Lambon-Quayefio Monica P, Owoo Nkechi S
Economics, Clark University, 950 Main Street, Worcester, MA, 01610, USA,
Appl Health Econ Health Policy. 2014 Oct;12(5):511-22. doi: 10.1007/s40258-014-0103-z.
Many Sub-Saharan African countries may not achieve the Millennium Development goal of reducing child mortality by 2015 partly due to the stalled reduction in neonatal deaths, which constitute about 60% of infant deaths. Although many studies have emphasized the importance of accessible maternal healthcare as a means of reducing maternal and child mortality, very few of these studies have explored the affordability and accessibility concerns of maternal healthcare on neonatal mortality.
This study bridges this research gap as it aims to investigate whether the number of antenatal visits and skilled delivery are associated with the risk of neonatal deaths in Ghana.
Using individual level data of women in their reproductive years from the 2008 Demographic and Health Survey, the study employs an instrumental variable strategy to deal with the potential endogeneity of antenatal care visits.
Estimates from the instrumental variable estimation show that antenatal care visits reduce the risk of neonatal death by about 2%, while older women have an approximately 0.2% higher risk of losing their neonates than do younger women.
Findings suggest that women who attend antenatal visits have a significantly lower probability of losing their babies in the first month of life. Further, results show that women's age significantly affects the risk of losing their babies in the neonatal stage. However, the study finds no significant effect of skilled delivery and education on neonatal mortality.
许多撒哈拉以南非洲国家可能无法实现到2015年降低儿童死亡率的千年发展目标，部分原因是新生儿死亡人数减少停滞，新生儿死亡约占婴儿死亡人数的60%。尽管许多研究强调了可获得的孕产妇保健作为降低孕产妇和儿童死亡率手段的重要性，但这些研究中很少有探讨孕产妇保健在可负担性和可及性方面对新生儿死亡率的影响。
本研究弥补了这一研究空白，旨在调查产前检查次数和熟练接生是否与加纳新生儿死亡风险相关。
利用2008年人口与健康调查中育龄妇女的个体层面数据，本研究采用工具变量策略来处理产前检查的潜在内生性问题。
工具变量估计结果显示，产前检查可将新生儿死亡风险降低约2%，而老年妇女失去新生儿的风险比年轻妇女高约0.2%。
研究结果表明，进行产前检查的妇女在婴儿出生后第一个月失去婴儿的概率显著较低。此外，结果表明妇女年龄对新生儿期失去婴儿的风险有显著影响。然而，该研究发现熟练接生和教育对新生儿死亡率没有显著影响。
