@article{cbde7b0152004b66bcceeea5dad5187f,
title = "Reducing the Cost of Remoteness: Community-Based Health Interventions and Fertility Choices",
abstract = "Distance to health centers can represent a significant healthcare cost for poor households. Community-based health interventions and community health workers can be an alternative to deficient formal health care provision among remote populations. We analyze the effects on fertility outcomes of a large-scale community-based health worker program that aims to reach remote areas distant from health facilities in Madagascar. We use a triple difference model that exploits time and geographic variation in the program rollout and the geocoded household distance to the closest health facility. Our findings indicate that the program decreased the probability of conception among women in treated areas but did not have a differential effect among women living in remote areas. A potential mechanism underlying this fertility reduction is that the program increased women's modern contraceptive use.",
keywords = "Africa, Community Health Workers, Cost of Remoteness, Fertility",
author = "Catalina Herrera-Almanza and Rosales-Rueda, {Maria F.}",
note = "We would like to thank Leonel Borja, Allie Smith, and Shuang Wang for their excellent research assistance and INSTAT-Madagascar, particularly Harivelo Rajemison, for providing access to and assistance with the databases. The authors thank Jere Behrman, Rebecca Dizon-Ross, G{\"u}nther Fink, Anne Fitzpatrick, Adrienne Lucas, Mindy Marks, Silvia Prina, Laura Schechter, Rebecca Thornton, Josselin Thuilliez, Joshua Wilde and the seminar participants at the Population Association of America Conference, Eastern Economics Conference, Princeton{\textquoteright}s Center for Health and Wellbeing seminar lunch, American Economic Association Conference, Ohio State Agricultural and Applied Economics Seminar Series, Paris Sorbonne Sustainable Development Seminar, Lafayette Economics Seminar, Bentley Economics Seminar and University of Wisconsin-Madison Applied Economics Seminar for helpful comments and discussions. The authors are grateful for funding support from the Population Reference Bureau and the Hewlett Foundation . We would like to thank Leonel Borja, Allie Smith, and Shuang Wang for their excellent research assistance and INSTAT-Madagascar, particularly Harivelo Rajemison, for providing access to and assistance with the databases. The authors thank Jere Behrman, Rebecca Dizon-Ross, G?nther Fink, Anne Fitzpatrick, Adrienne Lucas, Mindy Marks, Silvia Prina, Laura Schechter, Rebecca Thornton, Josselin Thuilliez, Joshua Wilde and the seminar participants at the Population Association of America Conference, Eastern Economics Conference, Princeton's Center for Health and Wellbeing seminar lunch, American Economic Association Conference, Ohio State Agricultural and Applied Economics Seminar Series, Paris Sorbonne Sustainable Development Seminar, Lafayette Economics Seminar, Bentley Economics Seminar and University of Wisconsin-Madison Applied Economics Seminar for helpful comments and discussions. The authors are grateful for funding support from the Population Reference Bureau and the Hewlett Foundation.",
year = "2020",
month = sep,
doi = "10.1016/j.jhealeco.2020.102365",
language = "English (US)",
volume = "73",
journal = "Journal of Health Economics",
issn = "0167-6296",
publisher = "Elsevier B.V.",
}