ArticleHealth research policy and systems2024
Do targeted intergovernmental fiscal transfers improve health outcomes? Evidence from Kenyan decentralization using the difference-in-differences technique.
Article in Health research policy and systems, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- From decentralization to re-centralization: lessons learned from Vietnam's rapid reversal in the financing of the Expanded Program on Immunization.The Lancet regional health. Western Pacific · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAs envisioned by the 2010 Constitution, Kenya implemented a devolved system of government in March 2013, setting up 47 counties and a corresponding number of local governments. These counties differed in their levels of development. While counties such as Nairobi and Kiambu led in social and economic indicators, others such as Turkana, Mandera and Wajir were at the bottom of the list. Keeping the between-country disparities and the need to remedy those disparities in mind, the national government used formula-based criteria to determine counties' eligibility for the receipt of financial resources. On the basis of these criteria, counties were classified into marginalized and nonmarginalized counties. The marginalized counties were the 14 (of the 47) most socially and economically disadvantaged counties. These counties receive additional financial resources, which we call targeted intergovernmental fiscal transfers (i.e. fiscal transfers from the national government to county governments).
methodsWe used the difference-in-differences (DID) technique and fixed effects models to estimate the effects of these targeted intergovernmental fiscal transfers on human immunodeficiency virus (HIV) incidence and diarrhoea incidence.
resultsThe results revealed that the counties receiving those transfers experienced a statistically significant decline in the incidence of diarrhoea but had no impact on the incidence of HIV. Our study fills a major gap in causal evidence linking intergovernmental fiscal transfers to health outcomes, especially in the context of low-middle-income countries in a newly decentralized setting.
conclusionsOur results imply that targeted intergovernmental fiscal transfers may be effective at improving some subnational health outcomes, and therefore in reducing within-country health inequalities.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.