Effect of Prenatal Care Frequency, Timing, and Quality on Child Birth Weight in Tajikistan

• Author: Derek Campbell,Chi Ho Cheung,Nazim Habibov,Lida Fan
• Date: 01 March 2017
• Published date: 01 March 2017
• DOI: http://doi.org/10.1002/wmh3.216

Effect of Prenatal Care Frequency, Timing, and Quality

on Child Birth Weight in Tajikistan

Nazim Habibov, Lida Fan, Derek Campbell, and Chi Ho Cheung

We focus on identifying the effects of prenatal care on child birth weight in Tajikistan. We evaluate

the effects of frequency, timing, and the quality of received care by estimating instrumental variable

models. The results of two-stage least square (2SLS) indicate that an additional prenatal visit

improves birth weight by 89 g, which constitutes approximately 2.7 percent of the original raw

mean. Similarly, a one-unit increase in the quality of prenatal care improves birth weight by 130 g,

which represents about 9.2 percent of the original mean. Likewise, having the f‌irst prenatal visit

take place during the f‌irst trimester improves birth weight by 304 g, which is about

3.9 percent of the original mean. Although prenatal care in Tajikistan suffers from various

ineff‌iciencies, it nevertheless remains an instrumental factor in improving birth outcomes in the

country. Finally, issues of endogeneity that result from self-selection and the importance of

adjusting for child selection for being weighed are highlighted.

KEY WORDS: Tajikistan, antenatal care, child health, birth weight, outcome evaluation

Introduction

Birth weight is the f‌irst weight taken of a baby just after he or she is born. Low

birth weight is an important factor that can negatively affect the prenatal and

postnatal development of children. Infants with low birth weight are almost 40

times more likely to die than are infants of normal birth weight (CDC, 2009).

Importantly, 95.6 percent of incidents of low birth weight can be observed in

developing and transitional countries (WHO, 2014). As such, the rate disparity

between developed, and developing and transitional countries is substantially high

when compared, for example, with the United Kingdom at 7.4 percent, Germany at

6.9 percent, and France at 6.6 percent (OECD, 2011). This is not surprising when

one considers the substantial barriers to access to prenatal health care in

developing and transitional countries (McIntyre, Thiede, Dahlgren, & Whitehead,

2008; Peters et al., 2008).

Prenatal care can be def‌ined as the primary health-care service received from

the time of conception up to the point of labor and delivery, which may positively

impact birth weight in the following four main ways (Gajate-Garrido, 2013). First,

World Medical & Health Policy, Vol. 9, No. 1, 2017

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