Does distance matter for institutional delivery in rural India?

Abstract

This article estimates the causal effect of distance to health facility on in-facility birth in rural India, taking into account the endogenous placement of the health facility. We find that women living farther away from the health facilities are less likely to give birth at a health facility. Each additional kilometre from the nearest health facility is associated with a 4.4% decline in the probability of in-facility birth. Policy simulation results indicate that providing access to a health facility within 5 km would increase institutional delivery by 10%. Overall, our findings confirm that distance is an important barrier to in-facility births in rural India.