First Advisor

Bruce Gilley

Term of Graduation

Spring 2020

Date of Publication


Document Type


Degree Name

Doctor of Philosophy (Ph.D.) in Public Affairs and Policy


Public Affairs and Policy




Infants -- Mortality -- Developing countries – Statistics, Congo (Brazzaville) -- Politics and government -- Case studies, Yemen (Republic) -- Politics and government -- Case studies, Mothers -- Health and hygiene, Infants -- Health and hygiene



Physical Description

1 online resource (ix, 258 pages)


The infant mortality rate (IMR) in some developing countries has decreased faster than the global average even though these countries lack strong economic growth, good governance, and democracy (often acknowledged precursors to improved health outcomes). What accounts for the improvement of the IMR in the absence of these traditional pathways to health gains? Some scholars suggest that the concept of "strategic governance" might help direct attention to intermediary factors that reduce neonatal deaths in countries that experience crisis conditions. The main objective of this dissertation is to investigate the set of governance practices that have reduced IMR in two such cases. In particular, what "strategic governance" practices, if any, can be identified as contributing to the IMR decline in such cases? Using case studies to explore the significant reduction in IMR in Republic of Congo (ROC) and Republic of Yemen (ROY), this dissertation finds that micro-strategic governance interventions such as decentralization, international partnerships, funding, performance-based funding and cultural change can mitigate the macro-structural crisis that threatens IMR in developing countries.


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