Maternal and Child Health in Developing Countries
Paper Session
Sunday, Jan. 8, 2017 3:15 PM – 5:15 PM
Hyatt Regency Chicago, Grand Ballroom CD North
- Chair: Erica Field, Duke University
Pre-Commitment, Cash Transfers, and Timely Arrival for Birth: Evidence from a Randomized Controlled Trial in Nairobi Kenya
Abstract
Maternal and neonatal mortality rates among the informal settlements (“slums”) of Nairobi, Kenya are among the highest in the world, even higher than in Kenya’s rural areas. Mounting evidence suggests that delivering in a health facility is not enough to ensure mortality reductions: women must deliver in high-quality facilities and they must arrive at the facility early enough for complications to be detected, managed or referred. Delays in facility arrival occur for many reasons including long distances to facilities, the cost of transportation, and poor information about when to go to a facility. Women living in urban areas women face the additional challenge of choosing a delivery facility from among many hundreds of highly heterogeneous options. In this complex choice environment, we saw that women often end up delivering in places they were not planning to deliver (or even considering) very late in pregnancy. We designed a “pre-commitment transfer package” which bundles a labeled cash transfer and pre-commitment conditional transfer, and is designed to help women deliver where they want, improve planning, and reduce delays in facility arrival. We conducted a randomized experiment with 361 pregnant women in the slums of Nairobi to evaluate the impact of this intervention package on the timing of seeking care. We also analyze various potential mechanisms through which the intervention changed the timing of facility departure and arrival. We find that the treatment leads women to seek care earlier during their labor and delivery. We also see evidence that the intervention leads to earlier and more effective planning of where to deliver during pregnancy.Personality Traits and Performance Contracts: Evidence from a field experiment among maternity care providers in India
Abstract
We study how agents respond to performance incentives according to key personality traits (conscientiousness and neuroticism) using data from a field experiment in which maternity care providers in rural India were offered financial incentives for improving maternal and neonatal health outcomes. While beneficial effects of performance incentives were dampened among more conscientious providers, the effectiveness of incentives is magnified among providers with lower levels of neuroticism (higher levels of emotional stability). Among the most neurotic providers in our sample, the potential gains due to incentives is completely undone – a result consistent with the “choking under pressure” hypothesis.Maternal Health Risk and the Gender Gap in Demand for Children
Abstract
In many parts of the developing world, men have significantly higher fertility preferences than women, and husbands’ fertility preferences are strong predictors of unmet need for contraception among women. One potential source of gender differences in preferences is differences in knowledge of the health risks of low birth spacing, which is significant in high maternal mortality settings such as sub-Saharan Africa. We investigate the association between knowledge of maternal health risk during delivery and preferences over birth spacing and contraceptive use in a large sample of men and women in Zambia. We first show that information on maternal health risk is low, particularly among men, and knowledge of risk negatively correlated with preferences over birth spacing and contraceptive use. We conduct a field experiment designed to reduce information gaps on maternal health risks to measure how male and female preferences over birth spacing and contraceptive use change in response to the greater knowledge of mortality and morbidity risk.Discussant(s)
Alessandra Voena
, University of Chicago
Jessica Cohen
, Harvard University
Seema Jayachandran
, Northwestern University
Manoj Mohanan
, Duke University
JEL Classifications
- I0 - General