Mothers’ Empowerment, Children’s Inoculations and Schooling in Pakistan: Urban vs Rural Areas, Daughters vs Sons and 1998-99 vs 2007-08

Mothers’ empowerment is thought to have considerable impact on children’s health and schooling. But the evidence for developing countries of the magnitudes of such effects, how they differ between urban and rural areas, whether they differ for daughters versus sons and whether they are changing over time is limited, particularly for countries that are characterized as having relatively great gender inequality. We construct a mothers’ empowerment index from Pakistani household survey data for 1998-99 and 2007-08 and investigate the associations between mothers’ empowerment and children’s inoculations and schooling. Because mothers’ empowerment may be endogenous, we explore instrumental variable estimates using women’s ages at the time of marriage as the identifying instrument. We find that the greater mothers’ empowerment: the more likely that preschool-age children have complete inoculations and the younger is the age of starting school and the greater is the schooling progression rate. These effects are larger in absolute magnitude for urban than for rural areas (though significantly so at the 5% level only for inoculations), suggesting that the urban context facilitates the effectiveness of mothers’ empowerment on investments in children’s human capital. They also are larger in absolute magnitude for daughters than for sons (though significantly so only for the schooling progression rate), suggesting some intergenerational own-gender reinforcement. Finally, these effects are significantly larger in absolute magnitudes for 2007-08 than for 1998-99, suggesting increased impact of a given degree of mothers’ empowerment in the first decade of the 21st century

Demand for Public Health Care in Pakistan

A health care demand model is estimated for each province in Pakistan to explain the outpatient visits to government hospitals over the period 1989–2006. The explanatory variables include the number of government hospitals per capita, doctors’ fee per visit at a private clinic, income per capita, the average price of medicine and the number of outpatient visits per capita in the previous period. All variables are significant determinants of the demand for health care in at least one province but their signs, magnitudes and the levels of significance vary. These variations may be attributed to cultural, social and religious factors that vary across provinces. Variations in health care quality offered at public hospitals may also be a factor. These factors and improved accessibility of health care facilities should be the focus of public policy aimed at increasing the usage of public sector health care facilities in Pakistan.Health Care, Hospitals, Human Resources, Policy, Public Health

Demand for Public Health Care in Pakistan

A health care demand model is estimated for each province in Pakistan to explain the outpatient visits to government hospitals over the period 1989-2006. The explanatory variables include the number of government hospitals per capita, doctors’ fee per visit at a private clinic, income per capita, the average price of medicine and the number of outpatient visits per capita in the previous period. All variables are significant determinants of the demand for health care in at least one province but their signs, magnitudes and the levels of significance vary. These variations may be attributed to cultural, social and religious factors that vary across provinces. Variations in health care quality offered at public hospitals may also be a factor. These factors and improved accessibility of health care facilities should be the focus of public policy aimed at increasing the usage of public sector health care facilities in Pakistan. JEL classification: I110, I180, O150 Keywords: Health Care, Hospitals, Human Resources, Policy, Public Healt

Fruit and vegetable consumption across population segments: evidence from a national household survey

Abstract Background The 2002 World Health Report documented that low fruit and vegetable intake are among the top ten risk factors contributing to attributable mortality and up to three million lives could be saved each year by adequate consumption of F&V across the globe, leading an examination of behavioral preferences of the individual and family social, environmental, and behavioral factors that constitute perceived barriers to fruit and vegetable consumption. Objective The study examines factors affecting the choice of eating fruits and vegetables by household members and calculates eating frequency probabilities of different population-origin associated with personal attributes and behavior. Method Turkish Health Survey (THS) 2019 data from the Turkish Statistical Institute (TSI) national representative household panel is applied. Estimating a random-effect bivariate probit model of fruit and vegetable choice, we calculated marginal probabilities of choosing fruits and vegetables, the joint probability of choosing both, and conditional probabilities between choosing to eat either, detecting consumption synergy. Results The role of uncontrolled variables in choosing to eat fruits and vegetable (F&V) differs between the decision of an average family and the decision of individual family members. The attitude is positive for an average family and contrasts with the negative attitude among some family members. Most individual and family attributes inversely affect fruit and vegetable choice across different groups, while a positive relationship exists between the likelihood of fruit and vegetable choice and attributes such as age, marital status, education, weight, having health insurance, income, and time and forms of physical activity. Conclusion and recommendation Instead of a general policy for the implementation of a healthy and balanced nutrition program to improve fruit and vegetable eating frequency, it appears more effective to adopt programs with distinct characteristics that segregate society into different cohorts. We suggest appropriate policies and offer suitable approaches to reach targeted groups