Hostname: page-component-848d4c4894-2pzkn Total loading time: 0 Render date: 2024-05-09T03:18:47.671Z Has data issue: false hasContentIssue false
  • English
  • Français

THE ASSOCIATION BETWEEN FAMILY STRUCTURE, REPORTS OF ILLNESS AND HEALTH CARE DEMAND FOR CHILDREN: EVIDENCE FROM RURAL BANGLADESH

Published online by Cambridge University Press:  17 June 2009

ATONU RABBANI  and
G. CALEB ALEXANDER
ATONU RABBANI
Affiliation:
Center for Health and Social Sciences, University of Chicago, USA Section of General Internal Medicine, Department of Medicine, University of Chicago, USA
G. CALEB ALEXANDER
Affiliation:
Center for Health and Social Sciences, University of Chicago, USA Section of General Internal Medicine, Department of Medicine, University of Chicago, USA MacLean Center for Clinical Medical Ethics, University of Chicago, USA Department of Pharmacy Practice, University of Illinois at Chicago School of Pharmacy, USA
Get access Rights & Permissions [Opens in a new window]

Summary

Access to health care in lesser-developed countries is often quite limited, especially in rural areas. However, less is known about how different factors, such as household structure, parental income and parental education, modify such access to care. This study uses individual-level data from rural Bangladesh during and following a period of major flooding to examine factors associated with reports of illness and demand for doctors in households with children less than 10 years of age. Using information about the number of children who were reported sick and also those who were taken to a doctor, a model was estimated for such reports and decisions to visit a doctor. Overall, 74% of households reported an illness in a child during the study period. The likelihood of reports was significantly greater for boys (36%) than girls (31%). In most analyses, there was no association between parental education and reports of child illness after adjusting for village- and household-level heterogeneity. However, in analyses limited to female children, greater education of the household head was associated with lower odds of such a report (odds ratio [OR] 0.95, 95% confidence interval [CI] 0.91–1.00). Parental education and income were also related to household decisions to seek medical care, though results once again differed based on the sex of the child. There was a particularly strong effect between maternal education level and demand for medical care for boys (OR 1.13; CI 1.01–1.27), though not for girls (OR 0.96; CI 0.84–1.09). Overall, the likelihood of a doctor's visit for a sick child was positively related to household income and at the highest levels of income was a virtual certainty.

Type
Research Article
Information
Journal of Biosocial Science , Volume 41 , Issue 5 , September 2009 , pp. 645 - 659
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alpu, O. & Fidan, H. (2004) Sequential probit model for infant mortality modeling in Turkey. Journal of Applied Sciences 4(4), 590–595.Google Scholar
Aly, H. Y. & Grabowski, R. (1990) Education and child mortality in Egypt. World Development 18(5), 733–742.CrossRefGoogle Scholar
Andersen, R. M. (1968) Behavioral Model of Families' Use of Health Services. Research Series No. 25. Center for Health Administration, University of Chicago, Chicago, IL.Google Scholar
Andersen, R. M. (1995) Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior 36(1), 1–10.CrossRefGoogle ScholarPubMed
Bankole, A. (1995) Desired fertility and fertility behaviour among the Yoruba of Nigeria: A study of couple preferences and subsequent fertility. Population Studies 49(2), 317–328.CrossRefGoogle Scholar
Becker, G. S. (1981). A Treatise on the Family. Harvard University Press, Cambridge, MA.Google Scholar
Beegle, K., Frankenberg, E. & Thomas, D. (2001) Bargaining power within couples and use of prenatal and delivery care in Indonesia. Studies in Family Planning 32(2), 130–146.CrossRefGoogle ScholarPubMed
Cameron, C. A. & Trivedi, P. (2005) Microeconometrics: Methods and Applications. Cambridge University Press, Cambridge.CrossRefGoogle Scholar
Del Ninno, C. (2001) Coping Strategies in Bangladesh (November 1998–December 1999). Survey Documentation. FMRSP Data Documentation Report No. 1. International Food Policy and Research Institute, Washington, DC.Google Scholar
Del Ninno, C., Dorosh, P. A., Smith, L. C. & Roy, D. K. (2001) The 1998 Flood in Bangladesh Disaster Impacts, Household Coping Strategies, and Response. Research Report 122. International Food Policy and Research Institute, Washington, DC. Available at http://www.ifpri.org/data/Bangladesh03.htm (accessed 31st January 2008).Google Scholar
Francis, A. F. (2007) Sex Ratios and the Red Dragon: Using the Chinese Communist Revolution to Explore the Effect of the Sex Ratio on Women and Children in Taiwan. Working Paper, Department of Economics, Emory University. Available at http://userwww.service.emory.edu/~afranc5/Red_Dragon.pdf (accessed 10th February 2008).Google Scholar
Grossman, M. (2000) The human capital model. In Culyer, A. J. & Newhouse, J. P. (eds) Handbook of Health Economics. Elsevier, pp. 347–408.Google Scholar
Gubhaju, B., Streatfield, K. & Majumder, A. K. (1992) Socioeconomic, demographic and environmental determinants of infant mortality in Nepal. Journal of Biosocial Science 23, 425–435.CrossRefGoogle Scholar
Hoddinott, J. & Haddad, L. (1995) Does female income share influence household expenditures? Evidence from Côte D'ivoire. Oxford Bulletin of Economics & Statistics 57(1), 77–96.CrossRefGoogle Scholar
Huq, M. N. & Tasnim, T. (2008) Maternal education and child healthcare in Bangladesh. Maternal and Child Health Journal 12, 43–51.CrossRefGoogle ScholarPubMed
Iram, U. & Butt, M. S. (2008) Socioeconomic determinants of child mortality in Pakistan: Evidence from sequential probit model. International Journal of Social Economics 35(1/2), 63.CrossRefGoogle Scholar
Lavy, V., Strauss, J., Thomas, D. & de Vreyer, P. (1996) Quality of health care, survival and health outcomes in Ghana. Journal of Health Economics 15(3), 333–357.CrossRefGoogle ScholarPubMed
Liang, K.-Y. & Zeger, S. L. (1986) Longitudinal analysis using generalized linear models. Biometrika 73, 13–22.CrossRefGoogle Scholar
Maitra, P. (2004) Parental bargaining, health inputs and child mortality in India. Journal of Health Economics 23(2), 259–291.CrossRefGoogle ScholarPubMed
Maitra, P. & Pal, S. (2007) Early Childbirth, Health Inputs and Child Mortality: Recent Evidence from Bangladesh. IZA Discussion Paper No. 2841. Available at http://ftp.iza.org/dp2841.pdf (accessed 10th February 2008).CrossRefGoogle Scholar
Majumder, A. K., May, M. & Dev Pant, P. (1997) Infant and child mortality determinants in Bangladesh: Are they changing? Journal of Biosocial Science 29(4), 385–399.CrossRefGoogle ScholarPubMed
National Institute of Population Research and Training (NIPORT), Mitra and Associates & ORC Macro (2005) Bangladesh Demographic and Health Survey 2004. National Institute of Population Research and Training, Mitra and Associates, and ORC Macro, Dhaka, Bangladesh and Calverton, Maryland, USA.Google Scholar
Oster, E. (2007) Proximate Sources of Population Sex Imbalance in India. Working Paper, Department of Economics, University of Chicago. Available at http://home.uchicago.edu/~eoster/proxcause.pdf (accessed 10th February 2008).Google Scholar
Panis, C. W. A. & Lillard, L. A. (1994) Health inputs and child mortality: Malaysia. Journal of Health Economics 13(4), 455–489.CrossRefGoogle ScholarPubMed
Qian, N. (2008) Missing women and the price of tea in China: The effect of sex-specific income on sex imbalance. Quarterly Journal of Economics 123(3).CrossRefGoogle Scholar
Rao, V. (1997) Wife-beating in rural south India: A qualitative and econometric analysis. Social Science and Medicine 44(8), 1169–1180.CrossRefGoogle ScholarPubMed
Schultz, T. P. (1993) Returns to women's education. In King, E. & Hill, M. A. (eds) Women's Education in Developing Countries: Barriers, Benefits and Policies. Johns Hopkins University Press, Baltimore, MD.Google Scholar
Schultz, T. P. (2002) Why governments should invest more to educate girls. World Development 30(2), 207–225CrossRefGoogle Scholar
Sen, A. (1992). Missing women. British Medical Journal 304, 587–588.CrossRefGoogle ScholarPubMed
Thomas, D. (1990) Intra-household resource allocation: an inferential approach. Journal of Human Resources 25(4), 635–664.CrossRefGoogle Scholar
Thomas, D. (1994) Like father, like son; like mother, like daughter: parental resources and child height. Journal of Human Resources 29(4), 950–988.CrossRefGoogle Scholar
Wooldridge, J. M. (2002) Econometic Analysis of Cross Section and Panel Data. MIT Press, Cambridge, MA.Google Scholar
World Bank (1993) World Development Report 1993: Investment in Health. Oxford University Press, New York.Google Scholar
World Health Organization (2005) Country Health System Profile Bangladesh. Available at http://www.searo.who.int/LinkFiles/Bangladesh_CountryHealthSystemProfile-Bangladesh-Jan2005.pdf (accessed on 13th March, 2009).Google Scholar
World Health Organization (2008) Getting health to rural communities in Bangladesh. Bulletin of the World Health Organization 86(2), 81–160.Google Scholar