IDEAS home Printed from https://ideas.repec.org/a/bla/ausecp/v62y2023i4p616-632.html
   My bibliography  Save this article

Distance to healthcare facilities, healthcare use and health outcomes: The case of Papua New Guinea

Author

Listed:
  • Ajay Mahal
  • Navy Mulou
  • Marie Ishida

Abstract

Papua New Guinea (PNG) has among the worst maternal and child health (MCH) outcomes in the Asia–Pacific region. Improving population access to and use of health services is a key government priority. However, it is unclear from the international evidence whether the observed inverse relationship between distance to health facilities and health outcomes is due to health service use. This article first seeks to estimate the relationship between distance to health facilities, the use of MCH services and health outcomes in PNG. The second goal is to assess whether the observed relationship between distance to health services and health outcomes occurs due to health service use. Cross‐sectional data from the Demographic and Health Survey 2016–18 for PNG were used to estimate the association between distance to health facilities, indicators of health service use and indicators of child health outcomes, using regression methods. Causal mediation methods were used to assess whether the observed associations between health outcomes and distance to health facilities were explained by health service use, or not. We find an inverse association between distance to health facilities and utilisation of MCH services; and between distance to health facilities and child health. However, our analyses do not support causal mediation via impact of distance on health service use. At odds with a large literature that implicitly assumes that health service use improves health outcomes, our findings reflect broader concerns about quality of care in PNG.

Suggested Citation

  • Ajay Mahal & Navy Mulou & Marie Ishida, 2023. "Distance to healthcare facilities, healthcare use and health outcomes: The case of Papua New Guinea," Australian Economic Papers, Wiley Blackwell, vol. 62(4), pages 616-632, December.
    • Handle: RePEc:bla:ausecp:v:62:y:2023:i:4:p:616-632
    DOI: 10.1111/1467-8454.12310
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/1467-8454.12310
    Download Restriction: no
    File URL: https://libkey.io/10.1111/1467-8454.12310?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Finn McGuire & Noemi Kreif & Peter C. Smith, 2021. "The effect of distance on maternal institutional delivery choice: Evidence from Malawi," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 2144-2167, September.
    2. Santosh Kumar & Emily A. Dansereau & Christopher J. L. Murray, 2014. "Does distance matter for institutional delivery in rural India?," Applied Economics, Taylor & Francis Journals, vol. 46(33), pages 4091-4103, November.
    3. Raymond Hicks & Dustin Tingley, 2011. "Causal mediation analysis," Stata Journal, StataCorp LP, vol. 11(4), pages 605-619, December.
    4. Masters, Samuel H. & Burstein, Roy & Amofah, George & Abaogye, Patrick & Kumar, Santosh & Hanlon, Michael, 2013. "Travel time to maternity care and its effect on utilization in rural Ghana: A multilevel analysis," Social Science & Medicine, Elsevier, vol. 93(C), pages 147-154.
    5. World Bank, 2013. "Below the Glass Floor : Analytical Review of Expenditure by Provincial Administrations on Rural Health from Health Function Grants and Provincial Internal Revenue," World Bank Publications - Reports 17567, The World Bank Group.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Abhishek Dureja & Digvijay S. Negi, 2024. "Birth Order Effects in Maternal Health-Seeking Behavior: Evidence from India," Working Papers 118, Ashoka University, Department of Economics.
    2. Lisa Cameron & Diana Contreras Suarez & Katy Cornwell, 2019. "Understanding the determinants of maternal mortality: An observational study using the Indonesian Population Census," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-18, June.
    3. Aggarwal, Shilpa, 2021. "The long road to health: Healthcare utilization impacts of a road pavement policy in rural India," Journal of Development Economics, Elsevier, vol. 151(C).
    4. Finn McGuire & Noemi Kreif & Peter C. Smith, 2021. "The effect of distance on maternal institutional delivery choice: Evidence from Malawi," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 2144-2167, September.
    5. Rao, Krishna D. & Mehta, Akriti & Noonan, Caitlin & Peters, Michael A. & Perry, Henry, 2024. "Voting with their feet: Primary care provider choice and its implications for public sector primary care services in India," Social Science & Medicine, Elsevier, vol. 340(C).
    6. Teketo Kassaw Tegegne & Catherine Chojenta & Deborah Loxton & Roger Smith & Kelemu Tilahun Kibret, 2018. "The impact of geographic access on institutional delivery care use in low and middle-income countries: Systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-16, August.
    7. D. Gunzler & W. Tang & N. Lu & P. Wu & X. Tu, 2014. "A Class of Distribution-Free Models for Longitudinal Mediation Analysis," Psychometrika, Springer;The Psychometric Society, vol. 79(4), pages 543-568, October.
    8. Hu, Shu & Das, Dhiman, 2019. "Quality of life among older adults in China and India: Does productive engagement help?," Social Science & Medicine, Elsevier, vol. 229(C), pages 144-153.
    9. Aoun, Nael & Matsuda, Hirotaka & Sekiyama, Makiko, 2015. "Geographical accessibility to healthcare and malnutrition in Rwanda," Social Science & Medicine, Elsevier, vol. 130(C), pages 135-145.
    10. Ma, Wanglin & Vatsa, Puneet & Zheng, Hongyun, 2022. "Cooking fuel choices and subjective well-being in rural China: Implications for a complete energy transition," Energy Policy, Elsevier, vol. 165(C).
    11. Jerg Gutmann & Stefan Voigt, 2020. "Judicial independence in the EU: a puzzle," European Journal of Law and Economics, Springer, vol. 49(1), pages 83-100, February.
    12. Ryan W. Buell, 2017. "Last Place Aversion in Queues," Harvard Business School Working Papers 18-053, Harvard Business School, revised Oct 2019.
    13. Noah Kaiser & Christina K. Barstow, 2022. "Rural Transportation Infrastructure in Low- and Middle-Income Countries: A Review of Impacts, Implications, and Interventions," Sustainability, MDPI, vol. 14(4), pages 1-48, February.
    14. Shelly Rathee & Kritika Narula & Arul Mishra & Himanshu Mishra, 2023. "Alphanumeric vs. Numeric Token Systems and the Healthcare Experience: Field Evidence from Healthcare Delivery in India," Management Science, INFORMS, vol. 69(2), pages 1180-1221, February.
    15. Alexander M. Danzer & Carsten Feuerbaum & Marc Piopiunik & Ludger Woessmann, 2022. "Growing up in ethnic enclaves: language proficiency and educational attainment of immigrant children," Journal of Population Economics, Springer;European Society for Population Economics, vol. 35(3), pages 1297-1344, July.
    16. Zwysen, Wouter, 2013. "Where you go depends on where you come from: the influence of father’s employment status on young adult’s labour market experiences," ISER Working Paper Series 2013-24, Institute for Social and Economic Research.
    17. Hille, Adrian & Schupp, Jürgen, 2015. "How Learning a Musical Instrument Affects the Development of Skills," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 44, pages 56-82.
    18. Joseph Flavian Gomes, 2020. "The health costs of ethnic distance: evidence from sub-Saharan Africa," Journal of Economic Growth, Springer, vol. 25(2), pages 195-226, June.
    19. Martin Huber & Michael Lechner & Giovanni Mellace, 2016. "The Finite Sample Performance of Estimators for Mediation Analysis Under Sequential Conditional Independence," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 34(1), pages 139-160, January.
    20. Adam, Marc T.P. & Krämer, Jan & Müller, Marius B., 2015. "Auction Fever! How Time Pressure and Social Competition Affect Bidders’ Arousal and Bids in Retail Auctions," Journal of Retailing, Elsevier, vol. 91(3), pages 468-485.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:ausecp:v:62:y:2023:i:4:p:616-632. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www.blackwellpublishing.com/journal.asp?ref=0004-900X .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.