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University of Nottingham (2021)

Essays on health and health care utilization in Botswana

Mmopelwa, David

Titre : Essays on health and health care utilization in Botswana

Auteur : Mmopelwa, David

Université de soutenance : University of Nottingham

Grade : Doctor of Philosophy (PhD) 2021

Résumé partiel
The role of health in both economic growth and development has been established in the literature. Consequently, public health policies aim to ensure an equitable provision of quality curative health services and promotion of preventive care. However, some national survey-based health indicators in Botswana show that both child and adult health deteriorated over time, which warrants investigation that is now timely given that both the current health policy and the integrated health service plan are nearing their end. Therefore, this three-essay thesis attempts to provide insights into deteriorating health.

Following an increase in the proportion of low birth weight (i.e., less than 2.5kg) children, during a period in which the country was among the worst performers in the WHO African region and the upper-middle-income category, the first essay assesses the role of prenatal care utilization on infant`s health. A joint treatment effect model for care utilization and infant outcome is estimated, accounting for the endogeneity of care utilization. As not all infants have birth weight reported, the essay also estimates the sample selection model to control for potential sample selection bias. Results show that adequate prenatal care utilization is positively associated with infant health and that failing to account for endogeneity reduces its effect. On average, birth weight improves by 0.67, 0.73 and 0.64 kg in full, urban and rural samples, respectively. These findings imply the need to audit care quality since utilization rates are high, but outcomes have been deteriorating.

Mots clés  : Prenatal care, Utilization, Botswana ; Children, Nutrition ; Households ; Sex ; HIV infections ; Antiretroviral agents


Page publiée le 19 janvier 2023