Essays on the determinants of women’s access to healthcare in India
(2024)
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- Authors
- Supervisors
- Maniquet, François
- Abstract
- This doctoral project focuses on the determinants of women’s choices within healthcare and how these are impacted by government sponsored health programs. The ultimate objective is to bring together econometric techniques and data to inform current debates in gendered health policy. Gender discrimination in health-related public programs, including family planning, medical treatment, and health care expenditures is historical and continues in India and adds to worsened female health and socio-economic outcomes. Thus, this thesis revolves around three topics: Chapter 1 of the thesis evaluates the female labor market effects of forcible sterilizations resulting from a national campaign in India in 1975-77. The identification strategy rests on three main pillars: (i) district-level sterilization intensity classifying districts into high- or low-intensity sterilization, (ii) the age of the respondent at the time of the campaign, (iii) the number of children born to the household before June 1975. Exploiting these parameters, I find that households that are more likely to be sterilized under this campaign have more women reporting not working and less likely to engage in agricultural labor. Moreover, the results remain robust regardless of the dataset used and a battery of other tests. I also identify that the mechanism by which women's reduced labor market access is not through health consequences or a decreased financial need on account of fewer children but through a reduction in their bargaining power. In chapter 2, I look at the non-economic determinants of women's healthcare utilization, specifically trust in political institutions. Due to the mutually reinforcing nature of trust in institutions and healthcare use, I instrument average electoral turnout for trust. This chapter has uncovered significant effects of trust in institutions on women's utilization of healthcare services, specifically when examining the disaggregated place of birth. I posit that enhancements in health-seeking behaviors are in line with the trust fostered by political institutions. However, it's important to note that these results do not extend to trust in public hospitals or state governments. Finally, chapter 3 looks at the interactive effects of a demand-side cash transfer program and community health workers on women's healthcare utilization. This paper fills two critical gaps in the literature on the joint evaluation of public policies and the combined effects of these two programs specifically. Consistent with earlier research on these two programs, this study finds that financial incentives and community health workers improve maternal use of formal healthcare services. By studying the two policies' joint effects using quartiles of coverage, I find that the largest impact derives from the maximal coverage of both. Through this, I hope to bridge the gap between policy interventions and gendered healthcare access.
- Affiliations
Citations
Prasad, N. (2024). Essays on the determinants of women’s access to healthcare in India. https://hdl.handle.net/2078.5/217871