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Increasing maternal healthcare use in Rwanda: Implications for child nutrition and survival

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  • Pierce, Hayley
  • Heaton, Tim B.
  • Hoffmann, John

Abstract

Rwanda has made great progress in improving maternal utilization of health care through coordination of external aid and more efficient health policy. Using data from the 2005 and 2010 Rwandan Demographic and Health Surveys, we examine three related questions regarding the impact of expansion of health care in Rwanda. First, did the increased use of health center deliveries apply to women across varying levels of education, economic status, and area of residency? Second, did the benefits associated with being delivered at a health center diminish as utilization became more widespread? Finally, did inequality in child outcomes decline as a result of increased health care utilization? Propensity score matching was used to address the selectivity that arises when choosing to deliver at a hospital. In addition, the regression models include a linear model to predict child nutritional status and Cox regression to predict child survival. The analysis shows that the largest increases in delivery at a health center occur among less educated, less wealthy, and rural Rwandan women. In addition, delivery at a health center is associated with better nutritional status and survival and the benefit is not diminished following the dramatic increase in use of health centers. Finally, educational, economic and residential inequality in child survival and nutrition did not decline.

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  • Pierce, Hayley & Heaton, Tim B. & Hoffmann, John, 2014. "Increasing maternal healthcare use in Rwanda: Implications for child nutrition and survival," Social Science & Medicine, Elsevier, vol. 107(C), pages 61-67.
  • Handle: RePEc:eee:socmed:v:107:y:2014:i:c:p:61-67
    DOI: 10.1016/j.socscimed.2014.02.007
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    References listed on IDEAS

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    1. Rajeev H. Dehejia & Sadek Wahba, 2002. "Propensity Score-Matching Methods For Nonexperimental Causal Studies," The Review of Economics and Statistics, MIT Press, vol. 84(1), pages 151-161, February.
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    Cited by:

    1. Hayley Pierce, 2021. "Nurturing Care for Early Childhood Development: Path to Improving Child Outcomes in Africa," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 40(2), pages 285-307, April.
    2. Laurence Lannes & Bruno Meessen & Agnes Soucat & Paulin Basinga, 2016. "Can performance-based financing help reaching the poor with maternal and child health services? The experience of rural Rwanda," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(3), pages 309-348, July.

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