HIPCs, Development Assistance and Children: Child Survival Imperatives in Aid Programmes

Jay Chaubey, Ph.D., Senior Policy Advisor, Division of Policy and Planning, UNICEF, New York


This paper studies the trends of Under-Five Mortality Rate (U5MR) and their determinants in 38 highly indebted poor countries (HIPCs). These countries are at different stages of the HIPC programme and have received different levels of debt assistance. While the initiative aims principally to promote debt sustainability, its underlying objective is to enable countries to invest sustainably in development and poverty reduction. The paper investigates how the initiative has helped these countries in achieving their poverty reduction objective.

To assess the impact of the programme on poverty, we need to go beyond an income poverty measure. We argue that under-five mortality (U5MR) is an effective indicator of poverty in its various facets. U5MR is not only an effective measure of poverty seen from a child lens, it also closely tracks various other poverty indicators of countries.

The HIPC Initiative started in 1996 and was revised in 1999 for greater effectiveness. Therefore, in this paper, the trends in U5MR have been examined during three distinct periods, namely pre-HIPC period (1990-96), HIPC period (1996-2000), and enhanced HIPC period (2000-2003). Our sample comprises countries that had reached completion point (13) and decision point (14), and those which had not qualified for assistance as of June 2004.

We estimate the mean rates of reduction in U5MR for each group of countries and for each of the three periods, and examine the statistical significance of mean differences among groups of countries over the three periods. The study found that there was no significant difference over time and across groups. This is despite the fact that the Completion Point countries successfully implemented the governance and macroeconomic conditionalities for the longest period of time and also received proportionately higher assistance. The paper also studies the impact of public finance variables on U5MR. We have found that income and social expenditures on health and education are significantly correlated with U5MR trends in the sample of countries. Our results show that child poverty is well served by improved income with which private services are bought, as well as by better access to basic social services.

Our results show that besides growth of income as an aid delivery condition, public expenditures to improve child survival should be emphasized in the programme. The determinants of child survival include key public expenditures and coverage of certain services, as well as family income support. There is perhaps a need to associate such “positive conditions” with aid delivery, including HIPC assistance, in order to ensure that such assistance improves child survival.


Prof. Chaubey obtained his Ph.D. in Economics for the Boston University in 1982.
He worked as a Senior Human Resource Economist for the World Bank and as Joint Secretary for the Prime Minister of India.
His current work involves analysing macroeconomic and development issues in global and country context. Examples are promoting application of Human Rights principles in development strategies, analyzing options to promote public-private partnership at community levels and advising governments in fiscal monitoring structures to enhance allocations, monitoring and accountability in social sector spending.

Venue: UNU-MERIT, Maastricht, conference room, 16h00

Date: 25 January 2007