Use of Modern Medical Care for Pregnancy and Childbirth Care : Does Female Schooling Matter?

Controversy exists over whether the estimated effects of schooling on health care use reflect the influence of unobserved factors. Existing estimates may overstate the schooling effect because of the failure to control for unobserved variables or may be downwardly biased due to measurement error. This paper contributes to the resolution of this debate by adopting an instrumental variable approach to estimate the impact of female schooling on maternal health care use. A school construction program in Indonesia in the 1970s is used to construct an instrumental variable for education. The choice between use and non-use of maternal health services is estimated as a function of schooling and other variables. Data from the Indonesia Family Life Survey are used for this paper. Standard regression models estimated in the paper indicate that each additional year of schooling does indeed have a significant, positive effect on maternal health care use. Instrumental variable estimates of the schooling effect are larger. The results suggest that schooling has a positive impact on maternal health care use even after eliminating the effect of unobserved variables and measurement error. This paper moves beyond previous work on the impact of education on health care use by adopting an IV approach to address the problem of endogeneity and measurement error. IV methods have been used widely in the labour economics literature to examine the impact of schooling on wages and other labour market outcomes but rarely to estimate the effect of schooling on health outcomes.

Bibliographic Details

Main Author:	Somanathan, Aparnaa
Format:	Policy Research Working Paper biblioteca
Language:	English
Published:	World Bank, Washington, DC 2008-05
Subjects:	ACCESS TO CARE, ACCESS TO HEALTH CARE, ACCESS TO HEALTH SERVICES, ANTE-NATAL CARE, AUTONOMY OF WOMEN, BIRTH ATTENDANT, BIRTH ATTENDANTS, BIRTH ORDER, BIRTHS, BULLETIN, CHILD CARE, CHILD DELIVERY, CHILD EDUCATION, CHILD HEALTH, CHILD MORBIDITY, CHILD MORTALITY, CHILD SURVIVAL, CHILD-CARE, CHILDBEARING, CHILDBIRTH, CHILDHOOD, CONTRACEPTIVE USE, CULTURAL CHANGE, CURATIVE HEALTH CARE, DELIVERY CARE, DEVELOPING COUNTRIES, DISEASES, DOCTOR, ECONOMIC GROWTH, ECONOMIC RESOURCES, EDUCATION SECTOR, EMPLOYMENT, ENROLLMENT, ENROLLMENT RATE, ENROLLMENT RATES, ENROLMENT RATE, EPIDEMIOLOGY, EXPENDITURES, EXTENDED FAMILIES, FAMILY HEALTH, FAMILY MEMBERS, FAMILY SIZE, FATHER, FATHERS, FEMALE, FEMALES, FERTILITY, FIRST BIRTH, FIRST CHILD, FIRST MARRIAGE, FIRST PREGNANCY, GENDER, HEALTH CARE, HEALTH CARE ACCESS, HEALTH CARE DEMAND, HEALTH CARE FINANCING, HEALTH CARE PROVIDER, HEALTH CARE SERVICES, HEALTH CARE USE, HEALTH CARE UTILIZATION, HEALTH CENTRE, HEALTH ECONOMICS, HEALTH OUTCOMES, HEALTH POLICY, HEALTH PROFESSIONALS, HEALTH SERVICES, HEALTH STATUS, HOSPITAL, HOSPITAL CARE, HOSPITAL DELIVERIES, HOSPITALS, HOUSEHOLD INCOME, HOUSEHOLD LEVEL, HUMAN CAPITAL, HUMAN DEVELOPMENT, HUMAN RESOURCES, ILLNESS, IMMUNIZATION, IMMUNIZATIONS, IMPACT OF EDUCATION, IMPACT ON HEALTH, INFANT, INFANTS, INSURANCE, INTERVENTIONS, JOURNAL OF EPIDEMIOLOGY, LABOUR MARKET, LEVEL OF DEVELOPMENT, LEVEL OF EDUCATION, LEVELS OF EDUCATION, LITERACY, LIVE BIRTH, MALES, MARITAL STATUS, MARRIED WOMAN, MARRIED WOMEN, MATERNAL CARE, MATERNAL HEALTH, MATERNAL HEALTH CARE, MATERNITY CARE, MEDICAL CARE, MEDICAL SERVICES, MIDWIFE, MIDWIFERY, MIGRATION, MINISTRY OF EDUCATION, MISCARRIAGE, MODERN HEALTH CARE, MODERN MEDICINE, MODERNIZATION, MORBIDITY, MORTALITY, MORTALITY DECLINE, MOTHER, MOTHERS, NUMBER OF CHILDREN, NURSE, NUTRITION, OLDER WOMEN, PACIFIC REGION, PARITY, POLICY RESEARCH, POLICY RESEARCH WORKING PAPER, POOR MATERNAL HEALTH, POPULATION AND DEVELOPMENT, POPULATION ASSOCIATION, POPULATION STUDIES, PREGNANCIES, PREGNANCY, PRENATAL CARE, PRESCHOOL CHILDREN, PRIMARY HEALTH CARE, PRIMARY HEALTH CARE SERVICES, PRIMARY SCHOOL, PRIMARY SCHOOL AGE, PRIMARY SCHOOL BUILDINGS, PRIMARY SCHOOL CONSTRUCTION, PRIMARY SCHOOL LEVEL, PRIMARY SCHOOLING, PROBABILITY, PROGRESS, PUBLIC HEALTH, PUBLIC HEALTH PROGRAMS, PUBLIC POLICY, QUALITY OF CARE, QUALITY OF HEALTH, QUALITY OF HEALTH CARE, REPRODUCTIVE HEALTH, REPRODUCTIVE HEALTH CARE, RESPECT, ROLE OF WOMEN, RURAL AREAS, SAFETY NETS, SANITATION, SCHOOL BUILDINGS, SCHOOL CONSTRUCTION, SCHOOLS, SIBLINGS, SOCIAL FACTORS, SOCIAL SCIENCE, SOCIAL SECTOR, SOCIOECONOMIC STATUS, SPOUSE, STILLBIRTH, TEACHER RECRUITMENT, TEACHERS, TEACHING, TRADITIONAL BIRTH ATTENDANT, TRADITIONAL BIRTH ATTENDANTS, UNEDUCATED WOMEN, URBAN AREAS, USE OF HEALTH SERVICES, USE OF MATERNAL HEALTH SERVICES, USER FEES, WOMAN, WOMEN'S HEALTH, YOUNG CHILDREN,
Online Access:	http://documents.worldbank.org/curated/en/2008/05/9456664/use-modern-medical-care-pregnancy-childbirth-care-female-schooling-matter http://hdl.handle.net/10986/6680
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