Does distance matter for institutional delivery in rural India: an instrumental variable approach

Abstract

This paper estimates the causal effect of distance to health facility on institutional delivery in rural India, taking into account the endogenous placement of the health facility. We find that women living closer to health facilities are more likely to give birth at health facility. An increase of one kilometer in the distance to nearest health facility decreases the probability of institutional delivery by 4.4%. Policy simulation results indicate restricting the maximum distance to 5 kilometers would increase institutional delivery by 10%. Overall, our findings show that distance is an important barrier to service utilization.