Fiscal consolidation and health inequality: Evidence from infant mortality in Sub-Saharan Africa

In this paper, we examine the effect of fiscal consolidation episodes conducted over 1975- 2015 on infant mortality in sub-Saharan African countries. Episodes of fiscal austerity are indeed likely to be associated with spending cuts which might negatively affect the quantity and/or quality of public services such as health centers and hospitals. Infant mortality is measured at the child level using the combination of Demographic and Health Surveys for 35 African countries. Fiscal consolidation is measured at the country level with a dummy variable that is equal to one if a fiscal consolidation occurred in the birth year of the child, or the year before. Fiscal consolidation is, on average, associated with higher infant mortality: the estimated contribution of fiscal austerity to infant mortality is around 7 per 1000 additional infant deaths as compared with a situation where birth would have occurred outside fiscal consolidation periods. We also investigate how fiscal consolidation influences health inequality and find that these episodes disproportionately affect child deaths of mothers belonging to the poorer segment of the population as well as those of middle-class mothers.