The Effect of Shocks on Prenatal Healthcare Choices

Abstract

The lack of prenatal healthcare has been identified as an important determinant of maternal mortality, which is the leading cause of death among women of child-bearing age in the world. This paper examines the effect of both idiosyncratic and covariate shocks and other economic determinants on prenatal healthcare provider choices. The main question addressed is: “Do idiosyncratic and covariate shocks affect a woman’s choice to seek prenatal care?” To answer this question this paper uses a large household data set from Madagascar. Four health care options are considered: hospital, private services, clinic, and no formal healthcare. This paper utilizes logit estimation to assess the use of formal prenatal care services and multinomial logit for the type of care chosen.
The results suggest that covariate shocks increase the likelihood of using formal prenatal care, while idiosyncratic shocks have the opposite effect. Idiosyncratic shocks reduce de demand for private clinics. Covariate shocks increase all formal healthcare. Covariate shocks may reduce inputs to women’s health (e.g., food, shelter, community support) which women can try to recompense by increasing demand for formal health care. Conversely, women who face idiosyncratic shocks can substitute formal prenatal care for informal healthcare.