An econometric analysis of the determinants of fertility and the demand for prenatal care services in Guatemala

This dissertation analyzes three important topics to the health care sector of developing countries: fertility, the choice of prenatal care provider and the demand for prenatal care visits using data from the Guatemala Survey of Family Health collected in 1995. ^ A poisson count model is estimated to analyze the determinants of fertility. The results show that education and income are important determinants of fertility as reported in previous studies. Income is negatively related to fertility indicating possible trade-off between the quality and quantity of children. Furthermore, unlike other studies, this analysis introduces health beliefs in the fertility model and found that the adoption of the germ theory of disease is positively related to fertility. ^ The dissertation also analyzes two aspects of prenatal care services: the choice of the first prenatal care provider and the demand for prenatal care visits. Based on a logistic regression model, the results show that the choice of midwives as first providers is less determined by money and time prices than by non-economic factors. Non economic factors such as education, the presence of health problems and the knowledge of the Spanish language are the key determinants of the process of selecting the first prenatal care providers. ^ A negative binomial model is also estimated to analyze the determinants of the number of prenatal care visits demanded. The results show that Guatemalan women perceive midwife prenatal care as a substitute for biomedical prenatal care. Moreover, education and health beliefs are key determinants of the quantity of midwife prenatal care visits demanded.