The effect of government contracting with faith-based health care providers in Malawi

Wiktoria Tafesse, Gerald Manthalu and Martin Chalkley
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Gerald Manthalu: Ministry of Health, Government of Malawi

No 167cherp, Working Papers from Centre for Health Economics, University of York

Abstract: We study the impact of contracting-out of maternal health care by the government of Malawi to providers from the Christian Health Association of Malawi (CHAM) in the form of Service Level Agreements (SLAs). Under a SLA, a CHAM facility provides agreed maternal and newborn services free-of-charge to patients, and is reimbursed on a fixed price per service. We merge data on health facilities in Malawi with pregnancy histories from the 2010 Malawi Demographic and Health Survey, and exploit the staggered implementation of SLAs across facilities. Using difference-in-differences, we estimate the differential effects on pregnancy- related health care utilisation to mothers residing near and far from facilities with a SLA over time. Our findings show that SLAs reduced home births and increased skilled deliveries at CHAM hospitals. We observe greater provision of prenatal care services at CHAM health centres but no overall increase in the number of prenatal care visits. We find evidence of a reduction in certain components of prenatal care.

Keywords: Healthcare; Least Developed Country; Contracting Out; Nonprofit. (search for similar items in EconPapers)
JEL-codes: I11 I12 I15 I18 L24 L30 L33 (search for similar items in EconPapers)
Pages: 54 pages
Date: 2019-07
New Economics Papers: this item is included in nep-dev and nep-hea
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Persistent link: https://EconPapers.repec.org/RePEc:chy:respap:167cherp

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