This paper analyzes the effects of a multilateral debt relief program on child health. The International
Monetary Fund and the World Bank launched the Heavily Indebted Poor Countries Initiative
in the late 1990s to reduce the debt burdens of poor countries, and explicitly linked the initiative to
the aim of poverty reduction and social targets. As a result, debt-servicing costs have gone down
by an average 1.8 percentage points of gross domestic product in Heavily Indebted Poor Countries.
However, the social effects of debt relief are not well known. The paper employs micro data on infant
mortality from 56 country-specific Demographic and Health Surveys to investigate the effects of
the Heavily Indebted Poor Countries Initiative on child health. The retrospective fertility structure of
the data allows for analysis using the within-mother variation in the probability of survival of babies
before and after different stages of the initiative. The results suggest that after a debt-ridden country
enters the program, which is conditional on reform and pro-development policies, and receives interim
debt relief, the probability of infant mortality goes down by about 0.5 percentage point. This
translates into about 3,000 fewer infant deaths in an average Heavily Indebted Poor Country. The
findings are particularly strong for infants born to poor mothers and mothers living in rural areas,
and are driven by access to vaccines early in life and during pregnancy. There are no child health
effects from graduating from the program and receiving full debt relief.