title: Expansion of rural health care and the use of maternal services in Nepal.
abstract: In order to improve living standards among the rural poor, the government of Nepal has invested heavily in improving the provision of health care services in rural areas. The purpose of this paper is to assess the impact of this investment on the use of maternal health care services. A bivariate probit model is used to estimate the effect of physical access to government health care services, along with individual-, household-, and other location-specific characteristics, on the use of prenatal care and birth delivery care. The results of the estimation are used to carry out policy simulations that assess the magnitude of the impact of improvements in health care availability on service utilization. The results indicate that physical access to a health care facility, as it is currently structured in rural areas, has a statistically significant but modest impact on the use of maternal services.
authors.affiliation: Department of International Health, School of Public Health and Tropical Medicine, Tulane University, Suite 2200, 1440 Canal Street, New Orleans, LA 70112, USA. david.hotchkiss@tulane.edu
authors.forename: D R
authors.initials: DR
authors.lastname: Hotchkiss
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D015233:Models, Statistical; D015999:Multivariate Analysis; D009390:Nepal; D011247:Pregnancy; D019035:Rural Health Services / Q000458:organization & administration*