The Effect of Health Facility Births on Newborn Mortality in Malawi and Ethiopia

Jung, Dawoon / Kim, Booyuel / Kim, Hyuncheol

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We study the causal effect of hospital births on infant survival in Malawi and Ethiopia. We find that the hospital births has a strong and statistical significant impact on infant survival. In order to overcome the endogeneity of hospital births, we utilize two different instrument variables (IVs). The first IV is the timing of labor contraction. If the pregnant woman feel labor contraction during night time, she is less likely to go to hospital to give a birth due to concern for the safety and transportation. The second iv is the interaction of distance to hospital and rainfall. Rainfall makes more exogenous variation by distance in the traveling cost to the health facility. We find a consistent sign of the causal estimates across two IVs and two different countries. We also provide the suggestive evidence that hospital births is likely to incentivize mothers to utilize hospital or medical care for their children after the births and this may link the relationship between hospital births and infant survival.

Issue Date
KDI School of Public Policy and Management
Series Title
KDI School Working Paper 16-15
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