Parental bargaining, health inputs and child mortality in India

J Health Econ. 2004 Mar;23(2):259-91. doi: 10.1016/j.jhealeco.2003.09.002.


The primary objective of this paper is to examine the relationship between the status of women in the household, the use of health care (demand for prenatal care and hospital delivery) and child mortality in India. Parents care about the health of their children but cannot directly affect child health by their actions. Instead they can, through their actions, control the use of health inputs. I jointly estimate the decision to use prenatal care, the decision to deliver the baby in hospital and child mortality. The estimation methodology allows us to account for unobserved heterogeneity and self-selection in the use of health inputs. The estimation results show that: (1) a woman's education has a stronger effect on health care usage relative to that of her husband; (2) a woman's control over household resources (ability to keep money aside) has a significant effect on health care usage; (3) both prenatal care and hospital delivery significantly reduces the hazard of child mortality; and (4) not accounting for unobserved heterogeneity and self-selection in the use of health inputs results in under-estimation of the effect of health inputs on child mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Child
  • Child Health Services / standards
  • Child Health Services / statistics & numerical data*
  • Educational Status
  • Family Characteristics
  • Fathers / education
  • Fathers / psychology
  • Female
  • Gender Identity
  • Humans
  • India
  • Infant
  • Infant Mortality*
  • Male
  • Middle Aged
  • Mothers / education
  • Mothers / psychology
  • Negotiating*
  • Parents / education
  • Parents / psychology*
  • Patient Acceptance of Health Care / psychology*
  • Power, Psychological
  • Pregnancy
  • Prenatal Care / standards
  • Prenatal Care / statistics & numerical data*
  • Quality of Health Care*