Preliminary Version. Comments Welcome. Parental Bargaining, Health Inputs and Child Mortality in India

The primary objective of this paper is to examine the relationship between the use of health care (use of prenatal care and hospital delivery) and child health (measured by child mortality) in India. I develop a framework where parents care about the health of their children but cannot directly affect child health by their actions. Instead they can, through their actions, affect health inputs. Parental bargaining affects decisions about the use of prenatal care and hospital delivery, which in turn are likely to affect child mortality. I jointly estimate the decision to use prenatal care, the decision to deliver the baby in hospital and child mortality. The estimation methodology allows us to account for unobserved heterogeneity and self-selection in the use of health inputs. The estimation results show that: (1) a woman’s education has a stronger effect on health care usage relative to that of her husband; (2) a woman’s control over household resources (ability to keep money aside) has a significant effect on health care usage; (3) both prenatal care and hospital delivery significantly reduces the hazard of child mortality; and (4) not accounting for unobserved heterogeneity and self selection in the use of health inputs results in under-estimation of the effect of health inputs on child mortality.