Women's Education Level, Maternal Health Facilities, Abortion Legislation and Maternal Deaths: A Natural Experiment in Chile from 1957 to 2007

The aim of this study was to assess the main factors related to maternal mortality reduction in large time series available in Chile in context of the United Nations' Millennium Development Goals (MDGs).Time series of maternal mortality ratio (MMR) from official data (National Institute of Statistics, 1957-2007) along with parallel time series of education years, income per capita, fertility rate (TFR), birth order, clean water, sanitary sewer, and delivery by skilled attendants were analysed using autoregressive models (ARIMA). Historical changes on the mortality trend including the effect of different educational and maternal health policies implemented in 1965, and legislation that prohibited abortion in 1989 were assessed utilizing segmented regression techniques.During the 50-year study period, the MMR decreased from 293.7 to 18.2/100,000 live births, a decrease of 93.8%. Women's education level modulated the effects of TFR, birth order, delivery by skilled attendants, clean water, and sanitary sewer access. In the fully adjusted model, for every additional year of maternal education there was a corresponding decrease in the MMR of 29.3/100,000 live births. A rapid phase of decline between 1965 and 1981 (-13.29/100,000 live births each year) and a slow phase between 1981 and 2007 (-1.59/100,000 live births each year) were identified. After abortion was prohibited, the MMR decreased from 41.3 to 12.7 per 100,000 live births (-69.2%). The slope of the MMR did not appear to be altered by the change in abortion law.Increasing education level appears to favourably impact the downward trend in the MMR, modulating other key factors such as access and utilization of maternal health facilities, changes in women's reproductive behaviour and improvements of the sanitary system. Consequently, different MDGs can act synergistically to improve maternal health. The reduction in the MMR is not related to the legal status of abortion

Precision-Guided or Blunt? The Effects of US Economic Sanctions on Human Rights

We use endogenous treatment-regression models to estimate the causal average treatment effect of US economic sanctions on four types of human rights. In contrast to previous studies, we find no support for adverse effects of sanctions on economic rights, political and civil rights, and basic human rights. With respect to women's rights, our findings even indicate a positive relationship. Emancipatory rights are, on average, strengthened when a country faces sanctions by the US. Our findings are robust when applying various changes to the empirical specification. Most importantly, this study provides strong evidence that the endogeneity of treatment assignment must be modelled when the consequences of sanctions are studied empirically

Rétrospective annuelle -- /

1989 /Titre de la couv

Exploring Incentives : an Introduction to Incentives and Economic Instruments for Sustainable Development

"Document préparé pour le Comité des incidences socio-économiques de la Table ronde nationale sur l'environnement et l'économie"(br.)Bibliogr.: p. 22-27, 22-2

Determinants of physicians' decisions to specialize

In this paper, we study physician specialty decisions using several unique data sets which include information on almost all Canadian physicians who practised in Canada between 1989 and 1998. Unlike previous studies, we use a truly exogenous measure of potential income across general and specialty medicine to estimate the effect of income on physicians' specialty choices. Furthermore, our estimation procedure allows us to purge the income-effect estimates of non-pecuniary specialty attributes which may be correlated with higher paying specialties. Understanding the effect of potential income (and other variables) on choices is necessary if the desired mix across generalists and specialists as well as across specialties is to be achieved. Our results show that physicians respond to differences in income when making their specialty decisions. Copyright © 2005 John Wiley & Sons, Ltd.