Subsidies, Information, and the Timing of Children’s Health Care in Mali

Abstract

Sustained progress in reducing child mortality requires better care for children who are acutely ill. This paper studies how health care subsidies and health workers providing information on symptoms affect the overuse and underuse of primary care, which depend not just on absolute levels of demand, but also on whether care is received when the child is actually sick. In a randomized controlled trial of 1,768 children in Mali, the study collected a unique panel of nine weeks of daily symptom and health care use data to study the impact of each policy on demand conditional on need for care, as defined by World Health Organization standards. Subsidies substantially increase care when it is medically indicated, while overuse remains rare. Health worker visits have no aggregate effect on demand, but they may help the youngest children take advantage of the subsidy.