Date of Award

Summer 8-10-2021

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Economics

First Advisor

Tom Mroz

Second Advisor

James Marton

Third Advisor

Melinda Pitts

Fourth Advisor

Nguedia Pierre Nguimkeu

Abstract

India accounts for two-thirds of global maternal deaths and the highest number of infant deaths annually. Given the poor performance of maternal and infant healthcare service indicators, India launched two maternal health programs- a conditional cash transfer program called Janani Suraksha Yojna (JSY) in 2005 and a free services program called Janani Shishu Suraksha Karyakaram (JSSK) in 2011. The programs aim to reduce maternal and infant mortality through the promotion of public institutional delivery. Both provide financial incentives to pregnant women through a reduced price effect on delivery care. Using the Indian District Household Surveys, I exploit the differences in individual eligibility rules across states to estimate the impact of the programs on healthcare utilization and infant mortality measures. The results suggest that JSY and JSSK reduced home births and increased the use of public institutional care. While JSY also shifted women away from private to public facilities, JSSK increased the use of private care. I also find evidence that JSY reduces fetal and perinatal mortality but does not impact higher days mortality rates. Further, the spread of information about healthier pregnancies by health facilitators under the programs increases the use of antenatal services. On the one hand, JSY reduces the probability of women going back for a postpartum checkup. On the other hand, free maternal care services with zero postpartum care costs under JSSK increase their likelihood of returning for a checkup. Also, I find heterogeneity in programs' impact with more educated and poorer women benefiting the most from them.

DOI

https://doi.org/10.57709/24112951

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