Reproduction and maternal health care among young women in Kenya: geographic and socio-economic determinants

Many factors influence the propensity of young women to seek appropriate maternal healthcare, and they need to be considered when analyzing these women’s reproductive behavior. This study aimed to contribute to the analysis concerning Kenyan young women’s determinants on maternal healthcare-seeking behavior for the 5 years preceding the 2008/9 Kenya Demographic and Health Survey. The specific objectives were to: investigate the individual and contextual variables that may explain maternal healthcare habits; measure the individual, household and community effect on maternal healthcare attitudes in young women; assess the link between young women’s characteristics and the use of facilities for maternal healthcare; find a relationship between young women’s behavior and the community where they live; examine how the role of the local presence of healthcare facilities influences reproductive behavior, and if the specificity of services offered by healthcare facilities affects their inclination to use healthcare facilities, and measure the geographic differences that influence the propensity to seek appropriate maternal healthcare. The analysis of factors associated with maternal healthcare-seeking behavior for young women in Kenya was investigated using multilevel models. We performed three major analyses, which concerned the individual and contextual determinants influencing antenatal care (discussed in Part 6), delivery care (Part 7), and postnatal care (Part 8). Our results show that there is a significant variation in antenatal, delivery and postnatal care between communities, even if the majority of variability is explained by individual characteristics. There are differences at the women’s level on the probability of receiving antenatal care and delivering in a healthcare facility instead of at home. Moreover, community factors and availability of healthcare facilities on the territory are also crucial in influencing young women’s behavior. Therefore, policies addressed to youth’s reproductive health should also consider geographic inequalities and different types of barriers in access to healthcare facilities.

"Ancestry, gender and language - The role of culture in economic development"

This thesis is a combination of research questions in development economics and economics of culture, with an emphasis on the role of ancestry, gender and language policies in shaping inequality of opportunities and socio-economic outcomes across different segments of a society. The first chapter shows both theoretically and empirically that heterogeneity in risk attitudes can be traced to the ethnic origins and ancestral way of living. In particular, I construct a measure of historical nomadism at the ethnicity level and link it to contemporary individual-level data on various proxies of risk attitudes. I exploit exogenous variation in biodiversity to build a novel instrument for nomadism: distance to domestication points. I find that descendants of ethnic groups that historically practiced nomadism (i) are more willing to take risks, (ii) value security less, and (iii) have riskier health behavior. The second chapter evaluates the nature of a trade-off between the advantages of female labor participation and the positive effects of female education. This work exploits a triple difference identification strategy relying on exogenous spike in cotton price and spatial variation in suitability for cotton, and split sample analyses based on the exogenous allocation of land contracts. Results show that gender differences in parental investments in patriarchal societies can be reinforced by the type of agricultural activity, while positive economic shocks may further exacerbate this bias, additionally crowding out higher possibilities to invest in female education. The third chapter brings novel evidence of the role of the language policy in building national sentiments, affecting educational and occupational choices. Here I focus on the case of Uzbekistan and estimate the effects of exposure to the Latin alphabet on informational literacy, education and career choices. I show that alphabet change affects people's informational literacy and the formation of certain educational and labour market trends.