Abstract
This study examines women's declining use of maternal healthcare services in post-socialist Tajikistan. Using data from the 2003 and 2007 Tajikistan Living Standards Surveys (TLSS), the findings support previous evidence that a woman's use of prenatal and delivery care depends on her education, household income, and proximity to services. However, previous models have not specified who makes the decision to use maternal healthcare services. This study finds that in Tajikistan a woman shares decision making with her spouse and the eldest woman in the household. There is limited evidence that traditional proxies for bargaining power, such as relative earnings level, affect outcomes. The authors conclude that where women's exit options are limited, surveys evaluating the value of women's assets and their services in the home, as well as questions about decision making, will allow more refined measures of women's bargaining power.
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