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Seattle, Washington, University of Washington, Seattle Population Research Center, 1995 Jan. 20,  p. (Seattle Population Research Center Working Paper No. 95-1)This paper examines the relationship between consumption smoothing and excess female mortality, by asking if favorable rainfall shocks in childhood increase the survival probabilities of girls to a greater extent than they increase boys' survival probabilities for a sample of rural Indian children....The impacts of households' landholdings, parents' education and the availability of health and educational institutions are also assessed. (EXCERPT)
Household demand for health care in El Salvador. Volume II: determinants of household demand for curative ambulatory medical care.
Arlington, Virginia, John Snow, Inc. [JSI], Resources for Child Health Project [REACH], 1990 Feb. viii, 70 p. (USAID Contract No. DPE-5927-C-00-5068-00)The results of a study designed to explain consumer behavior with regard to the consumption of curative ambulatory health services provided by doctors in El Salvador, paying close attention to behavioral differences among urban and rural populations, are reported. The study relied on data collected through a survey of 13, 896 people in 2885 households in San Salvador, other urban areas, and rural areas. In order to identify demand determinants, the effect on health care demand of individual characteristics (e.g., gender, education, and income), and as well as provider characteristics (e.g., price, travel time, and waiting time) were measured. Health providers were categorized into 3 groups: 1) those associated with the Ministry of Health (MOH); 2) those associated with the El Salvador Social Security Institute (ISSS); and 3) private health care providers, whether for-profit or nonprofit. Following a summary and introduction, section III describes the study goals and methodology. Section IV reports the findings on health care utilization patterns, while section V contains the findings on the determinants of health care demand. Section VI discusses the policy implication of the study. 53% of those interviewed reported a self-perceived health problem during the survey's 2-week recall period, but only 14.9% sought curative ambulatory care. Of those who sought care, 81% saw a doctor. Demand for ambulatory care was highest in San Salvador and lowest in rural areas. Differences between the 2 groups were attributed to factors such as education, income, and traveling distances. The study also revealed that the population perceives MOH services as being of very poor quality, while private for-profit providers are viewed as rendering the highest quality services.
Cambridge, Massachusetts, Harvard University, Migration and Development Program, 1987 Sep. 27 p. (Migration and Development Program Discussion Paper No. 32)The marital arrangements among households in rural India were examined to explain mobility patterns. It was hypothesized that the marrying out of daughters to locationally distant, dispersed yet kinship-related households is a manifestation of implicit interhousehold contractual arrangements aimed at mitigating income risks and facilitating consumption smoothing in an environment characterized by information costs and spatially covariant risks. The study's data were drawn from a longitudinal survey of households in 3 farm villages in Southern India. Of the 115 marriages included in this sample, only 14 (12%) involved partners who were not also relatives. In 82% of the marriages involving heads of households, the head and his wife had parents with either the same dry or irrigated landholdings or with the same parental schooling levels. The close matching of marital partners with respect to origin household characteristics and the diversity and distance characterizing the marriages were consistent with the hypothesis that marital arrangements influence a household's ability to smooth its consumption when confronted with highly variable income streams. The marital status of adult women in the household, and the interhousehold bonds created by marriage, is the decisive factor contributing to income risk mitigation. Marriage with migration contributed to a reduction in variability in consumption. Households exposed to higher income risks were more likely to invest in longer distance migration-marriage arrangements. The hypothesized and observed marriage-migration patterns contradict standard models of marriage or migration that are concerned primarily with search costs and static income gains.
[Unpublished] 1985. Presented at the Annual Meeting of the Population Association of America, Boston, Massachusetts, March 28-30, 1985. Also published in: Economic Development and Cultural Change 34(4):755-82. 1986 Jul. 26,  p.Mortality is assumed to be strongly reduced by medical care, however, the effects of medical services on health are often underestimated because some of the same factors which lead to an increased demand for primary health care (PHC) services are also associated with increased morbidity and mortality. Consequently, understanding the determinants of the demand for medical services is important for evaluating health outcomes. This paper estimates the parameters of a simple model of the demand for health services using data from the Bicol Multipurpose Survey data from the Philippines. The parameters of the demand for key components of PHC--outpatient, prenatal, delivery, well-child, and infant immunizations--are estimated. Findings suggest that the quality of the care may be very important, but that economic factors as deterrents to using medical care--inaccessibility, cash costs, and lack of income--may not be of paramount importance. Finally, it is shown that the provision of free services in rural areas may not insure that the services reach the poorest people. (author's modified)