Corruption – the Mother Of Maternal Mortality? A Nested Analysis of How Corruption Affects Maternal Mortality

Abstract

Maternal mortality remains a major global health challenge and exhibits substantial variation across countries. While previous research has shown that quality of government influences health outcomes, the relationship between corruption and maternal mortality has received limited attention. This study examines whether and how corruption affects maternal mortality. Using a nested analysis design, the study combines a cross-national statistical analysis with a case study of Nepal. The quantitative analysis demonstrates a robust and statistically significant relationship between corruption and maternal mortality. Lower levels of corruption are associated with lower maternal mortality, even after controlling for socioeconomic development, female education, abortion laws, public health spending, and inequality. The results further suggest that the effectiveness of public health spending is conditional on the level of corruption. The Nepal case study identifies several mechanisms through which corruption affects maternal mortality. Corruption reduces the effectiveness of public health spending by diverting resources from their intended purposes, increases barriers to care, and may undermine the reliability of health data. The findings also suggest that corruption operates as a cross-cutting factor affecting all three phases of delay in the Three Delays Model. The study contributes to the literature on quality of government and health by extending the analysis of corruption to maternal mortality and by identifying mechanisms linking corruption to adverse health outcomes.