Son preference, maternal health care, and infant death in rural China

It is widely known that adequate maternal health care is an important factor for prevention of avoidable maternal, infant, and child morbidity and mortality, and adverse pregnancy outcomes. Inadequate maternal health care utilization is often linked with social and cultural constraints and poor organizational policies. However, recent literature also suggests that the evidence for the effectiveness of prenatal care on reducing adverse health outcomes including infant mortality remains insufficient and further research is needed by taking into account socioeconomic, demographic, cultural, and environmental conditions. Based on a nationally representative data of the 2001 National Family Planning and Reproductive Health Survey, this study uses multilevel logistic regression models to assess the effects of socioeconomic conditions and interaction between son preference and one-child family planning policy on use of maternal health care and their effects on infant death in rural China. The present study takes into account the effect of very likely sex-selective abortion on use of maternal health care and the effect of also very likely underreporting of birth and infant deaths on the estimated socioeconomic differentials in use of maternal health care and infant death. Our result shows that despite a possible link between use of prenatal sex sex-selective abortion and use of maternal health care and very likely underreporting problem, the observed socioeconomic and gender differentials in use of maternal health care and infant death in rural China is still substantial. The effects of maternal health care on infant deaths and their policy implication will also be discussed.