小瓢虫传媒

Niranjana Prasad, CORE

will give a presentation on

Institutional trust and women's healthcare utilization: Evidence from India

Abstract:

Despite the reduction in global maternal mortality rates, there persists a significant proportion of women who continue to not access institutional care. 25% of women surveyed by the National Family Health Surveys in India, report giving birth at home, 20% receive ante-natal care at home and only 36 % received post-natal care. India also continues to report one of the highest estimated numbers of maternal deaths. This study focuses on the role of non-economic determinants of institutional services for delivery among pregnant women in India. I specifically aim to answer the question of how trust in institutions affects women's healthcare utilization. However, there is difficulty in linking mistrust in institutions to healthcare utilization, due to endogeneity concerns. If this is indeed the case, coefficients of trust in a simple health regression would be biased. I use percentage change in voter turnout as an instrument for district-level trust. To study health outcomes in conjunction with trust and electoral data, I employ the Indian National Family Health Survey (NFHS) (2015-16), the two waves of the Indian Human Development Survey - II (IHDS-II) and electoral data from the Election Commission of India. This study finds that an increase in regional trust in politicians reduces home and private hospital births by 0.202 and 0.348 standard deviations respectively and increases skilled delivery in public hospitals by 0.459 standard deviations. Similar results are found when testing the role of trust in local governments. Results remain robust to additional controls and instrumenting close elections in addition to electoral turnout