Jeffrey J. Rous

THE EFFECTS OF MATERNAL–CHILD HEALTH SERVICE UTILIZATION ON SUBSEQUENT CONTRACEPTIVE USE IN MOROCCO

There are a number of reasons for anticipating that contact by women in developing country settings with modern maternal-child health (MCH) services will lead to increased use of family planning services. Indeed, the expectation of such a relationship underlies the integrated service delivery strategy that has been adopted on a more or less global basis. However, the available empirical evidence in support of this proposition is inconclusive. This study re-examines this issue in Morocco. Household survey data and data on the supply environment for health and family planning services gathered in 1992 are analysed in the study. A full-information maximum likelihood estimator is used to control for the possible endogeneity of health care and contraceptive choices. The findings indicate a substantial and apparently causal relationship between the intensity of MCH service use and subsequent contraceptive use. Policy simulations indicate that sizeable increases in contraceptive prevalence might be realized by increasing the coverage and intensity of use of MCH services.

Effect of provider characteristics on choice of contraceptive provider: A two-equation full-information maximum-likelihood estimation

We use surveys of households and health-care facilities conducted in the same area at the same time to determine which characteristics of providers attract users of contraceptives. By using the full-information maximum-likelihood technique to jointly estimate choice of contraceptive method and choice of provider, we avoid self-selection bias. Results support the need for modeling quality and for jointly estimating the choice of contraceptive method and the choice of provider to avoid biased estimates of coefficients. The results suggest that for the Cebu, Philippines region, small local clinics that focus on family planning tend to be most favored by clients.

Provider Availability, Race, and Abortion Demand

Variations in the availability of abortion providers may impact the demand for abortions since greater provider availability reduces the travel cost associated with obtaining an abortion. This paper applies a fertility-control model to estimate the responsiveness of abortion demand to travel-cost variations using individual data from all births and abortions of women over age 20 in the state of Texas for 1993. The probability that a pregnant woman chooses an abortion appears to be sensitive to availability-induced variations in the travel cost of abortion services. Controlling for the endogeneity of travel distance, the results suggest that pregnant women who reside in counties with longer travel distances to the nearest abortion provider have lower probabilities of aborting their pregnancies than women in counties closer to abortion providers. Simulations show that changes in travel distance will have relatively large impacts on overall abortion rates and, furthermore, that these effects vary across race. In addition, these simulations show substantial differences by race in the effects of changes in other explanatory variables.

Access to finance and small enterprise growth:evidence from East Java

The widespread acknowledgement of the centrality of micro and small businesses in the development process has led to a proliferation of projects and programs designed to assist and promote these businesses. This research examines the common assumption that access to credit from formal financial institutions is an important determinant of growth at the firm level. Our data are from a recent survey of 858 small businesses in East Java. We employ a full information maximum likelihood approach known as discrete factor method. The results indicate that access to credit is not a significant determinant of small firm growth; instead, other observable and unobservable characteristics of firms appear to cause growth.

Awareness and quality of knowledge regarding HIV/AIDS among women in India

Abstract This paper examines the determinants of womens knowledge regarding HIV/AIDS using data from a nationally representative survey in India. Although around 45 per cent of sample women had heard about the disease, their knowledge regarding its modes of transmission and prevention is found to be limited. To explore the possibility that there may be a different process that determines awareness as opposed to quality of knowledge regarding HIV/AIDS, a negative binomial hurdle model and a two-stage ordered probit model are estimated. The results show that the effect of several covariates, such as education and mass media, on awareness is different from their effect on quality of knowledge.

Is Breast-Feeding a Substitute for Contraception in Family Planning?

Using data from the Cebu Longitudinal Health and Nutrition Survey, I disentangle the complex interrelationship between breastfeeding, postpartum amenorrhea, and choice of contraceptive method. I find evidence that women substitute breast-feeding for contraception. Further, endogeneity bias, if not controlled, would cause the relationship to be slightly overstated. In addition, the results suggest that although increased education and income result in decreased breast-feeding, any effect on fertility will be offset by changes in contraceptive use.

Measuring the benefit of prenatal care in a less-developed country: semi-parametric estimates from Uruguay

This study extends extant research on prenatal care and birthweight to the South American country of Uruguay. The data represent a population of poor women from a less-developed country with a health care system that provides both prenatal and obstetric care free of charge. We find a positive effect of increased prenatal care use on birthweight, with a small marginal effect that is similar to that found in studies using US data. The results highlight the usefulness of existing methodologies for estimating the effect of prenatal care on birthweight and the importance of extending these methodologies to data from developing countries.