Prenatal care utilization, community-group participation, and infant health in Indonesia

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NO FULL TEXT AVAILABLE. This thesis contains 3rd party copyright material. ----- The topic of this research is infant health and its links to prenatal care in Indonesia. The aim is to identify factors that influence infant health at birth and to develop policy implications that can address the current poor infant health in Indonesia. The number of economic analyses of infant health has been increasing. These studies typically use the concept of the infant health production as a framework to understand the determinants of infant health outcomes. These empirical studies on infant health production provide background information to this investigation. As most empirical studies have been based in developed countries, however, they provide little guidance for policy to developing countries, including Indonesia. The results, therefore, may not be appropriate for Indonesia with its different social values and economic circumstances; thus, there is a need to investigate these factors in the case of Indonesia. The first challenge in setting up the empirical work is the problem of potential selection bias because some babies are unweighed at birth, and these are more likely to be associated with traditional care and delivered outside of modern facilities; hence, they may be more likely to experience poorer outcomes. The finding from using the Heckman model provides no evidence of a selection bias relating to unweighed babies in this case. The study, therefore, proceeds to limit the sample to weighed babies (i.e., excluding unweighed babies) with the confidence that the results will provide unbiased estimates. The analysis then focuses on the role of prenatal care utilization on birth outcomes. Factors which influence prenatal care use also are associated with better infant health outcomes, particularly mothers’ education and family income. The findings support the view that the utilization of prenatal care is a major factor, independent of other maternal and family characteristics, that influences infant health. Therefore increasing the use of prenatal care should lead to better infant health outcomes. This study goes beyond previous economic studies by considering the impact of social support for mothers on infant health. It is hypothesized that social support may encourage the utilization of prenatal care and the adoption of more healthy behaviors and, thus, indirectly influence infant health. The results demonstrate that participation in community groups is associated with prenatal care utilization and infant health. In addition, this provides a short-term and effective strategy for the improvement of child health in Indonesia and supports Indonesia’s achievement of its Millennium Development Goals.
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