Maternal health-seeking behavior and child’s birth order: Evidence from Malawi, Uganda, and Zimbabwe

Makate, Marshall (2016): Maternal health-seeking behavior and child’s birth order: Evidence from Malawi, Uganda, and Zimbabwe.

Abstract

Factors influencing maternal health-seeking behavior before and shortly after birth have been widely studied, while the role of birth order in shaping these actions is infrequently examined. This study sought to examine the critical role played by a child’s birth order in altering the maternal health-seeking behavior of women in developing countries. The analysis uses the most recent rounds of the nationally representative standard Demographic and Health Survey for Malawi, Uganda, and Zimbabwe. The empirical analysis utilizes two-level random intercept logistic regression models to assess the potential influence of birth order on prenatal care utilization, birth in a health facility, and breastfeeding. We find that women in Malawi, Uganda, and Zimbabwe were 34.9%, 34.6%, and 43.5% respectively, less liable to complete more than four prenatal care visits for a fifth or later born child than they are for a first born child. Women in Malawi, Uganda, and Zimbabwe were 56.4%, 58.8%, and 77.2% respectively less liable to give birth to a fifth born child in a hospital facility. Also, women who seek prenatal care in Malawi were 50.9% less liable to experience a neonatal death. Also, in Malawi and Zimbabwe the odds of a child dying before reaching the age of one year were 23.7% and 41.6% respectively. Breastfeeding had a protective effect on child survival in all the countries. Overall, we found that women tend to make low investments in maternal health and child well-being for higher order births than they do for first order births. This suggests the need for providers to encourage and re-educate mothers on the importance of investments in maternal health inputs even for higher order births.

• Item Type: MPRA Paper
• Language: English
• Keywords: Birth order; prenatal care; facility delivery; breastfeeding; sub-Saharan Africa
• Subjects: I - Health, Education, and Welfare > I1 - Health; I - Health, Education, and Welfare > I1 - Health > I14 - Health and Inequality; J - Labor and Demographic Economics > J1 - Demographic Economics > J13 - Fertility ; Family Planning ; Child Care ; Children ; Youth

References

Abou Zahr C, Wardlaw TM: Antenatal care in developing countries : promises, achievements and missed opportunities : an analysis of trends, levels and differentials, 1990-2001 / [prepared by Carla AbouZahr and Tessa Wardlaw]: Geneva : World Health Organization ; New York : UNICEF, c2003.; 2003.

Evans WN, Lien DS: The benefits of prenatal care: evidence from the PAT bus strike. Journal of Econometrics 2005, 125(1):207-239.

Subramanian S, Katz KS, Rodan M, Gantz MG, El-Khorazaty NM, Johnson A, Joseph J: An integrated randomized intervention to reduce behavioral and psychosocial risks: pregnancy and neonatal outcomes. Maternal and child health journal 2012, 16(3):545-554.

Lincetto O, Mothebesoane-Anoh S, Gomez P, Munjanja S: Antenatal care. Opportunities for Africa's newborns: Practical data, policy and programmatic support for newborn care in Africa 2006.

Gartner LM, Morton J, Lawrence RA, Naylor AJ, O'Hare D, Schanler RJ, Eidelman AI: Breastfeeding and the use of human milk. Pediatrics 2005, 115(2):496-506.

Kramer MS, Chalmers B, Hodnett ED, Sevkovskaya Z, Dzikovich I, Shapiro S, Collet J-P, Vanilovich I, Mezen I, Ducruet T: Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus. Jama 2001, 285(4):413-420.

Coulibaly R, Séguin L, Zunzunegui M-V, Gauvin L: Links Between Maternal Breast-Feeding Duration and Québec Infants’ Health: A Population-Based Study. Are the Effects Different for Poor Children? Maternal & Child Health Journal 2006, 10(6):537-543.

Bustreo F, Okwo-Bele JM, Kamara L: World Health Organization perspectives on the contribution of the Global Alliance for Vaccines and Immunization on reducing child mortality. Archives of Disease in Childhood 2015, 100(Supp1):s34-s37.

Maitra P: Parental bargaining, health inputs and child mortality in India. Journal of Health Economics 2004, 23(2):259-291.

Dhakal S, Chapman GN, Simkhada PP, van Teijlingen ER, Stephens J, Raja AE: Utilisation of postnatal care among rural women in Nepal. BMC Pregnancy & Childbirth 2007, 7:19-27.

Adamu YM, Salihu HM: Barriers to the use of antenatal and obstetric care services in rural Kano, Nigeria. Journal Of Obstetrics And Gynaecology: The Journal Of The Institute Of Obstetrics And Gynaecology 2002, 22(6):600-603.

Chama-Chiliba CM, Koch SF: Utilization of focused antenatal care in Zambia: Examining individual- and community-level factors using a multilevel analysis. Health Policy and Planning 2015, 30(1):78-87.

Magadi MA, Madise NJ, Rodrigues RN: Frequency and timing of antenatal care in Kenya: explaining the variations between women of different communities. Social Science & Medicine 2000, 51(4):551-561.

Muchabaiwa L, Mazambani D, higusiwa L, Bindu S, Mudavanhu V: Determinants of Maternal Healthcare Utilization in Zimbabwe. International Journal of Economic Sciences & Applied Research 2012, 5(2):145-162.

Guliani H, Sepehri A, Serieux J: Determinants of prenatal care use: evidence from 32 low-income countries across Asia, Sub-Saharan Africa and Latin America. HEALTH POLICY AND PLANNING 2014, 29(5):589-602.

Singh GK, Kogan MD, Dee DL: Nativity/immigrant status, race/ethnicity, and socioeconomic determinants of breastfeeding initiation and duration in the United States, 2003. Pediatrics 2007, 119(Supplement 1):S38-S46.

Celi AC, Rich-Edwards JW, Richardson MK, Kleinman KP, Gillman MW: Immigration, race/ethnicity, and social and economic factors as predictors of breastfeeding initiation. Archives of pediatrics & adolescent medicine 2005, 159(3):255-260.

Maonga AR, Mahande MJ, Damian DJ, Msuya SE: Factors Affecting Exclusive Breastfeeding among Women in Muheza District Tanga Northeastern Tanzania: A Mixed Method Community Based Study. Maternal and Child Health Journal 2016, 20:77-87.

Kong SK, Lee DT: Factors influencing decision to breastfeed. J Adv Nurs 2004, 46(4):369-379.

Heck KE, Braveman P, Cubbin C, Chávez GF, Kiely JL: Socioeconomic Status and Breastfeeding Initiation Among California Mothers. Public Health Reports 2006, 121(1):51-59.

Buckles K, Kolka S: Prenatal investments, breastfeeding, and birth order. Social Science & Medicine 2014, 118:66-70.

Price J: Parent-Child Quality Time Does Birth Order Matter? Journal of Human Resources 2008, 43(1):240-265.

Monfardini C, See SG: Birth order and child outcomes: does maternal quality time matter? 2012.

Guliani H, Sepehri A, Serieux J: What impact does contact with the prenatal care system have on women’s use of facility delivery? Evidence from low-income countries. Social Science & Medicine 2012, 74(12):1882-1890.

De Haan M, Plug E, Rosero J: Birth Order and Human Capital Development Evidence from Ecuador. Journal of Human Resources 2014, 49(2):359-392.

Tenikue M, Verheyden B: Birth Order and Schooling: Theory and Evidence from Twelve Sub-Saharan Countries. Journal of African Economies 2010, 19(4):459-495.

Rutstein SO, Rojas G: Guide to DHS statistics. Calverton, Maryland: ORC Macro 2006.

Harris JE: Prenatal medical care and infant mortality. In: Economic aspects of health. edn.: University of Chicago Press; 1982: 13-52.

Gortmaker SL: The effects of prenatal care upon the health of the newborn. Am J Public Health 1979, 69(7):653-660.

Rabe-Hesketh S, Skrondal A: Multilevel and longitudinal modeling using Stata: STATA press; 2008.

Gage AJ, Calixte MG: Effects of the Physical Accessibility of Maternal Health Services on Their Use in Rural Haiti. Population Studies 2006, 60(3):271-288.

Lehmann J-Y, Nuevo-Chiquero A, Vidal-Fernandez M: Explaining the birth order effect: The role of prenatal and early childhood investments. 2012.

LaVeist TA, Keith VM, Gutierrez ML: Black/white differences in prenatal care utilization: an assessment of predisposing and enabling factors. Health services research 1995, 30(1 Pt 1):43.

Wehby GL, Murray JC, Castilla EE, Lopez-Camelo JS, Ohsfeldt RL: Prenatal Care Demand and its Effects on Birth Outcomes by Birth Defect Status in Argentina. Economics and human biology 2009, 7(1):84-95.

Barcellos SH, Carvalho LS, Lleras-Muney A: Child Gender and Parental Investments in India: Are Boys and Girls Treated Differently? American Economic Journal: Applied Economics 2014, 6(1):157-189.

Forste R, Weiss J, Lippincott E: The decision to breastfeed in the United States: does race matter? Pediatrics 2001, 108(2):291-296.

Morris SN, Johnson NR: Exercise during pregnancy: a critical appraisal of the literature. The Journal of reproductive medicine 2005, 50(3):181-188.