The World Bank, Organized Hypocrisy, and Women's Health: A Cross-National Analysis of Maternal Mortality in Sub-Saharan Africa

The theory of organized hypocrisy asserts that an organization depends upon its external environment for both financial support and conferred legitimacy, which can lead to conflicting policy agendas. We apply the theory of organized hypocrisy to World Bank structural adjustment and investment lending for reproductive health, hypothesizing these two lending policies should have differential effects on maternal mortality. We estimate a two-way fixed effects regression model with robust standard errors clustered by country to examine the effect of World Bank reproductive health lending on maternal mortality within sub-Saharan African nations over the period 1990–2010. We find that in every model the coefficients for World Bank structural adjustment lending in the health sector are positive and significant while the coefficients for World Bank investment lending in the reproductive health sector are negative and significant. The findings lend support to the theory that the World Bank is pursuing contradictory agendas, embodied by its lending policies, which can have differential effects on maternal mortality.