Mother’s Education, Learning-by-Doing, and Child Health Care in Rural India

This study analyzes the determinants of the use of prenatal care and child immunization in rural India relying primarily on the 1993/94 National Family Health Survey. The key question addressed is whether learning-by-doing is an important feature of the health care system. More specifically, are women who use prenatal care as a result more likely to immunize their children? We conclude that important unobserved traits influence the utilization of both prenatal and immunization services. Once these are controlled, learning-by-doing is important for educated women, but not for uneducated women. There are two possible interpretations of this finding. One is that a lack of education limits the ability of women to effectively learn from the prenatal experience. The other is failings of the health care system limits its effectiveness with uneducated women. We also find strong evidence of gender bias in the demand for immunization services particularly among uneducated women. In addition, the analysis provides estimates of the effects on prenatal care and immunization of formal education, media exposure, economic status, family composition, access to services, and other variables.