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The Effect of Absenteeism and Clinic Protocol on Health Outcomes: The Case of Mother-to-Child Transmission of HIV in Kenya

  • Markus Goldstein
  • Joshua Graff Zivin
  • James Habyarimana
  • Cristian Pop-Eleches
  • Harsha Thirumurthy

We show that pregnant women whose first clinic visit coincides with the nurse's attendance are 58 percentage points more likely to test for HIV and 46 percent more likely to deliver in a hospital. Furthermore, women with high pretest expectations of being HIV positive, whose visit coincides with nurse attendance, are 25 and 7.4 percentage points more likely to deliver in a hospital and receive PMTCT medication, and 9 percentage points less likely to breast-feed than women whose visit coincides with nurse absence. The shortcomings that prevent pregnant women from testing on a subsequent visit are common in sub-Saharan Africa. (JEL I12, J16, O15)

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Article provided by American Economic Association in its journal American Economic Journal: Applied Economics.

Volume (Year): 5 (2013)
Issue (Month): 2 (April)
Pages: 58-85

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Handle: RePEc:aea:aejapp:v:5:y:2013:i:2:p:58-85
Note: DOI: 10.1257/app.5.2.58
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  1. Timothy Besley, 1995. "Nonmarket Institutions for Credit and Risk Sharing in Low-Income Countries," Journal of Economic Perspectives, American Economic Association, vol. 9(3), pages 115-127, Summer.
  2. Robert M. Townsend, 1995. "Consumption Insurance: An Evaluation of Risk-Bearing Systems in Low-Income Economies," Journal of Economic Perspectives, American Economic Association, vol. 9(3), pages 83-102, Summer.
  3. Martina Björkman & Jakob Svensson, 2009. "Power to the People: Evidence from a Randomized Field Experiment on Community-Based Monitoring in Uganda," The Quarterly Journal of Economics, MIT Press, vol. 124(2), pages 735-769, May.
  4. Nazmul Chaudhury & Jeffrey Hammer & Michael Kremer & Karthik Muralidharan & F. Halsey Rogers, 2006. "Missing in Action: Teacher and Health Worker Absence in Developing Countries," Journal of Economic Perspectives, American Economic Association, vol. 20(1), pages 91-116, Winter.
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