ABSTRACT – Can political turnover and government transitions, which are transitory by nature, have irreversible impacts on development outcomes? We conjecture that this can be the case should transitions coincide with critical periods for human development. To test for this, we examine transition effects on health services and infant health outcomes in Brazilian municipalities by using municipality-by-month level data, and close elections for identification. We find negative effects on health services delivery, starting immediately after elections and continuing throughout the transition period and the beginning of the new government. These fluctuations have irreversible impacts when they overlap with critical gestational periods. Children exposed to transitions in utero have worse outcomes at birth and experience an increase in mortality by 0.96 deaths per 1,000 live births, or 6.7% of the mean. Fiscal incentives and health care personnel dismissals, used to reduce spending before the end of the electoral term, are relevant mechanisms.
Texto para Discussão n. 20
Does Increasing Public Spending in Health Improve Health? Lessons from a Constitutional Reform in Brazil
Our results contribute to the literature by providing one of the first wellidentified causal parameters of the relationship between public spending in health and health outcomes