Maternal and infant health is closely related to human resource accumulation, and is an important task in the Healthy China 2030 blueprint. Rural areas suffer from weak maternal and infant health, and the demand-side health policy is considered as a principal instrument to address this problem. This paper focuses on the hospitalized delivery subsidy policy in rural areas, which was implemented on a large scale in 2008. Using the information on policy implementation and birth cohort, this paper constructs a DID identification strategy, and investigates the effect of the policy on the hospitalized delivery rate and further on maternal and infant health. To our knowledge, this paper is the first to conduct an evaluation of this policy within a causal investigation framework. It sheds light on the future improvement in the maternal and infant health policy and the demand-side health policy in a broader sense.
The study finds that the hospitalized delivery subsidy policy has significantly improved the hospitalized delivery rate in rural areas, and the effect has been cumulated over time. By region, the effect is in alignment with the policy’s intention to help the disadvantaged central and western areas; the effect is quite limited among low-income and multiparous women, indicating insufficiency in terms of helping the weak; the effect on hospitalized delivery rate increases with the density of health institutions, reflecting the importance of simultaneous supply-side health reform. The analysis on maternal and infant health shows that the policy has been effective in improving maternal health, through enhancing delivery technique. However, the policy has not exerted a positive effect on the scientific parenting behavior, and thus is found unable to improve infant health. The density of health institutions could enhance the effect of the policy on maternal and infant health.
The policy implications are as follows: This paper calls for special policy attention to low-income and multiparous women and make these groups the real beneficiaries of hospitalized delivery; to enhance the effect of the demand-side health policy, it is necessary to increase the density of health institutions and improve health service quality; the demand-side health policy should work on effective health education, so as to cultivate scientific parenting and improve maternal and infant health in the long run.