328010060R 2 = 0.293040-2 -1 0 1 2Government effectiveness (KKM 2005)-100-2 -1 0 1 2Government effectiveness (KKM 2005)120300100200801006040R 2 = 0.222-2 -1 0 1 2Control of corruption (KKM 2005)0-100-2 -1 0 1 2Control of corruption (KKM 2005)1003008020060100R 2 = 0.08540-2 -1 0 1Voice and accountability (KKM 2005)0-2 -1 0 1Voice and accountability (KKM 2005)
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Fightingthe Diseasesof PovertyEdite
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Fighting the Diseases of PovertyEdi
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ContentsIntroductionPhilip Stevens1
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viiiFighting the Diseases of Povert
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IntroductionBy Philip StevensIn man
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IntroductionxiiiThis period saw an
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IntroductionxvSimilarly, lowering t
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Introductionxviiincomes (Kenny, 200
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Introductionxixrising overall level
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IntroductionxxiCorruption in health
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IntroductionxxiiiRights, Innovation
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Introductionxxv“Anecdotal evidenc
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Introductionxxviionly account for 0
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1 Wealth, health and thecycle of pr
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Wealth, health and the cycle of pro
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Diseases of poverty and the 10/90 g
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5 Increasing access tomedicinesProf
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8 The value of vaccinationDavid E.
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SourcesIntroductionAdelman, C., Nor
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healthcare industry. He writes and
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Fighting theDiseases of PovertyHow
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