CONICET | Buscador de Institutos y Recursos Humanos

Resumen The effects ofprenatal care utilization on birth outcomes such as birth weight are commonlyanalyzed in order to evaluate the potential that changing utilization rateswould have on improving birth outcomes. Studies using infant samples in the UnitedStates (US) have generally reported prenatal care utilization to be eitherineffective or modestly effective in improving birth weight after accountingfor maternal self-selection in prenatal care. An increase in birth weight meanranging from about 1 to 35 gm with each week prior to initiation of prenatalcare has been reported across studies that used time to care initiation as theutilization measure (Rosenzweig and Schultz, 1982, 1983, 1988; Grossman and Joyce, 1990; Warner 1995, 1998; Liu, 1998; Conway and Deb, 2005). Mixed results have also beenreported for number of prenatal care visits, with estimates between 1 to 45 gmper visit (Warner, 1995, 1998; Rous et al, 2004).Econometric studies thatclearly account for self-selection in prenatal care have been rare for lessdeveloped countries, including countries in South America. Using an infantsample from Uruguay, Jewell and Triunfo (2006) reported a decrease of about 14 gmon average with each week prior to prenatal care initiation. The study usedmarital status as an instrument to identify the 2SLS model and could not testfor the validity of excluding marital status from the birth weight productionfunction since the model was just identified. Recently, Jewell (2007) estimated the effects of prenatalcare on birth weight using a combined sample from Bolivia, Brazil, Colombia andPeru and reported an increase of about 51 gm with moving to a higher prenatalcare decile (from a average of 6 to 7 visits). Only individual-levelinstruments were used including rural/urban residence, maternal employment,marital status, and child wantedness.

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