Abstract: Low population density in rural developing countries coupled with deficient infrastructure, weak state capacity and limited budgets makes increasing health care coverage difficult. Contracting-out mobile medical teams may be a helpful solution in this context. This article examines the impact of a large-scale programme of this type in Guatemala. We document large impacts on immunisation rates for children and prenatal care provider choices. The programme increased substantially the role of physician and nurses at the expense of traditional midwives. The results indicate that mobile medical teams substantially increased coverage of health care services in Guatemala, and could be effective in other developing countries.
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The authors wish to thank Nohora Alvarado, Hedi Deman, Ariadna Garcia Prado, Gerard La Forgia, Roberto Iunes, Cristina Maldonado, Olga Namen, Isabel Nieves, Silvia Raw, Jose Rodas, Tomas Rosada, Guilherme Sedlacek, Yuri Soares, Rita Sorio and Federico Volpino, as well as seminar participants at the Inter-American Development Bank, the 2009 Population Association of America Annual Conference and the 2009 Latin American and Caribbean Economic Association Annual Conference, for invaluable comments and suggestions. Nicolas Bottan and Ted Enamorado provided excellent research assistance throughout this project. Beomsoo Kim was supported by the National Research Foundation of Korea Grant funded by the korean Government [NRF-2013S1A5A2A01018028]. The opinions expressed herein are those of the authors and do not necessarily reflect those of the Inter-American Development Bank.
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