Does Shorter Postnatal Hospital Stay Lead to Postdischarge Complications? An Instrumental Variables Approach

Abstract

We exploit the difference in means of postnatal hospital stays between beneficiary mothers of Janani Suraksha Yojana (JSY) and control mothers to estimate causal effects of postnatal hospital stay on postdischarge complications of a mother and her newborn. We argue that JSY increases the demand for institutional deliveries in those hospitals, which are assigned by the government to provide such services to the JSY recipients. Given the limited supply of beds, health professionals and other facilities, an excess demand for institutional deliveries in those hospitals forces JSY recipients to stay for a shorter time after birth compared with nonrecipients of JSY who are free to deliver in any hospital. Thus, the dummy for JSY becomes a suitable instrument for postnatal hospital stay. Using instrumental variables (IV) regressions, we find that postnatal hospital stay has statistically significant negative causal effects on half of the available postdischarge complications in the data, including abdominal pain, vaginal discharge, convulsion and severe headache of a mother and fever or cold of the newborn.

Sequential impact of components of maternal and child health care services on the continuum of care in India

“…This means that higher coverage with the individual components of service utilization does not ensure that women receive all the essential components (Shibanuma et al, 2018): this deficit is likely to result in persistently poorer health outcomes. Most maternal deaths occur during labour or delivery or in the immediate postpartum period and could be avoided with effective integration of the key services linked to the continuum of care (Iqbal et al, 2017;Rahman et al, 2019). It is important that women and children receive all key services as a continuum to avoid complications that can lead to morbidity and death.…”

Does cultural diversity hinder the implementation of IMF-supported programs? An empirical investigation

“…We find the expected sign of our selected instruments on our measures of ethnic diversity, which are significantly different from zero at the 1% level. Second, the selected instrument should not be associated with the error term in the second stage of the equation, i.e., [ω it |IV it = 0], meaning the selected instrument should not have any direct effect on the outcome variable of interest -the share of IMF conditions implemented, instead only impacting that outcome via the instrumented variable (Rahman et al, 2019). To the best our knowledge we are not aware of any theoretical proposition or empirical test directly linking artificial borders with compliance of IMF conditions.…”