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Use of Maternal Health Care in Tajikstan: A Bargaining Framework

Listed author(s):
  • Mieke Meurs
  • Lisa Giddings

Post-socialist economic declines have included declines in women's use of maternal health care. This paper examines the use of maternal health care in Tajikistan, where such declines have occurred. The findings support previous evidence that women's use of services depends on women's education, household income, and proximity of services. Previous models have not specified who makes the care decision. Using education as a proxy for preferences, the findings show that women share decisionmaking with their spouse and the eldest female in the household. However, the data provides limited evidence that traditional proxies for bargaining power affect outcomes. The authors conclude that measures of bargaining power require tailoring to local conditions. Surveys evaluating the value of women's assets and their services in the home, as well as questions about decision-making, will allow researchers to more effectively measure bargaining power across contexts. The paper concludes with policy recommendations.

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File Function: First version, 2012
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Paper provided by American University, Department of Economics in its series Working Papers with number 2012-05.

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Date of creation: Feb 2012
Handle: RePEc:amu:wpaper:2012-05
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  1. Mieke Meurs & Rasika Ranasinghe, 2003. "De-Development in Post-Socialism: Conceptual and Measurement Issues," Politics & Society, , vol. 31(1), pages 31-53, March.
  2. Nazim Habibov, 2009. "What determines healthcare utilization and related out-of-pocket expenditures in Tajikistan? Lessons from a national survey," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 54(4), pages 260-266, August.
  3. Haddad, Lawrence & Hoddinott, John & Alderman, Harold & DEC, 1994. "Intrahousehold resource allocation : an overview," Policy Research Working Paper Series 1255, The World Bank.
  4. Rasul, Imran, 2008. "Household bargaining over fertility: Theory and evidence from Malaysia," Journal of Development Economics, Elsevier, vol. 86(2), pages 215-241, June.
  5. Dabalen, Andrew & Wane, Waly, 2008. "Informal payments and moonlighting in Tajikistan's health sector," Policy Research Working Paper Series 4555, The World Bank.
  6. Michael Bittman & Paula England & Nancy Folbre & George Matheson, 2001. "When Gender Trumps Money: Bargaining and Time in Household Work," JCPR Working Papers 221, Northwestern University/University of Chicago Joint Center for Poverty Research.
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