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How important are individual, household and commune characteristics in explaining utilization of maternal health services in Vietnam?

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  • Sepehri, Ardeshir
  • Sarma, Sisira
  • Simpson, Wayne
  • Moshiri, Saeed

Abstract

Using Vietnam's latest National Household Survey data for 2001-2002 this paper assesses the influence of individual, household and commune-level characteristics on a woman's decision to seek prenatal care, on the number of prenatal visits, and on the choice between giving birth at a health facility or at home. The decision to use any care and the number of prenatal visits is modeled using a two-part model. A random intercept logistic model is used to capture the influence of unobserved commune-specific factors found in the data regarding a woman's decision to give birth at a health facility rather than at home. The results show that access to prenatal care and delivery assistance is limited by observed barriers such as low income, low education, ethnicity, geographical isolation and a high poverty rate in the community. More specifically, more prenatal visits increase the likelihood of giving birth at a health facility. Having compulsory health insurance increases the odds of giving birth at a health facility for middle and high income women. In contrast, health insurance for the poor increases the likelihood of having more prenatal visits but has little effect on the place of delivery. These results suggest that the existing safe motherhood programs should be linked with the objectives of social development programs such as poverty reduction, and that policy makers need to view both the individual and the commune as appropriate units for policy targeting.

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Bibliographic Info

Article provided by Elsevier in its journal Social Science & Medicine.

Volume (Year): 67 (2008)
Issue (Month): 6 (September)
Pages: 1009-1017

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Handle: RePEc:eee:socmed:v:67:y:2008:i:6:p:1009-1017

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Related research

Keywords: Vietnam Maternal health services Health seeking behavior Multilevel analysis Two-part model Prenatal care;

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Cited by:
  1. Yusuke Kamiya, 2010. "Endogenous Women's Autonomy and the Use of Reproductive Health Services: Empirical Evidence from Tajikistan," OSIPP Discussion Paper, Osaka School of International Public Policy, Osaka University 10E010, Osaka School of International Public Policy, Osaka University.
  2. Alassane DRABO & Christian EBEKE, 2010. "Remittances, Public Health Spending and Foreign Aid in the Access to Health Care Services in Developing Countries," Working Papers 201004, CERDI.
  3. Kruk, Margaret E. & Rockers, Peter C. & Mbaruku, Godfrey & Paczkowski, Magdalena M. & Galea, Sandro, 2010. "Community and health system factors associated with facility delivery in rural Tanzania: A multilevel analysis," Health Policy, Elsevier, vol. 97(2-3), pages 209-216, October.
  4. Guliani, Harminder & Sepehri, Ardeshir & Serieux, John, 2012. "What impact does contact with the prenatal care system have on women’s use of facility delivery? Evidence from low-income countries," Social Science & Medicine, Elsevier, Elsevier, vol. 74(12), pages 1882-1890.
  5. Adjiwanou, Vissého & LeGrand, Thomas, 2013. "Does antenatal care matter in the use of skilled birth attendance in rural Africa: A multi-country analysis," Social Science & Medicine, Elsevier, Elsevier, vol. 86(C), pages 26-34.

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