Central Data Catalog

Citation Information

Type Report
Title The impact of access to health facilities on maternal care use and health status: Evidence from longitudinal data from rural Uganda
Publication (Day/Month/Year) 2015
URL https://grips.repo.nii.ac.jp/index.php?action=pages_view_main&active_action=repository_action_common​_download&item_id=1295&item_no=1&attribute_id=20&file_no=1&page_id=13&block_id=24
Maternal and child mortality remains high in developing countries. While timely antenatal
care and delivery at formal facility are recommended, many mothers do not use them. This
paper investigates whether newly established health facilities affect maternal health care utilization
as well as the health of mothers and children. In order to deal with possibly endogenous
facility placement, we apply the community-level and mother-level fixed effects models to the
new, decade-long panel data from rural Uganda. Results demonstrate differential roles played
by large facilities and small clinics. Openings of large facilities increase the probability of delivery
at formal facility, attended by trained personnel. This is accompanied by an increased use
of inexpensive transportation modes such as walking and own bicycle to delivery places. Weak
evidence is also found for reduced degree of selective infant survival. New community-level clinics,
on the other hand, increase regular antenatal care usage and reduce complications during
delivery. These results suggest that accessible clinics help pregnant mothers to avoid preventable
problems through early diagnosis of risky cases and/or treatment of existing diseases. Overall,
these findings underscore the importance of providing good access to health facilities, in particular
to community-level clinics, in order to promote the utilization of maternal care and improve
maternal and infant health.

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