The impact of aid projects on maternal health outcomes in Tanzania

Sammanfattning

Research on aid effectiveness has produced mixed evidence on the impact of foreign aid on development outcomes. In recent decades, the literature has shifted from macro-level analyses toward local effects of aid projects. Maternal health has received relatively less attention, despite remaining a major public health challenge in low-income countries, particularly in Sub-Saharan Africa. This thesis investigates whether locally implemented health aid projects improve maternal healthcare utilization and antenatal care quality in Tanzania. The analysis combines geocoded data on DAC-funded health aid projects (1997-2011) with two rounds of the Demographic Health Surveys (DHS). Using a difference-in-differences approach, 28,713 geocoded individuals observed between 2005 and 2015 are matched to nearby aid project locations to estimate the local effects of aid exposure on maternal health outcomes. The results show that exposure to nearby health aid projects increased the probability of facility-based delivery by approximately 5 percentage points. Women living near aid projects are about 5 percentage points more likely to have their blood pressure measured during pregnancy and nearly 10 percentage points more likely to provide a urine sample, both key components of antenatal care quality. In contrast, the study finds relatively clean null findings for antenatal care utilization and timing of the first antenatal visit. Overall, the findings suggest that although locally targeted health aid projects can improve certain dimensions of maternal health utilization and quality in Tanzania, aid exposure alone may be insufficient to reduce broader inequalities among subgroups of the population.