Abstract
The Nordic countries have the lowest maternal and child mortality rates in the world. This has not always been the case. In 1887 the mortality rates in Norway were similar to those of developing countries today. During the next 34 years, Norwegian maternal mortality was halved and infant mortality fell by 40 percent. Investigating the relationship between health personnel and mortality at the local level during this period, we find a large and robust effect of midwives on reduced maternal mortality. No clear effect is found for other types of health personnel or on infant mortality.
Highlights
During most of human history, life expectancy has been low and maternal and child mortality have been high
We find that the increase in the number of midwives is robustly associated with a large decrease in maternal mortality in rural areas
Robust standard errors clustered at the medical district level in parentheses
Summary
During most of human history, life expectancy has been low and maternal and child mortality have been high. We observe the number of health personnel and various health outcomes at the medical district level annually from 1887 to 1920 and use this to study local variation in welfare provision within Norway using panel data techniques. Wüst (2012) confirm this finding in her study of the effect of the gradual roll-out of the Danish home visit program, where there is a quite clear positive impact on infant survival rates These studies only use data from urban areas, though. In a contemporary setting, Cesur et al (2017) analyze the gradual expansion of the Turkish Family Medicine Program, which provided increased access to physicians They find a clear decline in infant mortality. We do the latter, relying on Norwegian data from the period of the extensive roll-out of maternal care
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