Health inputs and child mortality: Malaysia

Area of Science:

• Health Economics
• Demography
• Public Health

Background:

• Child mortality remains a significant global health challenge.
• The relationship between healthcare utilization and child survival is complex.
• Understanding healthcare demand and its impact on mortality is crucial for policy.

Purpose of the Study:

• To analyze the impact of healthcare utilization on fetal and child mortality.
• To model the demand for prenatal care and institutional delivery.
• To assess the effects of self-selection bias in healthcare use.

Main Methods:

• Developed a simultaneous model of fetal and postnatal mortality risks.
• Incorporated input demand equations for prenatal medical care and institutional delivery.
• Utilized retrospective data from Peninsular Malaysia (1950-1988).

Main Results:

• Prenatal care and institutional delivery show strong positive effects on child survival.
• These effects are underestimated when adverse self-selection is ignored.
• Healthcare effectiveness in Malaysia improved until 1980, then declined.
• Fetal survival influences child mortality, but ignoring this introduces mild biases.
• Young mothers' higher child mortality is partly due to lower healthcare utilization.

Conclusions:

• Healthcare utilization, particularly prenatal care and institutional delivery, is vital for reducing child mortality.
• Accounting for self-selection in healthcare use provides more accurate impact estimates.
• Trends in healthcare effectiveness highlight the need for continuous monitoring and policy adjustments.