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Impact of an employment guarantee scheme on utilisation of maternal healthcare services: Results from a natural experiment in India

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  • Parmar, Divya
  • Banerjee, Aneesh

Abstract

We assess the impact of India's National Rural Employment Guarantee (NREG) scheme, the world's largest workfare scheme, on healthcare utilisation – specifically maternal healthcare. The primary objective of NREG is to improve the income of rural households by guaranteeing 100 days of employment. We expect that by improving household income, thereby reducing some of the financial barriers, such as out-of-pocket payments, NREG can increase utilisation of maternal health services. Using a nationally representative household survey and a difference-in-differences approach that exploits the phased rollout of the scheme, we estimate the impact of NREG on utilisation of maternal health services: mainly deliveries at health facilities. We find that NREG did not increase overall facility deliveries, even though it led to an increase in deliveries at public facilities. There is weak evidence to suggest that deliveries at private facilities reduced due to NREG. Furthermore, sub-group analyses reveal that among poorer households, who are more likely to participate in NREG, there is a reduction in facility deliveries while home deliveries increased. Among richer households, NREG increased deliveries at public facilities. There was no impact on households belonging to marginalised castes. We conclude by discussing the possible mechanisms for these effects and its impact on equity in healthcare utilisation.

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  • Parmar, Divya & Banerjee, Aneesh, 2019. "Impact of an employment guarantee scheme on utilisation of maternal healthcare services: Results from a natural experiment in India," Social Science & Medicine, Elsevier, vol. 222(C), pages 285-293.
    • Handle: RePEc:eee:socmed:v:222:y:2019:i:c:p:285-293
    DOI: 10.1016/j.socscimed.2019.01.028
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    1. World Bank, 2011. "Social Protection for a Changing India : Executive Summary," World Bank Publications - Reports 2746, The World Bank Group.
    2. Zimmermann, Laura V, 2012. "Labor Market Impacts of a Large-Scale Public Works Program: Evidence from the Indian Employment Guarantee Scheme," IZA Discussion Papers 6858, Institute of Labor Economics (IZA).
    3. Lenis Saweda O. Liverpool‐Tasie & Alex Winter‐Nelson, 2011. "Asset versus consumption poverty and poverty dynamics in rural Ethiopia," Agricultural Economics, International Association of Agricultural Economists, vol. 42(2), pages 221-233, March.
    4. Sagarika Dey, 2017. "Assessing the Poverty Impact of India’s Largest Livelihood Security Programme: A Study Based on 68th Round of NSSO," Journal of Development Policy and Practice, , vol. 2(1), pages 56-70, January.
    5. Jha, Raghbendra & Bhattacharyya, Sambit & Gaiha, Raghav & Shankar, Shylashri, 2009. ""Capture" of anti-poverty programs: An analysis of the National Rural Employment Guarantee Program in India," Journal of Asian Economics, Elsevier, vol. 20(4), pages 456-464, September.
    6. Deininger, Klaus & Liu, Yanyan, 2013. "Welfare and poverty impacts of India's national rural employment guarantee scheme : evidence from Andhra Pradesh," Policy Research Working Paper Series 6543, The World Bank.
    7. Clément Imbert & John Papp, 2015. "Labor Market Effects of Social Programs: Evidence from India's Employment Guarantee," American Economic Journal: Applied Economics, American Economic Association, vol. 7(2), pages 233-263, April.
    8. Ravi, Shamika & Engler, Monika, 2015. "Workfare as an Effective Way to Fight Poverty: The Case of India’s NREGS," World Development, Elsevier, vol. 67(C), pages 57-71.
    9. Lanjouw, Peter & Ravallion, Martin, 1999. "Benefit Incidence, Public Spending Reforms, and the Timing of Program Capture," The World Bank Economic Review, World Bank, vol. 13(2), pages 257-273, May.
    10. Songqing Jin & Yanyan Liu, 2013. "Welfare and Poverty Impacts of India’s National Rural Employment Guarantee Scheme: Evidence from Andhra Pradesh," Working Papers id:5530, eSocialSciences.
    11. Karthik Muralidharan & Paul Niehaus & Sandip Sukhtankar, 2023. "General Equilibrium Effects of (Improving) Public Employment Programs: Experimental Evidence From India," Econometrica, Econometric Society, vol. 91(4), pages 1261-1295, July.
    12. Liu, Yanyan & Barrett, Christopher B., 2012. "Heterogeneous pro–poor targeting in India’s Mahatma Gandhi National Rural Employment Guarantee Scheme:," IFPRI discussion papers 1218, International Food Policy Research Institute (IFPRI).
    13. M. Adato & L. Haddad, 2002. "Targeting Poverty through Community-Based Public Works Programmes: Experience from South Africa," Journal of Development Studies, Taylor & Francis Journals, vol. 38(3), pages 1-36.
    14. Steven Haider & Alison Jacknowitz & Robert Schoeni, 2003. "Welfare work requirements and child well-being: Evidence from the effects on breast-feeding," Demography, Springer;Population Association of America (PAA), vol. 40(3), pages 479-497, August.
    15. Ai, Chunrong & Norton, Edward C., 2003. "Interaction terms in logit and probit models," Economics Letters, Elsevier, vol. 80(1), pages 123-129, July.
    16. World Bank, 2011. "Social Protection for a Changing India : Main Report," World Bank Publications - Reports 2745, The World Bank Group.
    17. Navaneetham, K. & Dharmalingam, A., 2002. "Utilization of maternal health care services in Southern India," Social Science & Medicine, Elsevier, vol. 55(10), pages 1849-1869, November.
    18. Martin Ravallion & Emanuela Galasso & Teodoro Lazo & Ernesto Philipp, 2005. "What Can Ex-Participants Reveal about a Program’s Impact?," Journal of Human Resources, University of Wisconsin Press, vol. 40(1).
    19. Subbarao, Kalanidhi, 2003. "Systemic shocks and social protection : role and effectiveness of public works programs," Social Protection and Labor Policy and Technical Notes 25606, The World Bank.
    20. Maity, Bipasha, 2017. "Comparing Health Outcomes Across Scheduled Tribes and Castes in India," World Development, Elsevier, vol. 96(C), pages 163-181.
    21. Subbarao,Kalanidhi, 2003. "Systemic shocks and social protection : role and effectiveness of public works programs," Policy Research Working Paper Series 25606, The World Bank.
    22. Farzana Afridi & Abhiroop Mukhopadhyay & Soham Sahoo, 2016. "Female labor force participation and child education in India: evidence from the National Rural Employment Guarantee Scheme," IZA Journal of Labor & Development, Springer;Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 5(1), pages 1-27, December.
    23. Sonalde Desai & Prem Vashishtha & Omkar Joshi, 2015. "Mahatma Gandhi National Rural Employment Guarantee Act: A Catalyst for Rural Transformation," Working Papers id:7259, eSocialSciences.
    24. Azam, Mehtabul, 2012. "The Impact of Indian Job Guarantee Scheme on Labor Market Outcomes: Evidence from a Natural Experiment," IZA Discussion Papers 6548, Institute of Labor Economics (IZA).
    25. Bose, Nayana, 2017. "Raising Consumption Through India’s National Rural Employment Guarantee Scheme," World Development, Elsevier, vol. 96(C), pages 245-263.
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