under-five mortality have been well above historical antecedents in recent years in quite a number of developing countries. Recent success stories including countries as diverse as Nepal (142 of 1000 children to 55 between 1990 and 2007), Bangladesh (151 to 61), Eritrea (147 to 70), Lao People’s Democratic Republic (163 to 70), Mongolia (98 to 43), Bolivia (125 to 57), and Malawi (209 to 111) reveal huge mortality rate declines, making the achievement of MDG 4 very likely in these cases (You et al., 2009).<sup>8</sup> These reductions of often more than 60 per thousand points were achieved much more quickly—in only 17 years—than would be suggested by the average progress rate above.<sup>9</sup> In many of the success cases, different combinations of supply-side interventions such as immunization and nutrition programs as well as the strengthening of the health system, particularly in terms of primary care at the community/village level, seem to have been key factors behind the rapid declines. In some cases, for example, Nepal and Laos, these measures were accompanied by public awareness campaigns aimed at increasing demand for the services offered. In a cross-country comparison of eight sub-Saharan countries, Lay and Robilliard (2009) also find the expansion of vaccination coverage, a factor that is correlated with other early childhood interventions, to be among the major explanatory factors for the relative successes in their sample, for example, in Mozambique and Niger. This is in line with the earlier cross-country evidence from McGuire (2006), who shows child mortality rates to be strongly associated with maternal and infant health program efforts, while overall public health-care spending turns out to have no significant effect.<sup>10</sup> Supply-side interventions thus appear to have played a major role in recent child mortality reductions. For education, in contrast, this first crude assessment of the determinants of MDG achievement suggests a more prominent role for demand-side factors, specifically income growth and growth expectations, in recent increases in enrollment. Therefore, we can conclude that there are factors that allow some countries to depart from average trajectories, although the above analysis illustrates that there are probably limits to the variation around these paths. The regression results further indicate that there may indeed be an s-shaped pattern of MDG achievement. This pattern may be taken as a sign of the important role of demand-side factors, particularly income and its many household-level correlates.

> 8 At the same time, a number of sub-Saharan countries have made very little or no progress, so that the subcontinent now accounts for half of early childhood deaths worldwide. Progress also needs to accelerate in India, Pakistan, and China.

> 9 These trends typically rest on few data points and should, for some cases, be treated with caution. Yet with the increasing frequency and higher quality of demographic and health surveys in the past 15 years, national health statistics have generally improved considerably.

> 10 The latter missing effect was identified in earlier studies, for example by Filmer and Pritchett (1999).

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