Does Distance matter for Institutional Delivery in Rural India? An Instrumental Variable Approach

Santosh Kumar, Emily Dansereau and Chris Murray
Authors registered in the RePEc Author Service: Santosh Kumar Gautam

MPRA Paper from University Library of Munich, Germany

Abstract: Skilled attendance at childbirth is crucial for decreasing maternal and neonatal mortality, yet many women in low- and middle-income countries deliver outside of health facilities, without skilled help. Distance to health facility is considered to be an important non-monetary barrier that impede utilization of health facilities. In this paper, we examine if access to health facilities affects institutional births in a resource-constrained country like India. We use Two-Stage Residual Inclusion (2SRI) and IV-Probit models to account for endogenous placement of health facilities. Our findings indicate that women living closer to health facilities have a higher probability of giving birth in health facility. An increase of one kilometer in the distance to the nearest health facility decreases the probability of institutional delivery by 4.4%. The results from policy simulation suggest that restricting the maximum distance to 5 kilometers would increase institutional delivery by 10%. Overall, our findings show that distance is an important barrier to service utilization and increasing the density of health facilities or improving transport infrastructure may be an important policy tool to improve facility-based delivery in developing countries.

Keywords: In-facility delivery; access; distance; India. (search for similar items in EconPapers)
JEL-codes: I0 I15 I18 (search for similar items in EconPapers)
Date: 2012-10-01, Revised 2013-01-01
New Economics Papers: this item is included in nep-agr and nep-dem
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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