Study: “The Effects of Community-Based Interventions on Women and Children’s Health in Indonesia”
PI: Triyana, Margaret
Affiliation: University of Chicago
Funding Partner: IIE
Geographic Location: Indonesia
Description: Low birth weight is a global health problem, with approximately 16 percent of all newborns in developing countries being born with low birth weight. Motivated by these statistics, this research evaluates policies that target maternal and children’s health in low-resource settings. The research analyzes three community-based and household-based health interventions, including Program Keluarga Harapan (PKH), a household-based conditional cash transfer (CCT) program; PNPM Generasi Sehat dan Cerdas (Generasi ,a community-based CCT program,); and the “Midwife in the Village” (Bidan di Desa) program, a community-based program,. The “Midwife in the Village” program was implemented in the 1980s to provide each village with a trained midwife to provide prenatal care and delivery assistance, while the two CCT programs were piloted in 2007.
The first essay analyzes the effects of Indonesia’s household CCT program on the price and quality of health care services, and how these changes affect poor households. The household CCT program is associated with higher utilization of health care, driven by increased utilization among the poor. In response to increased demand for health care from the CCT program, price increases in sub-districts that offer the CCT, which suggests the importance of increasing the amount of health care centers available when implementing a program designed to increase demand for health care.
A second essay compares the relative effectiveness of household CCT and community CCT programs. Both programs increase health seeking behavior, but do not result in significant improvements in birth outcomes. However, the household CCT program reduces preterm birth, thus suggesting that the targeted household CCT program is more effective in improving birth outcomes than the broad community-based program, even though both programs improve health-seeking behavior.
The third essay analyzes the long-term impact of the “Midwife in the Village” program in rural Indonesia, including the effect of losing the village midwife after the 1998 financial crisis. The effects of gaining a midwife are qualitatively similar to earlier estimates that found improvements in women’s health status and birth weight, but are not statistically significant, which suggests that the program effects diminish over time. Losing a midwife has no statistically significant effect on women’s health status or low birth weight, suggesting that the program was effective in maintaining the health status of rural communities.
Triyana, Margaret. (2013). The effects of household and community-based interventions: Evidence from Indonesia (Doctoral Dissertation). The University of Chicago, Chicago, IL.
Triyana, Margaret. (2012). Do Health Care Providers Respond to Demand-Side Incentive? Evidence from Indonesia (Job market paper). University of Chicago, Chicago, IL.