Skip to main content

Advertisement

Log in

Is Maternal and Child Health Service use a Causal Gateway to Subsequent Contraceptive use?: A Multi-Country Study

  • Published:
Population Research and Policy Review Aims and scope Submit manuscript

Abstract

The purpose of this study is to examine the relationship between MCH service utilization and contraceptive use in five countries: Bolivia, Guatemala, Indonesia, Morocco, and Tanzania. The analysis is carried out at the level of the individual woman, with contraceptive-use status modeled as a function of: (1) the availability, quality, and packaging of MCH and family planning services; (2) community- and individual-level determinants of health service and contraceptive use; and (3) intensity of prior MCH service use. Data for the analysis comes from DHS data on women of reproductive age linked with data from service-availability surveys. We use full-information, maximum-likelihood regression techniques to control for the effects of unobserved heterogeneity that might otherwise bias our estimates. In three of the five countries (Morocco, Guatemala, and Indonesia) the results of the analysis suggest that the intensity of MCH service use is positively associated with subsequent contraceptive use among women, even after controlling for observed and unobserved individual- and community-level factors. This result lends support to the proposition that, at least in the context of these three countries, the intensity of MCH service per se use does have a “causal” impact on subsequent contraceptive use, even after controlling for factors that “predispose” sample women to use health care services.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • K. Acharya K. A. Maxwell S. E. Middlestadt J. D. Storey (2004) Gateway behaviors and factors: Improving the effectiveness and efficiency of health communication programs USAID Health Communication Partnership Washington, DC

    Google Scholar 

  • S. Ahmed W. H. Mosley (2002) ArticleTitleSimultaneity in the use of maternal-child health care and contraceptives: Evidence from developing countries Demography 29 IssueID1 75–93

    Google Scholar 

  • Andersen, R. M. (1968), A behavioral model of families’ use of health services, Research Series No. 25, Center for Health Administration Studies, University of Chicago

  • G. S. Becker (1960) An economic analysis of fertility, in National Bureau Committee for Economic Research, Demographic and economic change in developed countries – A conference of the universities Princeton University Press Princeton NJ

    Google Scholar 

  • InstitutionalAuthorNameBureau of Statistics [Tanzania] & Macro International Inc. (1997) Tanzania Demographic and Health Survey 1996 Bureau of Statistics and Macro International Calverton, MD

    Google Scholar 

  • J. Cleland C. Wilson (1987) ArticleTitleDemand theories of the fertility transition: An iconoclastic view Population Studies 41 IssueID1 5–30 Occurrence Handle10.1080/0032472031000142516

    Article  Google Scholar 

  • R. A. Easterlin E. M. Crimmons (1985) The fertility revolution: A supply-demand analysis University of Chicago Press Chicago, IL

    Google Scholar 

  • J. A. Ginzler B. N. Cochran M. Domenech-Rodriguez A. M. Cause L. B. Whitbeck (2003) ArticleTitleSequential progression of substance use among homeless youth: An empirical investigation of the gateway theory Substance Use & Misuse 38 725–758

    Google Scholar 

  • M. Grossman (1972) ArticleTitleOn the concept of health capital and the demand for health Journal of Political Economy 80 223–255

    Google Scholar 

  • Hardee, K. & Yount, K. (1995), From rhetoric to reality: Delivering reproductive health promises through integrated services. Women’s Studies Program, No. WP−9501. Research Triangle Park, NC: Family Health International

  • J. Heckman B. Singer (1984) ArticleTitleA method for minimizing the impact of distributional assumptions in econometric models for duration data Econometrica 52 271–320

    Google Scholar 

  • D. R. Hotchkiss R. J. Magnani J. J. Rous M. Azelmat T. A Mroz J. Heikel (1999) ArticleTitleThe effects of maternal-child health service utilization on subsequent contraceptive use in Morocco Journal of Biosocial Science 31 IssueID2 145–165 Occurrence Handle10.1017/S0021932099001455

    Article  Google Scholar 

  • D. R. Hotchkiss J. J. Rous E. E. Seiber A. A. Berruti (2002) The influence of maternal & child health service utilization & access to private sector family planning services on subsequent contraceptive use: A multicountry study USAID Commercial Markets Strategies Project Washington, DC

    Google Scholar 

  • G. S. Maddala (1992) Introduction to econometrics MacMillan New York

    Google Scholar 

  • T. A. Mroz (1999) ArticleTitleDiscrete factor approximations in simultaneous equation models: Estimating the impact of a dummy endogenous variable on a continuous outcome Journal of Econometrics 92 IssueID2 233–274 Occurrence Handle10.1016/S0304-4076(98)00091-8

    Article  Google Scholar 

  • T. A. Mroz D. R. Weir (1990) ArticleTitleStructural change in life cycle fertility during the fertility transition: France before and after the Revolution of 1789 Population Studies 44 IssueID1 61–87 Occurrence Handle10.1080/0032472031000144386

    Article  Google Scholar 

  • M. Tucker M. Reicks (2002) ArticleTitleExercise as a gateway behavior for healthful eating among older adults: An exploratory study Journal of Nutrition Education & Behavior 34 S14–S19

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David R. Hotchkiss.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hotchkiss, D.R., Rous, J.J., Seiber, E.E. et al. Is Maternal and Child Health Service use a Causal Gateway to Subsequent Contraceptive use?: A Multi-Country Study. Popul Res Policy Rev 24, 543–571 (2005). https://doi.org/10.1007/s11113-005-4852-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11113-005-4852-0

Keywords

Navigation