Three essays on the economics of maternal health care

This thesis consists of three essays that address various aspects of the economics of maternal health care. The first two essays examine the determinants of utilization of maternal health care services in low-income countries, while the third essay examines the determinants of utilization of prenata...

Full description

Bibliographic Details
Main Author: Guliani, Harminder Kaur
Other Authors: Serieux, John (Economics) Sepehri-Borojeni, Ardeshir (Economics)
Published: 2012
Subjects:
Online Access:http://hdl.handle.net/1993/5104
id ndltd-LACETR-oai-collectionscanada.gc.ca-MWU.1993-5104
record_format oai_dc
spelling ndltd-LACETR-oai-collectionscanada.gc.ca-MWU.1993-51042014-03-29T03:43:48Z Three essays on the economics of maternal health care Guliani, Harminder Kaur Serieux, John (Economics) Sepehri-Borojeni, Ardeshir (Economics) Loxley, John (Economics) Avery, Lisa (Community Health Sciences) Case, Anne (Princeton University) Prenatal care health facility delivery low income countries multilevel analysis two part model Prenatal ultrasonography Poisson Regression Canada This thesis consists of three essays that address various aspects of the economics of maternal health care. The first two essays examine the determinants of utilization of maternal health care services in low-income countries, while the third essay examines the determinants of utilization of prenatal ultrasonography in Canada. The first essay examines the influence of prenatal attendance (as well as a wide array of observed individual-, household- and community-level characteristics) on a woman’s decision to give birth at a health facility or at home for thirty-two low-income countries (across Asia, Sub-Saharan Africa and Latin America). This empirical investigation employs the Demographic and Health Surveys (DHS) data and a two-level random intercept model. The results show that prenatal attendance has a substantial influence on the use of facility delivery in all three geographical regions. Women having four prenatal visits were 7.3 times more likely to deliver at a health facility than those with no prenatal care. The second essay addresses two related questions: what factors determine a woman’s decision to seek prenatal care; and are those the same factors that determine the frequency of care? This investigation also utilizes Demographic and Health Surveys (DHS) data for thirty-two low-income countries (across Asia, Sub-Saharan Africa and Latin America) and applies a two-part and multi-level model to that data. The results suggest that, though a wide range of factors influence both decisions, that influence varies in magnitude across the two decisions, as well as across the three geographical regions. The third essay examines the influence of various socioeconomic and demographic factors on the frequency of prenatal ultrasounds in Canada, while controlling for maternal risk profiles. This investigation utilizes data from the Maternity Experience Survey (MES) of the Canadian Perinatal Surveillance System and employs a count data regression model (the Poisson distribution) to estimate the effect of various factors on the number of prenatal ultrasounds. The results of this investigation suggest that, even after controlling for maternal risk factors, the type of health-care provider, province of prenatal care, and timings of first ultrasound are the strongest predictors of number of ultrasounds. 2012-01-17T19:49:31Z 2012-01-17T19:49:31Z 2012-01-17 http://hdl.handle.net/1993/5104
collection NDLTD
sources NDLTD
topic Prenatal care
health facility delivery
low income countries
multilevel analysis
two part model
Prenatal ultrasonography
Poisson Regression
Canada
spellingShingle Prenatal care
health facility delivery
low income countries
multilevel analysis
two part model
Prenatal ultrasonography
Poisson Regression
Canada
Guliani, Harminder Kaur
Three essays on the economics of maternal health care
description This thesis consists of three essays that address various aspects of the economics of maternal health care. The first two essays examine the determinants of utilization of maternal health care services in low-income countries, while the third essay examines the determinants of utilization of prenatal ultrasonography in Canada. The first essay examines the influence of prenatal attendance (as well as a wide array of observed individual-, household- and community-level characteristics) on a woman’s decision to give birth at a health facility or at home for thirty-two low-income countries (across Asia, Sub-Saharan Africa and Latin America). This empirical investigation employs the Demographic and Health Surveys (DHS) data and a two-level random intercept model. The results show that prenatal attendance has a substantial influence on the use of facility delivery in all three geographical regions. Women having four prenatal visits were 7.3 times more likely to deliver at a health facility than those with no prenatal care. The second essay addresses two related questions: what factors determine a woman’s decision to seek prenatal care; and are those the same factors that determine the frequency of care? This investigation also utilizes Demographic and Health Surveys (DHS) data for thirty-two low-income countries (across Asia, Sub-Saharan Africa and Latin America) and applies a two-part and multi-level model to that data. The results suggest that, though a wide range of factors influence both decisions, that influence varies in magnitude across the two decisions, as well as across the three geographical regions. The third essay examines the influence of various socioeconomic and demographic factors on the frequency of prenatal ultrasounds in Canada, while controlling for maternal risk profiles. This investigation utilizes data from the Maternity Experience Survey (MES) of the Canadian Perinatal Surveillance System and employs a count data regression model (the Poisson distribution) to estimate the effect of various factors on the number of prenatal ultrasounds. The results of this investigation suggest that, even after controlling for maternal risk factors, the type of health-care provider, province of prenatal care, and timings of first ultrasound are the strongest predictors of number of ultrasounds.
author2 Serieux, John (Economics) Sepehri-Borojeni, Ardeshir (Economics)
author_facet Serieux, John (Economics) Sepehri-Borojeni, Ardeshir (Economics)
Guliani, Harminder Kaur
author Guliani, Harminder Kaur
author_sort Guliani, Harminder Kaur
title Three essays on the economics of maternal health care
title_short Three essays on the economics of maternal health care
title_full Three essays on the economics of maternal health care
title_fullStr Three essays on the economics of maternal health care
title_full_unstemmed Three essays on the economics of maternal health care
title_sort three essays on the economics of maternal health care
publishDate 2012
url http://hdl.handle.net/1993/5104
work_keys_str_mv AT gulianiharminderkaur threeessaysontheeconomicsofmaternalhealthcare
_version_ 1716658392373657600