Does Contracting Out Primary Care Services Improve Child Health? The Case of Guatemala

Julian P. Cristia, Inter-American Development Bank
William N. Evans, University of Maryland
Beomsoo Kim, University of North Carolina at Greensboro

Around the developing world, policy-makers are searching for new ways to improve population access to health services. In the last 15 years, a growing interest has arisen regarding contracting out health care services to circumvent capacity constraints and to rapidly scale-up the provision of services. Unfortunately, there is little solid empirical evidence regarding whether this type of solution can outperform publicly-provided services. This paper aims to contribute to filling this gap by estimating the impact of a large-scale health intervention in Guatemala on health access and outcomes. NGOs were contracted to provide health services focused on preventive services toward young children and mothers. Data to be used includes the census of births and deaths from 1990 to 2006, full-sample 1994 and 2002 Population Censuses and household surveys. The empirical methodology will tackle non-random selection into the program by estimating impacts using within-region over time variation.