IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v222y2019icp285-293.html
   My bibliography  Save this article

Impact of an employment guarantee scheme on utilisation of maternal healthcare services: Results from a natural experiment in India

Author

Listed:
  • Parmar, Divya
  • Banerjee, Aneesh

Abstract

We assess the impact of India's National Rural Employment Guarantee (NREG) scheme, the world's largest workfare scheme, on healthcare utilisation – specifically maternal healthcare. The primary objective of NREG is to improve the income of rural households by guaranteeing 100 days of employment. We expect that by improving household income, thereby reducing some of the financial barriers, such as out-of-pocket payments, NREG can increase utilisation of maternal health services. Using a nationally representative household survey and a difference-in-differences approach that exploits the phased rollout of the scheme, we estimate the impact of NREG on utilisation of maternal health services: mainly deliveries at health facilities. We find that NREG did not increase overall facility deliveries, even though it led to an increase in deliveries at public facilities. There is weak evidence to suggest that deliveries at private facilities reduced due to NREG. Furthermore, sub-group analyses reveal that among poorer households, who are more likely to participate in NREG, there is a reduction in facility deliveries while home deliveries increased. Among richer households, NREG increased deliveries at public facilities. There was no impact on households belonging to marginalised castes. We conclude by discussing the possible mechanisms for these effects and its impact on equity in healthcare utilisation.

Suggested Citation

  • Parmar, Divya & Banerjee, Aneesh, 2019. "Impact of an employment guarantee scheme on utilisation of maternal healthcare services: Results from a natural experiment in India," Social Science & Medicine, Elsevier, vol. 222(C), pages 285-293.
    • Handle: RePEc:eee:socmed:v:222:y:2019:i:c:p:285-293
    DOI: 10.1016/j.socscimed.2019.01.028
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953619300280
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2019.01.028?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Lenis Saweda O. Liverpool‐Tasie & Alex Winter‐Nelson, 2011. "Asset versus consumption poverty and poverty dynamics in rural Ethiopia," Agricultural Economics, International Association of Agricultural Economists, vol. 42(2), pages 221-233, March.
    2. Sagarika Dey, 2017. "Assessing the Poverty Impact of India’s Largest Livelihood Security Programme: A Study Based on 68th Round of NSSO," Journal of Development Policy and Practice, , vol. 2(1), pages 56-70, January.
    3. Jha, Raghbendra & Bhattacharyya, Sambit & Gaiha, Raghav & Shankar, Shylashri, 2009. ""Capture" of anti-poverty programs: An analysis of the National Rural Employment Guarantee Program in India," Journal of Asian Economics, Elsevier, vol. 20(4), pages 456-464, September.
    4. Deininger, Klaus & Liu, Yanyan, 2013. "Welfare and poverty impacts of India's national rural employment guarantee scheme : evidence from Andhra Pradesh," Policy Research Working Paper Series 6543, The World Bank.
    5. Lanjouw, Peter & Ravallion, Martin, 1999. "Benefit Incidence, Public Spending Reforms, and the Timing of Program Capture," The World Bank Economic Review, World Bank, vol. 13(2), pages 257-273, May.
    6. Clément Imbert & John Papp, 2015. "Labor Market Effects of Social Programs: Evidence from India's Employment Guarantee," American Economic Journal: Applied Economics, American Economic Association, vol. 7(2), pages 233-263, April.
    7. Karthik Muralidharan & Paul Niehaus & Sandip Sukhtankar, 2023. "General Equilibrium Effects of (Improving) Public Employment Programs: Experimental Evidence From India," Econometrica, Econometric Society, vol. 91(4), pages 1261-1295, July.
    8. Liu, Yanyan & Barrett, Christopher B., 2012. "Heterogeneous pro–poor targeting in India’s Mahatma Gandhi National Rural Employment Guarantee Scheme:," IFPRI discussion papers 1218, International Food Policy Research Institute (IFPRI).
    9. Steven Haider & Alison Jacknowitz & Robert Schoeni, 2003. "Welfare work requirements and child well-being: Evidence from the effects on breast-feeding," Demography, Springer;Population Association of America (PAA), vol. 40(3), pages 479-497, August.
    10. Ai, Chunrong & Norton, Edward C., 2003. "Interaction terms in logit and probit models," Economics Letters, Elsevier, vol. 80(1), pages 123-129, July.
    11. Erlend Berg & Sambit Bhattacharyya & Rajasekhar Durgam & Manjula Ramachandra, 2012. "Can Rural Public Works Affect Agricultural Wages? Evidence from India," CSAE Working Paper Series 2012-05, Centre for the Study of African Economies, University of Oxford.
    12. Martin Ravallion & Emanuela Galasso & Teodoro Lazo & Ernesto Philipp, 2005. "What Can Ex-Participants Reveal about a Program’s Impact?," Journal of Human Resources, University of Wisconsin Press, vol. 40(1).
    13. Maity, Bipasha, 2017. "Comparing Health Outcomes Across Scheduled Tribes and Castes in India," World Development, Elsevier, vol. 96(C), pages 163-181.
    14. Subbarao,Kalanidhi, 2003. "Systemic shocks and social protection : role and effectiveness of public works programs," Policy Research Working Paper Series 25606, The World Bank.
    15. Bose, Nayana, 2017. "Raising Consumption Through India’s National Rural Employment Guarantee Scheme," World Development, Elsevier, vol. 96(C), pages 245-263.
    16. World Bank, 2011. "Social Protection for a Changing India : Executive Summary," World Bank Publications - Reports 2746, The World Bank Group.
    17. Zimmermann, Laura V, 2012. "Labor Market Impacts of a Large-Scale Public Works Program: Evidence from the Indian Employment Guarantee Scheme," IZA Discussion Papers 6858, Institute of Labor Economics (IZA).
    18. Ravi, Shamika & Engler, Monika, 2015. "Workfare as an Effective Way to Fight Poverty: The Case of India’s NREGS," World Development, Elsevier, vol. 67(C), pages 57-71.
    19. Songqing Jin & Yanyan Liu, 2013. "Welfare and Poverty Impacts of India’s National Rural Employment Guarantee Scheme: Evidence from Andhra Pradesh," Working Papers id:5530, eSocialSciences.
    20. M. Adato & L. Haddad, 2002. "Targeting Poverty through Community-Based Public Works Programmes: Experience from South Africa," Journal of Development Studies, Taylor & Francis Journals, vol. 38(3), pages 1-36.
    21. World Bank, 2011. "Social Protection for a Changing India : Main Report," World Bank Publications - Reports 2745, The World Bank Group.
    22. Navaneetham, K. & Dharmalingam, A., 2002. "Utilization of maternal health care services in Southern India," Social Science & Medicine, Elsevier, vol. 55(10), pages 1849-1869, November.
    23. Subbarao, Kalanidhi, 2003. "Systemic shocks and social protection : role and effectiveness of public works programs," Social Protection and Labor Policy and Technical Notes 25606, The World Bank.
    24. Farzana Afridi & Abhiroop Mukhopadhyay & Soham Sahoo, 2016. "Female labor force participation and child education in India: evidence from the National Rural Employment Guarantee Scheme," IZA Journal of Labor & Development, Springer;Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 5(1), pages 1-27, December.
    25. Sonalde Desai & Prem Vashishtha & Omkar Joshi, 2015. "Mahatma Gandhi National Rural Employment Guarantee Act: A Catalyst for Rural Transformation," Working Papers id:7259, eSocialSciences.
    26. Azam, Mehtabul, 2012. "The Impact of Indian Job Guarantee Scheme on Labor Market Outcomes: Evidence from a Natural Experiment," IZA Discussion Papers 6548, Institute of Labor Economics (IZA).
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Klonner, Stefan & Oldiges, Christian, 2022. "The welfare effects of India’s rural employment guarantee," Journal of Development Economics, Elsevier, vol. 157(C).
    2. Bose, Nayana, 2017. "Raising Consumption Through India’s National Rural Employment Guarantee Scheme," World Development, Elsevier, vol. 96(C), pages 245-263.
    3. Deininger, Klaus & Liu, Yanyan, 2019. "Heterogeneous welfare impacts of National Rural Employment Guarantee Scheme: Evidence from Andhra Pradesh, India," World Development, Elsevier, vol. 117(C), pages 98-111.
    4. Misra, Kartik, 2019. "Does historical land inequality attenuate the positive impact of India’s employment guarantee program?," World Development, Elsevier, vol. 124(C), pages 1-1.
    5. Sheahan, Megan & Liu, Yanyan & Narayanan, Sudha & Barrett, Christopher B., 2015. "Disaggregated labor supply implications of guaranteed employment in India," 2016 Annual Meeting, July 31-August 2, Boston, Massachusetts 237345, Agricultural and Applied Economics Association.
    6. Berg, Erlend & Bhattacharyya, Sambit & Rajasekhar, D. & Manjula, R., 2018. "Can public works increase equilibrium wages? Evidence from India’s National Rural Employment Guarantee," World Development, Elsevier, vol. 103(C), pages 239-254.
    7. Deininger, Klaus & Nagarajan, Hari K & Singh, Sudhir K, 2020. "Women's political leadership and economic empowerment: Evidence from public works in India," Journal of Comparative Economics, Elsevier, vol. 48(2), pages 277-291.
    8. Merfeld, Joshua D., 2019. "Spatially heterogeneous effects of a public works program," Journal of Development Economics, Elsevier, vol. 136(C), pages 151-167.
    9. Mushtaq Ahmad Malla, 2020. "MGNREGA in Kashmir: An Analysis of Labour Market Outcomes and Livelihood Security," Indian Journal of Human Development, , vol. 14(3), pages 424-446, December.
    10. Drèze, Jean & Khera, Reetika, 2017. "Recent Social Security Initiatives in India," World Development, Elsevier, vol. 98(C), pages 555-572.
    11. Klonner, Stefan & Oldiges , Christian, 2014. "Safety Net for India's Poor or Waste of Public Funds? Poverty and Welfare in the Wake of the World's Largest Job Guarantee Program," Working Papers 0564, University of Heidelberg, Department of Economics.
    12. Karthik Muralidharan & Paul Niehaus & Sandip Sukhtankar, 2023. "General Equilibrium Effects of (Improving) Public Employment Programs: Experimental Evidence From India," Econometrica, Econometric Society, vol. 91(4), pages 1261-1295, July.
    13. Merfeld, Joshua D, 2017. "Spatially Heterogeneous Effects of a Public Works Program," MPRA Paper 80630, University Library of Munich, Germany.
    14. Kartik Misra, 2019. "No Employment without Participation : An Evaluation of India's Employment Program in Eastern Uttar Pradesh," UMASS Amherst Economics Working Papers 2019-13, University of Massachusetts Amherst, Department of Economics.
    15. Deepak Varshney & Deepti Goel & J. V. Meenakshi, 2018. "The Impact of MGNREGA on Agricultural Outcomes and the Rural Labour Market: A Matched DID Approach," The Indian Journal of Labour Economics, Springer;The Indian Society of Labour Economics (ISLE), vol. 61(4), pages 589-621, December.
    16. Chari, A.V. & Glick, Peter & Okeke, Edward & Srinivasan, Sinduja V., 2019. "Workfare and infant health: Evidence from India's public works program," Journal of Development Economics, Elsevier, vol. 138(C), pages 116-134.
    17. World Bank Group, 2015. "India Development Update, April 2015," World Bank Publications - Reports 21872, The World Bank Group.
    18. Imbert, Clément & Papp, John, 2020. "Costs and benefits of rural-urban migration: Evidence from India," Journal of Development Economics, Elsevier, vol. 146(C).
    19. Deininger, Klaus & Liu, Yanyan, 2013. "Welfare and poverty impacts of India’s national rural employment guarantee scheme: Evidence from Andhra Pradesh:," IFPRI discussion papers 1289, International Food Policy Research Institute (IFPRI).
    20. World Trade Organisation, 2015. "India Development Update : Towards a Higher Growth Path," Working Papers id:6821, eSocialSciences.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:222:y:2019:i:c:p:285-293. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.