How Important are Individual, Household and Commune Characteristics in Explaining Utilization of Maternal Health Services? The Case of Vietnam?

Social Science and Medicine, 2008

35 Pages Posted: 23 Sep 2010 Last revised: 24 Feb 2015

See all articles by Ardeshir Sepehri

Ardeshir Sepehri

University of Manitoba - Department of Economics

Sisira Sarma

Independent

Wayne Simpson

University of Manitoba - Department of Economics

Saeed Moshiri

Saint Thomas More College University of Saskatcehwan

Date Written: September 22, 2008

Abstract

Using Vietnam’s latest National Household Survey data for 2001-2002 this paper assesses the influence of individual, household and commune-level characteristics on a woman’s decision to seek prenatal care, on the number of prenatal visits, and on the choice between giving birth at a health facility or at home. The decision to use any care and the number of prenatal visits is modeled using a two-part model. A random intercept logistic model is used to capture the influence of unobserved commune-specific factors found in the data regarding a woman’s decision to give birth at a health facility rather than at home. The results show that access to prenatal care and delivery assistance is limited by observed barriers such as low income, low education, ethnicity, geographical isolation and a high poverty rate in the community. More specifically, more prenatal visits increase the likelihood of giving birth at a health facility. Having compulsory health insurance increases the odds of giving birth at a health facility for middle and high income women. In contrast, health insurance for the poor increases the likelihood of having more prenatal visits but has little effect on the place of delivery. These results suggest that the existing safe motherhood programs should be linked with the objectives of social development programs such as poverty reduction, and that policy makers need to view both the individual and the commune as appropriate units for policy targeting.

Keywords: Vietnam, maternal health services, health seeking behavior, multilevel analysis, two-part model

Suggested Citation

Sepehri, Ardeshir and Sarma, Sisira and Simpson, Wayne and Moshiri, Saeed, How Important are Individual, Household and Commune Characteristics in Explaining Utilization of Maternal Health Services? The Case of Vietnam? (September 22, 2008). Social Science and Medicine, 2008, Available at SSRN: https://ssrn.com/abstract=1681021

Ardeshir Sepehri

University of Manitoba - Department of Economics ( email )

Winnipeg, Manitoba R3T 5V5
Canada

Sisira Sarma

Independent ( email )

No Address Available
United States

Wayne Simpson

University of Manitoba - Department of Economics ( email )

Winnipeg, Manitoba R3T 5V5
Canada

Saeed Moshiri (Contact Author)

Saint Thomas More College University of Saskatcehwan ( email )

1437 College Dr
Saskatoon, Saskatchewan S7N 0W6
Canada

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