title: Impact of hospital delivery on child mortality: An analysis of adolescent mothers in Bangladesh.
abstract: New medical inventions for saving young lives are not enough if these do not reach the children and the mother. The present paper provides new evidence that institutional delivery can significantly lower child mortality risks, because it ensures effective and timely access to modern diagnostics and medical treatments to save lives. We exploit the exogenous variation in community's access to local health facilities (both traditional and modern) before and after the completion of the 'Women's Health Project' in 2005 (that enhanced emergency obstetric care in women friendly environment) to identify the causal effect of hospital delivery on various mortality rates among children. Our best estimates come from the parents fixed effects models that help limiting any parents-level omitted variable estimation bias. Using 2007 Bangladesh Demographic Health Survey data from about 6000 children born during 2002-2007, we show that, ceteris paribus, access to family welfare clinic particularly boosted hospital delivery likelihood, which in turn lowered neo-natal, early and infant mortality rates. The beneficial effect was particularly pronouncedamong adolescent mothers after the completion of Women's Health Project in 2005; infant mortality for this cohort was more than halved when delivery took place in a health facility.
authors.affiliation: University of Surrey, UK. Electronic address: s.pal@surrey.ac.uk.
authors.forename: Sarmistha
authors.initials: S
authors.lastname: Pal
mesh_terms: D000293:Adolescent; D001459:Bangladesh; D002675:Child, Preschool; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006297:Health Services Accessibility; D006761:Hospitals; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D009035:Mothers / Q000193:education*; D011247:Pregnancy; D055815:Young Adult
keywords: Access to health facilities; Adolescent mothers; Bangladesh; Emergency and obstetric care; Endogeneity and identification; Household fixed effects models; Infant and child mortality indices; Women's health project