Road Access, Fertility and Child Health in Rural India

Expansion in access to public infrastructure can have varied, micro-level impacts. In this paper, we use quasi-random access to rural paved roads through a large-scale road-construction program in India to study how road access impacts fertility decisions and investments in child health. We find that increased access to paved roads at the district-level leads to a rise in fertility, improved investments in children—measured through breastfeeding duration and immunization—and lower infant mortality. We also investigate the potential labor market mechanisms that drive these effects, and heterogeneity in the impacts by plausibly exogenous variation in levels of female labor force participation (FLFP). We find that in districts with erstwhile lower levels of FLFP, the effects on fertility and child health are driven by paved road access causing women to drop out of the labour force, while men shift from unpaid work to paid work. On the other hand, in districts with higher FLFP due to women’s involvement in agriculture, we find that the increase in fertility can be explained by women substituting away from (paid) employment towards full-time domestic work.