To get more detailed information on how reaching Decision Point of the HIPC Initiative affects child health, I examine how a number of individual-level health measures other than mortality are associated with HIPC. The country-specific PRSPs and Decision Point documents more or less exhaustively describe which areas in the health sector are targeted for improvements in relation to HIPC and interim debt relief. The areas include health care provision for children, mothers, and disadvantaged group (rural, poor, uneducated) and sanitation measures. In some cases particular diseases are identified for prevention and treatment measures, e.g. Measles and Tuberculosis, and most countries aim for better provision of vaccines. A number of these measures are known to reduce child mortality (death before reaching five years of age) (Jones et al., 2003) and vaccines which are often given to babies before they turn one year of age, most notably Bacillus Calmette-Gurin (BCG) (against Tuberculosis), Measles, Diarrhea, and Polio, are associated with non-specific health effects and linked to reduced infant and neonatal mortality from causes other than specific diseases they are aimed at preventing (Cooper, Boyce, Wright, & Griffin, 2003).

In the individual-level health measure analysis I make use of older DHS data for the countries in the sample. Because mothers report on various health measures of their babies born within five years of the survey date, combining the newest survey data with the older surveys enables analysis of how health variables relate to debt relief through HIPC. I pool all available surveys from the countries in the sample<sup>9</sup> to obtain a panel of the following health measures: BCG vaccine, the first shot of Diphtheria, Pertussis and Tetanus (DPT) vaccine, Measles vaccine, the first shot of Polio vaccine, Tetanus vaccine for pregnant mothers, access to skilled assistance<sup>10</sup> at delivery, prenatal care by skilled health worker, oral rehydration solution for treating Diarrhea, and access to improved sanitation facilities (flush toilets and drinking water from piped water sources). The Tetanus vaccine for pregnant mothers and skilled prenatal care variables are measured 4.5 months prior to the baby’s birth. The two sanitation variables are measured at the time of the interview and the same value is given to all births in the past five years. Restricting this to a lower number than five does not influence the conclusions. Vaccination rates, skilled delivery and prenatal care, and oral rehydration solution variables not only measure the specific health care delivery channels, but may also give indications of any general progress in the health care sector which may be associated with Decision Point of the initiative.

Since mothers only report on their latest births, mother fixed effects cannot be applied in the same way as in the main analysis. Instead, I create groups of mothers for within-mother-group estimations,

> 9Surveys from Angola and Laos do not include these health measures and are thus excluded from this analysis on health mechanisms.

> 10Skilled assistance is defined as assistance from a doctor, nurse or midwife, or other health professional (see the DHS Recode Manuals at `http://www.dhsprogram.com/publications/publication-dhsg4-dhs-questionnaires -and-manuals.cfm` for more information).

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