Abstract
Lack of cash on hand is a significant obstacle in accessing healthcare services in developing countries. Many expectant mothers in the least developed countries do not receive sufficient care during pregnancy due to financial constraints. If such hurdles in accessing healthcare can be overcome, it will contribute to reduction in maternal and newborn mortality, which is a key target of Sustainable Development Goal 3. This study reports the first assessment of the impact of mobile money services on maternal care utilization. We hypothesize that mobile money adoption would motivate rural Ugandan women to receive antenatal care and to deliver their children at health facilities or with skilled birth attendants. By receiving remittances utilizing mobile money, poor rural households may obtain more cash in hand, which might change women’s health-seeking behavior. We apply community- and mother-fixed effects models with heterogeneity analysis to longitudinal panel data (the RePEAT [Research on Poverty, Environment, and Agricultural Technology] survey) of three waves (2009, 2012, and 2015). The analysis uses pregnancy reports of 2007–2015 from 586 rural Ugandan households. We find suggestive evidence that mobile money adoption positively affects the take-up of antenatal care. Heterogeneity analysis indicates that mobile money brings a larger benefit to geographically challenged households by easing their liquidity constraint as they face higher cost of traveling to distant health facilities. The models failed to reject the null hypothesis of no mobile money effect on the delivery-related outcome variables. This study suggests that promoting financial inclusion by means of mobile money motivates women in rural and remote areas to make antenatal care visits while the evidence of such effect is not found for take-up of facility delivery or delivery with skilled birth attendants.
Highlights
In developing countries, a large proportion of the population lacks access to basic financial services because the financial infrastructure is not well developed
One can think that mobile money, which is another tool of financial inclusion, may positively influence healthcare utilization
(2) In addition to the control variables listed, the regressions (3)–(5) control for a dummy, indicating that the distance from the household to the closest road was larger than the mean, a dummy indicating that the distance from the household to the reference point of the village was larger than the mean, a dummy indicating an area largely occupied by water surface, a dummy indicating that the distance from the household location to the reference point of the village was larger than the mean, a dummy indicating that the driving time to the nearest district town from the village was less than the mean, three dummies for the number of higher-level health facilities, and two dummies for the number of lower-level health facilities
Summary
A large proportion of the population lacks access to basic financial services because the financial infrastructure is not well developed. In this paper, utilizing the RePEAT (Research on Poverty, Environment, and Agricultural Technology) data of Uganda, we attempt to fill this gap by addressing a research question: “Does mobile money adoption improve maternal healthcare utilization of the poor?” The study conducts regression analysis of community- and mother-level fixed effects models. The impact is strong for households located in villages that did not initially have a higher-level health facility around their residential area These results suggest that mobile money mitigates geographical barriers and encourages mothers to travel to and receive ANC at distant health facilities. The results failed to reject the null hypothesis of no mobile money effect on the facility delivery and the delivery assisted by SBAs. This study contributes to financial inclusion literature and maternal health literature. The results suggest that mobile money as a tool of financial inclusion positively affects women’s maternal health-seeking behavior.
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