Do Women Respond to Expansions in Reproductive Health Care?

Author(s): Frankenberg E, Buttenheim A, Sikoki B, Suriastini W

Year: 2008

Abstract:

We use data from the Indonesia Family Life Survey to investigate the impact of a major expansion in access to midwifery services on use of prenatal care and delivery assistance for women of reproductive age. Between 1991 and 1998, Indonesia trained some 50,000 midwives, placing them in relatively poor communities that were relatively distant from health centers. We show that regardless of a woman’s educational level, additions of village midwives to communities are associated with significant increases in receipt of iron tablets and in choices about care during delivery, which reflect a movement away from reliance on traditional birth attendants. For women with relatively low levels of education, village midwives have the additional benefits of increasing use of any prenatal care and use of prenatal care during the first trimester. The results are robust to the inclusion of fixed effects at the individual level, a strategy that addresses many of the concerns about biases because of non-random program placement.