Social networks, bargaining power within couples, and maternal health care in Tanzania

 

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dc.contributor.advisor Burns, Justine en_ZA
dc.contributor.author Mukong, Alfred Kechia en_ZA
dc.date.accessioned 2016-02-02T14:40:38Z
dc.date.available 2016-02-02T14:40:38Z
dc.date.issued 2015 en_ZA
dc.identifier.citation Mukong, A. 2015. Social networks, bargaining power within couples, and maternal health care in Tanzania. University of Cape Town. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/16691
dc.description Includes bibliographical references en_ZA
dc.description.abstract This thesis focuses on the use of maternal health services and child health in Tanzania. The main focus is on how these issues relate to social networks and bargaining power within couples. These issues are interrelated and are discussed in three essays. The first essay investigates the impact of information externalities in social networks on the use of antenatal services. Particular emphasis is placed on the extent to which the probability of early antenatal check-up and antenatal completion are affected by social networks. Adopting an econometric technique that minimises the problem of omitted variable bias, the analysis suggests that these network effects increase the probability of antenatal care completion by an additional 6 to 35 percent, and may be as high as 59 percent. The study further finds that without adequate control of omitted variables, the network impact would be understated. It is also evident that failure to control for individual and household observable characteristics overstates the impact of networks. Results from the two approaches used in this study confirm that irrespective of the definition of social network, having a high quality contacts increase the probability of utilising maternal health services. The second essay examines the effect of bargaining power within couples on the probability of delivering in a health facility (public and private), as opposed to a home birth. It further investigates the effect of bargaining on the probability of health care provider choice at childbirth using a multinomial nested logit. Evidence suggests that cooperation within couples in decision-making, female discretion over household resources, and freedom from domestic violence increases the probability of childbirth in a facility, as opposed to home. The study finds that a woman's influence on service use varies if she is better educated than her partner. In addition, while cooperation in household decision and the incidence of domestic violence significantly affect private facility use, female discretion over household resources has a strong effect on public facility choice. Finally, antenatal completion, health knowledge, and maternal specific factors increase the probability of delivering in a public and private facility. ii The third essay empirically explores the contribution of intra-household bargaining, to the rural-urban gap in child nutrition. The study analyses the effect of parental bargaining indicators (cooperation in household decisions, the incidence domestic violence and discretion over household resources) on the probability of child stunting in both rural and urban areas. The essay contributes to the literature by demonstrating empirically that differences in intra-household bargaining increase the rural-urban gap in child health. It further contributes to the literature by correcting for possible sample selection bias. The results suggest that the significant effects of household bargaining indicators on child stunting in Tanzania are mainly from the rural and not the urban population. It provides evidence that weak bargaining power within couples in rural areas account for 5 percent of the rural-urban gap in child nutrition. The contribution reduces to 4 percent after correcting for sample selection bias. The results also suggest that failure to adequately correct for selection bias leads to a substantial underestimation of the overall rural-urban gap in child nutrition by 11 percent. en_ZA
dc.language.iso eng en_ZA
dc.subject.other Economics en_ZA
dc.subject.other maternal health services en_ZA
dc.subject.other social networks en_ZA
dc.subject.other Tanzania en_ZA
dc.title Social networks, bargaining power within couples, and maternal health care in Tanzania en_ZA
dc.type Doctoral Thesis
uct.type.publication Research en_ZA
uct.type.resource Thesis en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Commerce en_ZA
dc.publisher.department School of Economics en_ZA
dc.type.qualificationlevel Doctoral
dc.type.qualificationname PhD en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Mukong, A. K. (2015). <i>Social networks, bargaining power within couples, and maternal health care in Tanzania</i>. (Thesis). University of Cape Town ,Faculty of Commerce ,School of Economics. Retrieved from http://hdl.handle.net/11427/16691 en_ZA
dc.identifier.chicagocitation Mukong, Alfred Kechia. <i>"Social networks, bargaining power within couples, and maternal health care in Tanzania."</i> Thesis., University of Cape Town ,Faculty of Commerce ,School of Economics, 2015. http://hdl.handle.net/11427/16691 en_ZA
dc.identifier.vancouvercitation Mukong AK. Social networks, bargaining power within couples, and maternal health care in Tanzania. [Thesis]. University of Cape Town ,Faculty of Commerce ,School of Economics, 2015 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/16691 en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Mukong, Alfred Kechia AB - This thesis focuses on the use of maternal health services and child health in Tanzania. The main focus is on how these issues relate to social networks and bargaining power within couples. These issues are interrelated and are discussed in three essays. The first essay investigates the impact of information externalities in social networks on the use of antenatal services. Particular emphasis is placed on the extent to which the probability of early antenatal check-up and antenatal completion are affected by social networks. Adopting an econometric technique that minimises the problem of omitted variable bias, the analysis suggests that these network effects increase the probability of antenatal care completion by an additional 6 to 35 percent, and may be as high as 59 percent. The study further finds that without adequate control of omitted variables, the network impact would be understated. It is also evident that failure to control for individual and household observable characteristics overstates the impact of networks. Results from the two approaches used in this study confirm that irrespective of the definition of social network, having a high quality contacts increase the probability of utilising maternal health services. The second essay examines the effect of bargaining power within couples on the probability of delivering in a health facility (public and private), as opposed to a home birth. It further investigates the effect of bargaining on the probability of health care provider choice at childbirth using a multinomial nested logit. Evidence suggests that cooperation within couples in decision-making, female discretion over household resources, and freedom from domestic violence increases the probability of childbirth in a facility, as opposed to home. The study finds that a woman's influence on service use varies if she is better educated than her partner. In addition, while cooperation in household decision and the incidence of domestic violence significantly affect private facility use, female discretion over household resources has a strong effect on public facility choice. Finally, antenatal completion, health knowledge, and maternal specific factors increase the probability of delivering in a public and private facility. ii The third essay empirically explores the contribution of intra-household bargaining, to the rural-urban gap in child nutrition. The study analyses the effect of parental bargaining indicators (cooperation in household decisions, the incidence domestic violence and discretion over household resources) on the probability of child stunting in both rural and urban areas. The essay contributes to the literature by demonstrating empirically that differences in intra-household bargaining increase the rural-urban gap in child health. It further contributes to the literature by correcting for possible sample selection bias. The results suggest that the significant effects of household bargaining indicators on child stunting in Tanzania are mainly from the rural and not the urban population. It provides evidence that weak bargaining power within couples in rural areas account for 5 percent of the rural-urban gap in child nutrition. The contribution reduces to 4 percent after correcting for sample selection bias. The results also suggest that failure to adequately correct for selection bias leads to a substantial underestimation of the overall rural-urban gap in child nutrition by 11 percent. DA - 2015 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Social networks, bargaining power within couples, and maternal health care in Tanzania TI - Social networks, bargaining power within couples, and maternal health care in Tanzania UR - http://hdl.handle.net/11427/16691 ER - en_ZA


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