Journal of Biosocial Science

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THE EFFECTS OF MATERNAL–CHILD HEALTH SERVICE UTILIZATION ON SUBSEQUENT CONTRACEPTIVE USE IN MOROCCO


DAVID R.  HOTCHKISS a1, ROBERT J.  MAGNANI a1, JEFFREY J.  ROUS a2, MUSTAPHA  AZELMAT a3, THOMAS A.  MROZ a4 and JAFFAR  HEIKEL a3
a1 Tulane University Medical Center, School of Public Health and Tropical Medicine, Department of International Health and Development, New Orleans, LA, USA
a2 University of North Texas, Department of Economics, Denton, TX, USA
a3 Ministere de la Sante Publique, Service des Etudes et de L'Information Sanitaire, Rabat, Morocco
a4 University of North Carolina at Chapel Hill, Department of Economics and Carolina Population Center, Chapel Hill, NC, USA

Abstract

There are a number of reasons for anticipating that contact by women in developing country settings with modern maternal–child health (MCH) services will lead to increased use of family planning services. Indeed, the expectation of such a relationship underlies the integrated service delivery strategy that has been adopted on a more or less global basis. However, the available empirical evidence in support of this proposition is inconclusive. This study re-examines this issue in Morocco. Household survey data and data on the supply environment for health and family planning services gathered in 1992 are analysed in the study. A full-information maximum likelihood estimator is used to control for the possible endogeneity of health care and contraceptive choices. The findings indicate a substantial and apparently causal relationship between the intensity of MCH service use and subsequent contraceptive use. Policy simulations indicate that sizeable increases in contraceptive prevalence might be realized by increasing the coverage and intensity of use of MCH services.