Democracy Narrows Infant Mortality Gap in Africa, Study Shows

Why This Matters

Democracy is often associated with better aggregate welfare, but less is known about whether democratic regimes reduce gaps between advantaged and disadvantaged groups. Carmen Jacqueline Ho, Marie Christelle Mabeu, and Roland Pongou tackle this question for Africa by examining infant mortality—a direct measure of welfare that disproportionately affects the most vulnerable.

What the Authors Did

The authors analyze microdata on 3.8 million births across African countries from 1960 to 2016 to compare outcomes for higher-risk infants (twins) and lower-risk infants (singletons). Twins are used as a proxy for disadvantaged births because they face a materially higher mortality risk at birth. To address reverse causality and omitted-variable bias, the study exploits within-family variation—comparing siblings and births within the same family—thereby isolating the effect of regime type from family-level confounders.

Key Findings

• There is strong and robust evidence that transitions to and sustained periods of democracy reduced disparities in infant mortality between twins and singletons.
• The results hold under a variety of specifications and robustness checks that account for potential confounders and selection issues.

How Democracy Appears to Work

The authors’ evidence points to an expansion in the provision of basic goods and services under democratic governments as a plausible mechanism. By improving access to health-related public goods and services, democracies appear to have disproportionately benefited the more vulnerable infants, narrowing the health gap.

What This Means

The study provides micro-level evidence that democratization in Africa did more than raise average welfare—it also narrowed inequality in early-life health outcomes. Those interested in regime effects on distributional outcomes and public-good provision will find this large-sample, within-family analysis a valuable contribution.