Choice Decisions Research Articles

Eye movements in binary food choice context: assessing the complexity of restaurant menus on virtue vs. vice foods

ABSTRACT This paper explores binary food choices through the lens of information load theory. We conducted two laboratory studies using the eye-tracking approach to understand the influence of the high menu complexity on visual attention for virtue versus vice food options. This paper also examined the moderating effect of time on the initial fixation. Our findings showed that the time duration taken to reach the first fixation influences binary food choices. This was evident when participants were tasked with selecting food options from a high menu complexity. Specifically, fixation duration is greater for virtue food than vice food in a high menu complexity context. However, no differences in fixation duration between vice and virtue foods were observed in low menu complexity. This study provides key insights into understanding how differences in menu complexity impact customers’ binary food choice decisions concerning vice and virtue foods.

BS SO08 - Prospective audit of weight loss and resolution co-morbidities of various bariatric surgeries and Comparisions of weight loss and ORM resolution between bypass and sleeve-1 years follow up- Audit outcomes from Jan 2019-2023

Abstract Background Bariatric surgery is the gold standard in managing bariatric patients. There are various bariatric surgeries that have been approved. Sleeve gastrectomy is the most common procedure to be done globally. RYGB is considered the gold standard surgery as it gives the best weight loss and comorbidity resolution. OAGB is now a well-established procedure. Other procedures which are offered to the patients are duodenal switch and SADIS. Method We prospectively analysed the patients who underwent bariatric surgery at our center. All the bariatric surgery patients were included. Aim To calculate EBWL at 6 m, 1 year Resolutions of obesity related morbidity Comparision of the outcomes between Sleeve and Bypass Results 1024 patients underwent bariatric surgery. All the patients undergo MDT discussion and the decision of choice of surgery is made based on MDT discussion and patients' preference. For the first 6 months both sleeve and bypass fair equal in terms of weight loss and resolution of comorbidities. Subsequently weight loss is better with bypass. It is also better sustained with the bypass. Resolution of comorbidities is the best within the first 6 months post-surgery. Conclusion There is a direct relationship between weight loss and resolution of co-morbidities. These patients are under follow up for outcomes at 2 years. Results will be published at the time of conference presentation

Impact of integrated marketing communication strategies on choice of higher education institutions

In today’s fiercely competitive realm of higher education, Integrated Marketing Communications (IMC) have emerged as a crucial approach for institutions to effectively connect with prospective students. This study examines the influence of IMC strategies on students’ choices of higher education institutions (HEIs) in Bangalore, India. Using a descriptive research design, data were gathered via a structured questionnaire from a sample of 384 students. The findings reveal notable disparities in perceptions of IMC based on gender, academic discipline preference, and institution type. Interestingly, age does not yield significant differences in IMC perceptions. A positive correlation (0.632) between IMC perceptions and choice of HEIs underscores the importance of customized strategies in attracting and engaging students. IMC strategies such as digital marketing, social media engagement, content marketing, alumni engagement, and student ambassadors significantly influence the choice of HEIs with the variance of 0.315, 0.523, 0.394, 0.619, and 0.298, respectively. Further, IMC strategies such as digital marketing, social media engagement, alumni engagement, partnership with influencers, and student ambassadors significantly influence the selection of disciplines with the variance of 0.298, 0.642, 0.497, 0.421, and 0.234, respectively. In essence, this study emphasizes the pivotal role of effective IMC strategies in higher education choice decision-making and provides actionable insights for institutions seeking to refine their marketing approaches.

Assessing metacognitive knowledge in subjective decisions: The knowledge of weights paradigm

Subjective, multi-attribute choice decisions – such as whom to marry or which college to attend – play a substantial role in decision makers’ long-term well-being. However, the metacognition literature lacks tools for assessing metacognitive capacities in subjective decisions. We present three studies in which we propose and validate the Knowledge of Weights (KoW) paradigm, a novel method for assessing metacognitive knowledge of attribute weights in subjective, multi-attribute choice decisions. In Study 1, we demonstrate the test-retest reliability of metrics generated by the KoW paradigm. In Study 2, we apply the KoW paradigm in four domains and show that it generates consistent results. In Study 3, we demonstrate that participants who perform better on the KoW paradigm make choices with which they are more satisfied, providing suggestive evidence of predictive validity. Use cases in cognitive psychology and beyond are discussed.

Consumer Moral Decision Making: The Impact of Alignable Versus Nonalignable Differences

Abstract Consumer choice decisions often involve a tradeoff between an alignable difference (a difference along a shared attribute) and a nonalignable difference (a difference between unique attributes of each alternative). For example, Café A provides friendly service, while Café B offers unwelcoming service (an alignable difference). However, Café A occasionally makes billing errors, and Café B has comfortable seating (a non-alignable difference). Prior research shows that alignable differences tend to have a greater impact on choice than nonalignable differences (known as the “alignability effect”). Yet, little research has examined tradeoffs involving moral attributes. Contrary to the prevailing evidence, eight studies (N = 2,861) demonstrate that in moral attribute tradeoffs, nonalignable (vs. alignable) differences have a greater impact on choice (termed the “nonalignability effect”). Consequently, consumers prefer an alternative that is superior on a nonalignable moral difference but inferior on an alignable moral difference. Moreover, in moral-quality tradeoffs, where one alternative is more ethical but is of lower quality, consumers show a stronger preference for the ethical alternative when its moral superiority is represented by a nonalignable (vs. alignable) difference. The nonalignability effect is driven by consumers’ unique decision process in making moral attribute tradeoffs, characterized by categorical valence coding and attribute-by-attribute win-loss counting.

6.P. Scientific session: Economic evaluation of health impacts for better decision choices

Abstract The strategy of Health in All Policies (HiAP) pursues to analyse the wider determinants of health affected by the decision-making process of traditionally non-health sectors, seeking to enhance population health benefits while avoiding health inequalities. This usually involves the use of health impact assessment (HIA) or health lens analysis to any policy, program, plan or project (PPPP), preferably prior to its implementation. On the other hand, decision-makers from a wide range of public and private sectors also demand a better insight of the meaning of the health impacts quantified under HIA. Assuming the (ubiquitous) situation of limited resources and budgets, decisions need to be based on cost effectiveness criteria and, whenever possible, direct and indirect health costs should be part of the impact assessment. Economic appraisal attempts to define whether a proposal makes a net contribution to social welfare, quantifying and valuing changes to individuals’ utility from the societal perspective, taking into account the impact of health on the individual, their family, employers, healthcare providers and the state. This approach can incorporate different components of the welfare costs of illness, including direct medical and paid care expenses, indirect lost opportunity costs such as productivity and the value of informal care time, as well as a value that monetises the disutility or pain and suffering associated with disease. The range of methods and estimated benefits can make it challenging to identify a best practice approach. The present session aims to address certain methodological aspects related to the economic evaluation of health impacts, which still generate some controversy and debate, with particular emphasis on the following topics: • Approaches for synthesizing evidence on health impact pathways and economic evaluation of health impacts for a better decision choice; • Health metrics: influence on the conclusions of economic analysis within HIA; • Sources of metrics used for economic analysis; • Uncertainties inherent to economic valuation of health outcomes: how to deal with it. Key messages • The economic analysis of health impacts can help prioritizing aspects with the greatest impact on population health, facilitating a more effective use of human and economic resources. • The economic analysis within HIA can improve decision-making but requires careful consideration of health metrics, sourcing of data, and management of uncertainties.

Touchscreen response precision is sensitive to the explore/exploit tradeoff.

The explore/exploit tradeoff is a fundamental property of choice selection during reward-guided decision making. In perceptual decision making, higher certainty decisions are more motorically precise, even when the decision does not require motor accuracy. However, while we can parametrically control uncertainty in perceptual tasks, we do not know what variables - if any - shape motor precision and reflect subjective certainty during reward-guided decision making. Touchscreens are increasingly used across species to measure choice, but provide no tactile feedback on whether an action is precise or not, and therefore provide a valuable opportunity to determine whether actions differ in precision due to explore/exploit state, reward, or individual variables. We find all three of these factors exert independent drives towards increased precision. During exploit states, successive touches to the same choice are closer together than those made in an explore state, consistent with exploit states reflecting higher certainty and/or motor stereotypy in responding. However, exploit decisions might be expected to be rewarded more frequently than explore decisions. We find that exploit choice precision is increased independently of a separate increase in precision due to immediate past reward, suggesting multiple mechanisms regulating choice precision. Finally, we see evidence that male mice in general are less precise in their interactions with the touchscreen than females, even when exploiting a choice. These results suggest that as exploit behavior emerges in reward-guided decision making, individuals become more motorically precise reflecting increased certainty, even when decision choice does not require additional motor accuracy, but this is influenced by individual differences and prior reward. These data uncover the hidden potential for touchscreen tasks in any species to uncover the latent neural states that unite cognition and movement.

Conflicts, crop choice, and agricultural investments: Empirical evidence from Nigeria

Conflict remains a major driver of poverty in Africa. Conflicts and political instability in the region have been increasing recently and are drawing more attention in public discourse. While it is widely acknowledged that conflicts disrupt agricultural production and food systems, the full extent of the damage inflicted on the lives and livelihoods of farming households and the mechanisms to redress this harm remain poorly understood. In particular, the link between violent conflicts and households’ land allocation and related agricultural investment decisions remains understudied. In this study, we use geocoded longitudinal data along with detailed agricultural panel household surveys in Nigeria to assess the impact of violent conflicts on crop choice decisions and related agricultural investments. Specifically, we explore how farmers’ land allocation and agricultural investment decisions relate or respond to the outbreak and intensity of violent conflicts. We find that violent conflicts are associated with a reduction in the share of both land area cultivated and area harvested. We also find suggestive evidence that violent conflicts may shape farmers’ crop choices and related investments, as violent conflicts are associated with reduction in the share of land allocated to long-term crops (e.g., perennial crops, trees, roots and tubers). Overall, our findings suggest that violent conflicts can negatively influence farmers’ agricultural investments directly by affecting both land utilization patterns and portfolio allocation across activities with varying returns to investments.

Displaying Altruism as a Sexual Signal in Human Mate Choice is an Adaptation – An Interdisciplinary Overview of the Evidence

AbstractNumerous studies in humans have shown that altruism may influence mate choice decisions, highlighting its potential role as a sexual signal. Whether using altruism as a signal is an adaptation, however, remains largely unresolved. In this review, we aim to investigate the adaptive nature of altruism as a sexual signal by constructing a comprehensive nomological network of evidence. Drawing upon interdisciplinary scientific modes of evidence (psychology, medicine, physiology, genetics, phylogenetics, hunter-gatherer studies, cross-cultural studies, and theoretical studies), our analysis reveals an extensive breadth of evidence across the various disciplines supporting the hypothesis that altruism is an adaptive sexual signal. However, only the psychological evidence demonstrates substantial depth. Other fields exhibit a lack of variation in research methods or a minimal amount of studies, limiting the strength of their respective contributions. Despite these limitations, there is still sufficient support for the nomological network. Based on the evidence of the various disciplines, we conclude that there is sufficient support that altruism as a sexual signal is an adaptation. We provide considerations for future research that would expand the scope of the evidentiary depth across the various disciplines, which would strengthen our understanding of the role of sexual selection in human altruism.

The Influence of Social Media on College Choice among Undergraduates Majoring in Big Data Management and Application in China: Taking Guilin University of Electronic Technology as an Example

This study aims to investigate the influence of social media on college choice among undergraduates majoring in Big Data Management and Application in China. The study attempts to reveal how information on social media platforms such as Weibo, WeChat, and Zhihu influences the cognition and choice process of prospective students. By employing an online quantitative survey questionnaire, data were collected from the 2022 and 2023 classes of new students majoring in Big Data Management and Application at Guilin University of Electronic Technology. The aim was to evaluate the role of social media in their college choice process and understand the features and information that most attract prospective students. Social media has become a key factor influencing the college choice decision-making of undergraduates majoring in Big Data Management and Application in China. Students tend to obtain school information through social media platforms and use this information as an important reference in their decision-making process. Higher education institutions should strengthen their social media information dissemination, providing accurate, timely, and attractive information. It is also necessary to ensure effective management of social media platforms, maintain a positive reputation for the school on social media, and increase the interest and trust of prospective students. Simultaneously, educational decision-makers should consider incorporating social media analysis into their recruitment strategies to better attract new student enrollment. This study provides a new perspective for understanding higher education choice behavior in the digital age, particularly by revealing the importance of social media in the educational decision-making process. This has important practical and theoretical implications for higher education institutions, policymakers, and social media platform operators.

Dating algorithms? Investigating the reciprocal relationships between partner choice FOMO, decision fatigue, excessive swiping, and trust in algorithms on dating apps

Dating apps have changed the way people establish contact with potential romantic partners. However, more and more dating apps use algorithms to keep their users’ engagement high. Studies suggest that trust in algorithms can shape offline dating experiences. We theorize that excessive swiping, driven by fear of missing out, predicts trust. We also explore the role of decision fatigue. Findings from a two-wave panel study with NTime2 = 521 young dating app users suggest that the fear of missing out on potential romantic partners was positively related to decision fatigue on dating apps. Moreover, excessive swiping and decision fatigue were positively related to trust in algorithms. No reciprocal effects of trust in algorithms on excessive swiping or decision fatigue were observed. It seems that trust in algorithms might present some kind of relief strategy for compulsive behaviors such as excessively swiping, or for negative feelings such as decision fatigue.

IMPACT ASSESSMENT OF INFORMATION TECHNOLOGY ON INVESTMENT CHOICE DECISIONS OF ACADEMIC PROFESSIONALS

The substantial impact of information technology on investment decision-making is explored in this study, and strong empirical support is provided through a significant regression model. Understanding the extent to which technology influences investment choices is of utmost relevance in a time of fast technological advancement. The research makes use of a varied dataset that includes a variety of economic and market characteristics, employing robust statistical analysis to evaluate the relationship between technology and investment decisions. Our findings show that information technology and investing choices are statistically significantly correlated. The regression model illustrates how technology is increasingly being used into investment strategies and how it influences investors' decisions. This study emphasizes the importance of incorporating technical expertise into investment plans, with a focus on data analytics, artificial intelligence, and long-term tech investments. Furthermore, the ease with which mutual funds can be invested in, with alternatives for both novice and experienced investors, has made them a practical and accessible option as the study points mutual funds as the most preferred option for investment. Their liquidity and transparency also resonate with investors who appreciate the ability to monitor their investments easily and access their funds when needed. The results of the study highlight how crucial it is to comprehend investor preferences for financial goods. The popularity of mutual funds not only demonstrates their benefits but also emphasizes the necessity for financial institutions and advisors to customise their services and products in order to meet investor needs. KEYWORDS: Information Technology, Investment Choice Decisions, Mutual Funds

Travel mode choice behavior analysis using multinomial logit models towards creating sustainable college campus: a case study of the University of Toledo, Ohio

By employing descriptive statistics and multinomial logistic regression models, the paper investigates factors that affect the travel mode choice behavior of a college community for both commuting to the campus from their residences and commuting on campus from one facility to another. Results show that car ownership, travel distance, age, gender, academic status, income, perception of safety, number of weekly trips, and weather conditions affect people’s mode choice decisions significantly. The study finds that increasing travel distance, age, and being a staff member positively impact car mode choice, faculty members are more likely to bike and walk compared to undergraduate students, and unlike the authors’ predictions, the higher-income people are more likely to walk on campus. Results also reveal that car users change travel modes more often than active transport mode users based on semesters and that although women are less likely to bike to the campus, they are more likely to walk and bike on campus. If the number of trips increases, people prefer cars to walk, bike, and ride a bus to commute to the campus while they prefer walking to driving a car on campus. The study contributes to help create pollution-free and healthy urban college campuses that, on larger scales, will further contribute to developing sustainable cities to achieve the Sustainable Development Goals as described by the United Nations, particularly goal number 11, “to make cities and human settlements inclusive, safe, resilient and sustainable,” and thereby contribute to improving urban living conditions.

A dynamic discrete choice modelling approach for forward-looking travel mode choices

In this paper, we present a systematic approach based on dynamic discrete choice models (DDCM) to investigate individuals’ forward-looking mode choice behaviours in daily travel tours with multiple destinations. We propose a novel network transformation model that encompasses the entire decision space of all feasible mode combinations for every observed trip/tour in the dataset. By applying the well-established Recursive Logit model structure commonly used in path choice modelling, we address the tour mode choice problem effectively and quantify forward looking considerations in the mode choice process. The proposed model captures the complex considerations individuals take into account when making mode choices. The network transformation incorporates downstream mode limitations into the preceding mode choice options, enabling us to model individuals’ forward-looking behaviour and gain insights into how considerations of future trips such as a shopping in the evening, or school pick-up trip influence previous mode choice decisions earlier in the day. Uncovering and quantifying these hidden forward-looking factors can help modellers better explain the private car usage usually observed for the entire sequences of daily trips, even in presence of competitive alternative modes. The proposed network transformation also enables us to measure the effect of the requirement/preference to return private vehicles (car, motorcycle, and bicycle) home on mode choices in home-bound trips, and subsequently, on the entire daily mode choice decisions. To validate the proposed model, we utilise the VISTA household travel survey data from the Melbourne Metropolitan area in Australia. The model is compared against baseline models, demonstrating its statistical advantages. Additionally, intuitive illustrations using the data showcase the model’s efficacy. From transport planning and policy perspective, tour-based mode choice modelling provides a more comprehensive and precise understanding of travel behaviour by considering the sequence of trips made by an individual. This can help capture the interactions and dependencies between different trips, which trip-based models may overlook. The proposed model is more suitable for analysing the effects of policy interventions like congestion pricing, public transport investments, or new mobility initiatives, as they can better represent the cascading effects of such policies across multiple trips.

Odour information enables patch choice by mammalian herbivores from afar, leading to predictable plant associational effects

Abstract Neighbouring plants can alter the susceptibility of high‐quality focal plants to herbivores by affecting herbivore patch choice. Herbivores can use plant odour to make patch‐scale foraging decisions from afar, but the actual information they rely on within complex plant odours is rarely defined. Revealing the information enabling patch choice by herbivores will provide the mechanistic link underpinning associational effects of plant neighbours arising from these foraging decisions. Here, our first aim was to test whether odour cues alone enable a mammalian herbivore to make patch choice decisions leading to predictable associational effects of neighbours on high‐quality focal plants. Our second aim was then to test whether artificial odour, designed to mimic the informative odour component within the whole odour profile of low‐quality neighbours, is as effective as real plants in influencing patch choice and associational refuge. We tested patch choice by African elephants, Loxodonta africana using a giant Y‐maze and real or artificial plant odours as the only cues for the neighbours of a high‐quality focal plant. We quantified the probability of various odour treatments being chosen in comparison with the odour of a focal plant alone. Compared with focal plants alone, we found that elephants were more likely to choose patches with the focal plant plus high‐quality neighbours of the same or different species, but less likely to choose patches with the focal plant plus low‐quality neighbours. We also demonstrated that an artificial subset of odours, designed to be informative, were as effective as real low‐quality neighbours in influencing patch choice and hence associational refuge to the focal plant. Our results demonstrate a key role of plant odour—and specifically informative components within complex odour profiles—in patch choice decisions by a mammalian herbivore, leading to plant associational effects on high‐quality focal plants. Understanding what olfactory information herbivores use when deciding which patches to visit or avoid, and how it affects focal plant susceptibility is important ecologically. Non‐random patch choice will not only affect individual fitness of herbivores, but also shape plant community dynamics through impacting plant survival and recruitment. Furthermore, artificially re‐creating odour information could offer a new tool to influence herbivore foraging decisions, with implications for wildlife management and conservation, including plant protection. Read the free Plain Language Summary for this article on the Journal blog.

Safety and bicycle route choice – To what extent does accident risk and perceived safety influence bicycle route choice?

Safety is a major issue in bicycle traffic and understanding safety-related factors that influence bicycle route choice is crucial for improving safety and promoting sustainable transportation. However, there is a notable lack of research on the impact of accident risk and perceived safety on cyclists' route choice. This study addresses this gap by investigating whether accident-prone areas or perceived insecure locations affect actual route choice decisions. The contribution explores this relationship by leveraging an extensive dataset comprising approximately 4,000 trips from around 170 participants, alongside additional data on infrastructure, operations, exposure, accidents, and mobility diaries on critical incidents. The findings broadly confirm the results from other studies regarding the influence of route characteristics (e.g., existence of cycling infrastructure, traffic volumes of motorized traffic, or presence of signal-controlled intersections). Moreover, the study reveals that a high accident risk along a route does have a slight negative influence on route choice. Surprisingly, perceived safety does not significantly influence route choice of cyclists.

Increasing the Confidence of Local Brand Through Package Design and Information Label

Packaging design issues are rapidly gaining the attention of researchers as evidence indicates that most consumers are making choice decisions based on product package design. Furthermore, product information on packaging, such as ingredients and nutrition information, also increases consumers’ attention since consumers are concerned about healthy products. This study seeks to develop a theoretical model to show the effects of consumer attitudes toward visual food packaging and information labels on brand awareness and purchase intention. Six hundred fifty people completed a self-administered online questionnaire based on the literature. The empirical results show that attitudes toward visual packaging and information labels directly impact brand awareness and indirectly (through brand awareness) influence purchase intention. Surprisingly, the comparison between global and local brands shows no differentiation between global and local brands. It means the local brands can compete with the global brands. Additionally, this research indicated no differentiation between high and low business reputations. It implies that consumers in Indonesia have positive perceptions and the same favorability for any brand. This study provides managers with insights emphasizing the visual packaging design factors and informative labels to form consumers’ brand awareness and influence purchase intention.

Exploring sustainable livelihood options for COVID-impacted rural communities in Bangladesh

The COVID pandemic paralyzed all economy-generating sectors of Bangladesh, putting abrupt pressure on livelihood-making. In this study, two sequential surveys were conducted in the Mymensingh district of Bangladesh to gain a deep understanding of the impacts of COVID on job status and post-COVID job preference. The effectiveness of preferred occupations in livelihood resilience within the Sustainable Livelihood Approach (SLA) framework was also empirically analyzed and people-driven policies were recommended for sustaining livelihoods. About 35.96 % of respondents experienced short-to long-term unemployment and migrated to rural areas. The groups most severely affected were predominantly engaged in both formal and informal employment, characterized by lower levels of education, older age brackets, and predominantly female (45 out of 114). In the COVID situation, a large portion of respondents adopted agriculture (18.42 %), aquaculture (10.53 %), livestock farming (5.26 %), and small businesses (13.27 %) as their means of livelihood. However, for post-COVID preferences, respondents remained limited to only 13 job categories, considering aquaculture (22.02 %), agriculture (19.90 %), and livestock farming (26.22 %) as their most desired sectors. Considering all five capitals within the SLA framework, aquaculture and livestock farming were found to be more effective in bringing livelihood resilience within COVID-affected rural communities than agriculture. However, the greater advantages that aquaculture offers in achieving post-COVID livelihood led the authors to consider aquaculture as a decisive choice for policy recommendation. Therefore, the study proposed 28 people-oriented policies under four broad categories (financial support, technical assistance, marketing and logistics, and governance and institutional) in making sustainable livelihoods from aquaculture where financial support takes precedence as their top priority.

Determinants of Patient Preference for Private Hospitals Over Public Hospitals: An Empirical Study

Introduction: There are several choices when it comes to choosing the type of hospital. In Nepal, the general public is free to seek medical attention from any facility they feel is suitable for them. People have to make vital decisions while choosing a hospital because these decisions relate to health and relieve them from any burden regarding their health. There is a preference for private hospitals over public ones. Despite the relatively cheaper cost of care in public hospitals, such a setup was not preferred by the people; this observation motivated us and created a need to conduct a research study to validate the observation statistically. This study examines reasons why private hospitals are preferred by patients over public ones. Methods: The quantitative description research methodology has been adopted for this study. Developmental research approach is used in conducting this study through quantitative descriptive research. The researcher has followed a deductive research approach to examine the hypotheses we had set up with respect to their significance. Only 117 responses out of the 120 persons of the sample were found to be significant for the research study. A structured questionnaire was designed based on a five-point Likert scale. Random sampling was selected because of the probability sampling methodology used for the research study. Findings: In Tarkeshwor Municipality, the general public does not select a private hospital over a public hospital considering their income. There is no visible relation between the level of hospital services, treatment costs, and hospital selection criteria with income level of respondents. Three dependent variables—service quality, cost, and individual selection motive—have an influence on hospital choice decisions. The vast majority of the respondents appeared to make some kind of valuation about the value for money of the hospitals they visited, irrespective of their income. Since there exists a strong positive correlation between the cost and service mean, they attach higher costs to higher quality of service. Service quality: When asked about service quality, most of the respondents replied that what inclined their preference towards private hospitals and not government-run ones was the short waiting time and up to date medical equipments. Conclusion: Hence, based on this, it can be concluded that the choice of hospitals among the public is determined in view of the cost of treatment and hospital selection motives, such as access to up-to-date medical technology and lesser wait times and so on, rather than by income, which is not related to any of the dependent variables: service quality, treatment costs, and selection motives for hospitals.

Women’s Bargaining Power and Children’s Nutritional Status: Evidence from Indonesia

Child stunting is a serious challenge in Indonesia, one of the largest middle-income countries in the world. Beyond the influence of bio-behavioral determinants, mothers’ bargaining power in the household is expected to have an overarching contribution to stunting, particularly as the primary caregivers of their children. Using a dataset from the fifth wave of the Indonesia Family Life Survey (IFLS-5), this study examines whether and to what extent a mother’s bargaining power influences children’s nutritional status. The study uses the instrumental variables method to correct the potential endogeneity of the mother’s bargaining power. Results suggest that children of mothers with higher intrahousehold bargaining power have a lower prevalence of stunting and better anthropometric outcomes. However, other members of the household matter, in the sense that improved outcomes are evidenced when the mother exercises her choice in decision making in a more consensual manner, by consultation with other household members. HIGHLIGHTS In Indonesia, higher women’s bargaining power enhances child nutritional long-term outcomes. Child nutrition improves when women make decisions jointly with other family members. Boys appear to be the main beneficiaries of mothers’ higher bargaining power. Policies to increase women’s agency need to consider family support and social norms.