Malnutrition, infections, and delayed psychological and motor development are common among pre-school children in low to middle-income nations such as the Philippines. Public sector health services are a key input for improving health and nutrition among young children. But there are serious gaps in current understanding of the causal impact of the quality of health and early childhood development (ECD) related services on child health and ECD. This project will use innovative and rich longitudinal data on service providers and facilities to understand the effect of the quality of public health and ECD-related services on ECD and the demand for health and ECD-related services. The setting for the study is three regions in the Philippines. The analysis will use four rounds of data on 7,922 children age 0 to 4 in round 1 that can be linked to three types of providers (midwives, village health workers, day care providers) per round. The proposed project will be the first to examine data from extensive tests administered to service providers to measure their health and ECD-related knowledge, aptitude, and skills. The study is also unique in other respects. It will consider how the human capital (e.g. schooling) of service providers affects ECD outcomes and demand for services. The project will utilize detailed measures of the characteristics of health facilities. The analysis will extend the existing literature through examination of a range of ECD indicators including height, weight, hemoglobin, and seven domains of cognitive, social and motor development. The study will also consider the under-researched issue of whether family background (e.g. mother's schooling, family wealth) and provider quality characteristics (e.g. ECD-related skills) operate interactively in affecting ECD and demand for ECD-related services. The analysis will involve estimation of fixed effects models that relate health and ECD to health service quality and control for unobserved variables (e.g. related to the non- random placement of better health services across communities) that may bias the estimated impact of the quality of services on health and ECD and demand for health services. The study will provide valuable insight on the role of the human and physical resources of the health sector in improving child health. The findings will be shared with agencies that formulate health policy in the Philippines to provide information that will directly aid them in achieving their aim of improving health service delivery. ? ? ?
| Duazo, Paulita; Avila, Josephine; Kuzawa, Christopher W (2010) Breastfeeding and later psychosocial development in the Philippines. Am J Hum Biol 22:725-30 |
