The Effects of Access to Health Care on Infant Mortality in Indonesia

Citation: Frankenberg (1995) The Effects of Access to Health Care on Infant Mortality in Indonesia. Health Transition Review (RSS)
Internet Archive Scholar (search for fulltext): The Effects of Access to Health Care on Infant Mortality in Indonesia
Tagged: uw-madison (RSS), wisconsin (RSS), sociology (RSS), demography (RSS), prelim (RSS), qual (RSS), WisconsinDemographyPrelimAugust2009 (RSS)

Summary

Notes: This paper examines the impact of access to health facilities and personnel on infant and child mortality in Indonesia; it explores the spatial distribution of health services and accounts for these processes in a model relating the mortality risks of individuals to access to health services. On of the main issues that this paper attempts to address which has been not controlled for or addressed as well in previous papers is the nonrandom distribution of health facilities. Demographic and Health Survey data are combined with village-level censuses of infrastructure collected by the Central Bureau of Statistics. Because the village-level data are available from 2 points in time, it is possible to analyze the effects on mortality risks within the village of changes in access to health care. Factors about villages that might affect both access to health care and mortality risks are held constant by using matched pairs from each village in a fixed-effects model, where one member of the pair serves as the case and one member of the pair is the control. Frankenberg compares survival outcomes for pairs of children from the same village; therefore, she matches on village characteristics so that differences in the survival outcomes of the children will not reflect unobserved characteristics that very across villages but are constant within villages. Frankenberg finds that a decline in mortality risks has occurred over time in Indonesia. Adding a maternity clinic to a village decreases the odds of infant mortality by almost 15 %, in comparison to the risk before the clinic was added. An additional doctor reduces the odds by about 1.7 %. Some of her other findings were unexpected. For example, additional health care workers actually were negatively associated with survival chances. Frankenberg argues that increasing the number of health care workers does not increase access to their services. Moreover, the category is vague and encompasses people with varied levels of training.