| dc.description.abstract | The paper reviews a unified model of demand for health care inputs and health production, first
proposed by Rosenzweig and Schultz (1982), and shows how the model can be applied to design
and implement policies to improve reproductive health of the population. Although the focus of
the applications is sub-Saharan Africa, the illustrative examples presented are of general interest.
The key feature of the model is the link between demand for reproductive health services and the
production of health by households and individuals.
The demand for reproductive health services together with the associated health production
technology is first analyzed in the context of a unitary model of the household, before
positioning the analysis in a more general collective model. In one of the several illustrations
presented, the control function approach is used on Kenyan data to estimate the effect of tetanus
immunization on birth weight in a unitary-household setting. Vaccinating mothers against
tetanus during pregnancy is found to increase birth weight but indirectly through complementary
behaviors and health care consumption patterns that are induced by vaccination. The effects of
unobserved variables on birth weight, such as the knowledge gaps among mothers about health
care, are also found to be substantial. An investigation is required on how to extend information
to mothers about essential health care during pregnancy. It is argued that if mothers do not
possess such information, tetanus vaccination may never induce them to invest in activities that
improve birth weight in line with the complementarity hypothesis. More generally, we find a
need to implement what we term immunization plus interventions to empower women to use
reproductive health services effectively. The types of data needed to estimate other models
presented in the paper are briefly discussed. | en |
