OSIPP Discussion Paper : DP-2010-E-010

Endogenous Women’s Autonomy and the Use of Reproductive
Health Services: Empirical Evidence from Tajikistan

December 15, 2010

Yusuke Kamiya

Ph.D candidate, Osaka School of International Public Policy (OSIPP)【Keywords】Female autonomy; Antenatal care; Delivery care; Reproductive healthservices; Tajikistan; Bivariate probit model【JEL classification】J12, J13, J16【Abstract】Though gender equity is widely considered to be a key to improving
maternal health in developing countries, little empirical evidence has been presented tosupport this claim. This paper investigates whether or not and how female autonomy
within the household affects women’s use of reproductive health care in Tajikistan,where the situation of maternal health and gender equity is worse compared withneighbouring countries. Estimation is performed using bivariate probit models in which
woman’s use of health services and the level of female autonomy are recursively andsimultaneously determined. Empirical results reveal that female autonomy measured by
women’s decision-making on child wellbeing and on economic affairs within thehousehold increases the probability of receiving both antenatal and delivery care.
Policymakers need to address women’s empowerment in the household in addition to
implementing direct health interventions towards improvement of maternal health.
Address: Osaka School of International Public Policy, Osaka University, 1-31 Machikaneyama, Toyonaka,
Osaka 560-0043 Japan, Tel/Fax: (81) 6-6850-5839, E-mail address: y-kamiya@osipp.osaka-u.ac.jp I
acknowledge Professor Naoto Yamauchi, Osaka School of International Public Policy, for permitting me
to publish this paper.

11. Introduction
Improvement of maternal health has become a global agenda as it is clearly stipulated as
the fifth target of Millennium Development Goals (MDGs). However, maternal mortality
ratio in developing countries declined by just 6% from 430 per 100,000 live births in 1990
to 400 per 100,000 live births in 2005, whilst under-five mortality rate fell by 28% during
1990-2007. One possible reason for this stagnation is uneven and inequitable utilisation of
reproductive health care services (Gill et al., 2007). It has been confirmed that almost 80%
of maternal deaths could have be prevented if women had had access to essential
reproductive health care (Wessel et al., 1999, Bartlett et al., 2005, Kilpatrick et al., 2002).
In particular, early timing and high frequency of antenatal visits help to identify andmitigate the risk of threatening lives of mothers and newborns by helping to reachpregnant women with multiple vital interventions for their health (Taguchi et al., 2003,
Abou-Zahr and Wardlaw, 2003, Bloom et al., 1999). At birth delivery, skilled birthattendants, i.e. doctors, nurses or midwives with a diploma, in well-equipped facilities
play vital roles in averting deaths from pregnancy complications (UNICEF, 2009).
Although recent studies have questioned the effectiveness of antenatal care in preventing
maternal deaths (Carroli et al., 2001), there is a wide consensus that appropriate
reproductive health services contribute to better pregnancy outcomes for mothers andnewborns through timely preventive measures (Campbell and Graham, 2006, Adam et al.,2005). Nevertheless, many women in the developing regions confront the difficulty of2

accessing to adequate antenatal and delivery care due to multiple layers of constraints.
Among all, gender equity, i.e. environment which respects women’s rights and theirsocioeconomic status, has been increasingly realized as a crucial factor in assuring further
access to reproductive health. Actually, there was a long process of linking reproductive
health issues to gender equity, human rights and development throughout several
benchmarking events such as the International Conference on Population andDevelopment (ICPD) in Cairo in 1994, the Fourth World Conference on Women in
Beijing in 1995, ICPD+5 in 1999, and the Women Deliver in London in 2007 and in
Washington, D.C. in 2010. In accordance with these movements, the second target of
MDG 5 which seeks the universal access to reproductive health was introduced in 2005.
Improvement of access to reproductive health care is a special interest of
Tajikistan, where the situation of maternal health is worse compared to neighbouring
countries. Table 1 summarises indicators on maternal health and gender equity in Central
Asia. Maternal mortality ratio in Tajikistan is among the highest in the region, i.e. 170 per
100,000 live births in 2005. Utilization of reproductive health care is also lower thanneighbouring countries. For instance, the percentages of women who visited at least one
antenatal consultation and at least four antenatal consultations are 89% and 49%
respectively. Regarding gender equity, all of the listed indicators in Table 1, i.e. female
earned income, enrolment and attendance ratios, female life expectancy relative to men,and contraceptive prevalence in Tajikistan are the lowest in the region. Previous studies

3

identified socioeconomic and demographic determinants of reproductive health care use
among women in Tajikistan, using household survey datasets (Habibov and Fan, 2008,
Falkingham, 2003, Fan and Habibov, 2009). However, they do not scrutinize the role ofgender in reproductive health. For this reason, this paper aims to examine whether or not
and how female autonomy within the household affect women’s utilisation of healthservices in Tajikistan.

<Table 1>

2. Literature Review
In this section, I review the literature on the effects of female autonomy in affecting
reproductive health care utilisation in developing countries. A number of empirical studies
have clarified factors hampering women’s access to reproductive health care in developing
countries (Anson, 2004 for China, Navaneetham and Dharmalingam, 2002, Chandrashekar
et al., 1998, Bhatia and Cleland, 1995 for India, Mahabub-Ul-Anwar et al., 2006 for
Bangladesh, Fatmi and Avan, 2002 for Pakistan, Hotchkiss, 2001, Allendorf, 2007 for
Nepal, Obermeyer and Potter, 1991 for Jordan, Phoxay et al., 2001 for Laos, Sepehri et al.,2008, Trinh et al., 2007 for Viet Nam, Erbaydar, 2003 for Turkey, Magadi et al., 2000 for
Kenya, Gage, 2007 for Mali, LeVine et al., 1991 for Mexico, Wehby et al., 2009a forArgentina, Wehby et al., 2009b for Brazil, Pebley et al., 1996 for Guatemala, Vecino-4

Ortiz, 2008 for Colombia, Elo, 1992 for Peru, Jewell, 2009 for Bolivia, Columbia andPeru, and for systematic reviews see: Simkhada et al., 2008, Say and Raine, 2007).
Recently, a growing body of literature confirm that intra-household women’s status asmeasured by education, employment, intimate partner violence affects their access to
reproductive health services (Bloom et al., 2001, Gill et al., 2007, Blanc, 2001, Beegle etal., 2001, Matsumura and Gubhaju, 2001, Becker et al., 2006, Furuta and Salway, 2006).
In contrast, some other studies also find that female autonomy within the household has
only a weak or no effect on women’s health care use (Simkhada et al., 2008, Fotso et al.,2009). The problem entailed in the above studies is the assumption that female autonomy
is exogenous to household’s decision-making on women’s use of reproductive healthservices. Because female autonomy is highly likely to be determined through negotiation
processes among family members which reflect the socioeconomic background of bothwife and husband, empirical models which do not take into account this simultaneous
relationship would yield biased results.
Several recent economics literature explicitly tackles this endogeneity problem in
the analysis on intra-household decision-making. Basu, 2006 proposed an “endogenous
power” theoretical model in which female autonomy is determined endogenously throughnegotiation processes within the household. Following this framework, Lancaster et al.,2006 and Maitra and Ray, 2005, confirmed statistically significant effects of a genderbalance of power on household expenditure patterns under the assumption of an5

endogenous balance of power within the household for micro datasets from India andAustralia respectively. These results justify the use of the endogenous power model for
analysing intra-household decision-making processes like this paper. The following
analysis therefore adopts this framework to examine the relationship between female
autonomy and women’s use of reproductive health care.

3. ModelTraditionally, models to analyze the household decision-making are based on the unitary
approach in which household preferences are defined over a single utility function subject
to income constraints (Becker, 1981). Underlying assumption of the unitary model is thateither family members’ preferences are the same, or individual preferences are aggregatedinto a single utility. Nevertheless, this assumption was found to be inappropriate toreconcile the fact that there are many individuals within the household who have different
preferences. A growing number of empirical results reject the validity of the unitary
approach (Schultz, 1990, Quisumbing and Otsuka, 2001, Udry, 1996). Accordingly, moregeneral approach—collective household model—was developed to illustrate intrahousehold decision-making processes. In particular, Chiappori, 1988 suggested acollective model which incorporates an intra-household resource allocation under the
Pareto-efficient sharing rule with certain regularity conditions. I hence apply this Paretoefficient collective household model in which each adult (f=female, m=male) has a6distinct utility which is defined over each members’ consumption, leisure and child health.
The household utility function is defined as a weighted product of the utility of both
members, with weights capturing an intra-household balance of power. The utility
function of the woman (= wife) and the man (= husband) is expressed as a function of abundle of commodities including consumption goods ( ), leisure ( ) and child healthstatus (c):[1]  =   ,  , = ,Child health production function is written as:[2]  = ; 
where r represents health inputs and  denotes a household’s health production efficiency
parameter. Couples choose  ,  , and  to maximize the following composite function:[3]Max   ,  ,   −     ,  , −   subject to the full income constraint:[4] !"  +  + !$  ≤ & ' −  + & ' −  + ( + (where  and  denote the “threat utility” which represents the utility that wife andhusband would receive outside the household if the household dissolves. ) ∈ 0,1 is thePareto weight of a gender balance of power which indicates women’s autonomy within thehousehold. Woman’s autonomy increases as ) augments. !" , !$ and (1 − & ) represent
prices of consumption goods, health inputs, and leisure (i.e. price of labour = & )7

respectively. ' and ' are time endowments. ( and ( are unearned income by the
woman and the husband respectively.
By solving the above maximization problem, a reduced form demand function forchild health input is obtained as:[5]  = !, & , ( ,  , ); = ,For the empirical analysis, r is defined over a price vector (p) consisting of !" and!$ , price of labour (& , woman’s autonomy ()), and characteristics of individuals—
woman and husband (-. )—, household (-/ ) and community (-0 ):[6]  = !, & , ), -. , -/ , -0

= ,Univariate probit model
In the following analysis, I treat the child health input (=) as a binary variable since I
focus on whether or not women utilises antenatal and delivery care for the better healthchild health outcomes. I hence employ probit models for the empirical estimations. I first
adopt the univariate probit model to assess the relationship of female autonomy within thehousehold with women’s receipt of reproductive health care by assuming that female
autonomy is exogenously determined. I let  ∗ be a latent variable which denotes theprobability that the woman will receive reproductive health care.  ∗ depends on the female
autonomy ( ) ) within the household and a vector of individual-, household- and8community-level factors ( 2 ). The univariate probit model is therefore expressed asfollows.
[7]  ∗ = 3) + 24 + 5
=6

1
0

 ∗ > 08∗ ≤ 0where  is a binary variable that takes  = 1 if the woman receives a specific reproductive
service, or  = 0 otherwise. 5 is an error term.

Bivariate probit model
The univariate probit model described above assumes that female autonomy within thehousehold is exogenously given, which may bring about biased results. I therefore apply
the “endogenous power” model to estimate the role of female autonomy following theliterature review in the previous section. For the estimation, I use the bivariate probit
model in which female autonomy and women’s receipt of health services are
simultaneously determined inside the model. The bivariate probit is a joint model for two
binary outcomes which may be correlated with each other (Greene, 2007, Greene, 1998).
It also allows one of the binary outcomes, i.e. female autonomy in this case, to be included
as a covariate of the other binary outcome, i.e. women’s receipt of health care. Greene,
1998 shows that estimators from the bivariate probit model becomes consistent andefficient when dependent variables in two equations are binary, and omitted variables arecorrelated with each other. The bivariate probit model is specified as follows.

9[8]  ∗ = 3) + 24 + 9
=6

 ∗ > 08∗ ≤ 01
0[9] ) ∗ = 2: + 9;)=6)∗ > 0 8) ∗ ≤ 0,1
0where ) ∗ is a latent variable which denotes the level of female autonomy within thehousehold. ) is a binary variable that takes ) = 1 if the female autonomy is high, or ) = 0
otherwise. The error terms 9 and 9; are jointly normally distributed with means of 0,
variances of 1, and correlations of <. If the error correlation < is 0, the model collapses
into two probit models for  and ).
The probability that a woman receives reproductive health care when the level offemale autonomy in the household is high, for instance, can be written as[10] !=> = ?@A = 1, ) = 1= ?@A2 <  , 2; < ;
"I

"G

H

H

=C C

D , D; ; E FD FD;

= J2 4 , 2; 4; ; E ,where F is the bivariate normal cumulative distribution function with correlation
coefficient E. The density
D , D; ; E = K

is given as:/; "GI M"II ;N"G "I / NI 

Q
2P1 − E; /;The log-likelihood function is10

WR S4 , 4; ; E = TU= × )= R J2= 4 , 2=; 4; ; E + ==X× 1 − )= R Y2= 4 J2= 4 , 2=; 4; ; E + 1 − = Y−2= 4 Z
where Y denotes the univariate standard normal distribution function.

4. Data
The data for the following analysis are from the Tajikistan Living Standards Survey(TLSS) 2007. The survey was conducted by the National Committee for Statistics
collaborating with the World Bank and UNICEF. TLSS 2007 was carried out from July to
November in 2007 to collect information about 4,860 households from 270 clusters. TLSS
2007 contains questions asked of women from 19 to 49 years old about their use of healthservices during pregnancy and birth delivery together with socioeconomic anddemographic variables of household members.
As dependent variables to represent the use of reproductive health services (=  , I
use the following four binary indicators: (1) At least one antenatal care = whether or not
the woman visited at least one antenatal care during the last pregnancy; (2) At least fourantenatal care = whether or not the woman visited at least four antenatal care during thelast pregnancy 1; (3) Skilled birth attendance = whether or not the woman was attended bya professional health worker, i.e. doctor, nurse or midwife with a diploma, at the last birth-

1

UNICEF and WHO recommend that the minimum number of antenatal visits during pregnancy is four.

11

delivery; and (4) Facility delivery = whether or not the woman used a health facility2 at
the last birth-delivery. The distribution of the number of antenatal visits is shown in
Figure 1.

<Figure 1>

As a proxy variable to represent female autonomy, I focus on women’s decisionmaking power within the household following the definition of female autonomy as “theability of women to make decisions within the household relative to their husband”(Anderson and Eswaran, 2009). TLSS 2007 contains questions about whether household’s
decisions on specific subjects are made by female or male members. Table 2 summarises
the descriptive statistics of all of 19 indicators on household’s decision-making. For theempirical analysis, I focus on three binary variables: (1) whether or not female members
make a decision on ‘children's wellbeing’; (2) whether or not female members make adecision on ‘buying major items’; and (3) whether or not female members make a decisionon ‘borrowing money’. Selection of these variables is based on the empirical findings
from past studies which show women’s involvement into decision-making on key aspectof life such as family planning and household economy is an important predator of

2

Health facilities include “city hospitals”, “SUB” (rural hospitals) and “SVA” (physician ambulatory
facilities)

12women’s capacity to access to maternal health services (Gill et al., 2007, Furuta and
Salway, 2006).

<Table 2>

Explanatory variables include socioeconomic and demographic factors at the levels
of individual (wife and husband), household and community. Of the individual-levelvariables, age, ethnicity, educational attainment, a plot area of land (in hectare) belonging
to each individual, and working status are included as common variables for both woman
and husband. Following Habibov and Fan, 2008, a dummy variable on the women’s
knowledge about issues related to sexual matters is included. Women are considered tohave wider knowledge about sexual matters if their primary source of information on
those issues is someone outside the household including friends, co-workers, doctors,
pharmacist, teachers, books, or the media. Women’s knowledge about sexual life is shown
to be positively related to use of reproductive health care in Tajikistan by past studies(Habibov and Fan, 2008). Household-level variables include the number of children,
household expenditure per capita, and the situation of water (= whether or not thehousehold treats water to make it safer to drink), sanitation (= whether or not thehousehold has either a flush toilet or a latrine with a septic tank) and communication
infrastructure (= whether or not the household has a telephone) in each household.

13

Community-level variables consist of regional dummies (Dushanbe as a reference, Sogd,
Khatlon, RRP, Gbao), and the number of health facilities including hospitals, women’s
consultation places and first aid (ambulance) services per community.
Table 3 summarises descriptive statistics. It shows that 46% of women are fromthe households in which female members make a decision on children’s wellbeing. On theother hand, women’s involvement into decision-making on economic affairs measured bydecisions on buying major items (19.0%) and borrowing money (18.3%) is very limited.
Turning to the variables about reproductive health care, the percentage of women who
attended to at least one and at least four antenatal visits during the last pregnancy is 86.2%
and 52.6% respectively. As many as 83.8% of women were attended by skilled
professionals, whilst just 16.1% of women used health facilities at their last birth-delivery.

<Table 3>

5. Results
Univariate probit estimates
Tables 4.a-4.c present the univariate probit estimates on the effects of female autonomy asmeasured by female members’ decision-making within the household on woman’s receipt
of antenatal and delivery care. The results show that women’s decision-making on child’s
wellbeing is positively associated with an increased use of skilled birth attendants and14

facility delivery at the less than 1% significance level, whilst it does not affect the receipt
of antenatal care. In contrast, decision-making on buying major items and borrowing
money does not exert any significant effect on women’s health care use.

<Tables 4.a-4.c>Bivariate probit estimates
Tables 5.a-5.c provide the bivariate probit estimates. Table 5.a demonstrates that women’s
decision-making on child wellbeing increases the probability that the woman receives atleast four antenatal care, skilled birth attendants, and facility delivery at the less than 1%
significance level. The null hypothesis < = 0, i.e. female autonomy and reproductive
health care use are independently determined, is rejected for the estimates on the use of atleast four antenatal visits as well as skilled birth attendant at the less than 1% significancelevel. It suggests that the use of these health services and female autonomy are
simultaneously determined and therefore the bivariate probit model specification is more
appropriate than the two separate univariate probit models. This result also implies that the
impact of female autonomy on increased use of health care would be underestimated if
female autonomy is treated as an exogenous variable.

<Tables 5.a-5.c>

15

Tables 5.b-5.c show that women’s decision-making on buying major items as wellas on borrowing money also increases the likelihood of using at least one antenatal care,skilled birth attendants and facility delivery. The null hypothesis < = 0 is rejected for theestimates on facility delivery in the equation of “buying major items”, while it is rejected
for skilled birth attendants and facility delivery in the “borrowing money” specification.

Socioeconomic determinants of reproductive health care utilization
Tables 5.a-5.c also report the effects of other socioeconomic variables on women’s uptakeof reproductive health services in the estimation equation for women’s decision-making
on child’s wellbeing. Of individual-level factors, the women who have achieved
secondary or higher education are more likely to attend to the first antenatal visit and at
least four visits compared with the reference population (= primary education) at the lessthan 1% significance level. Women’s educational attainments are also significantly related
to being attended by a health professional whereas they are not significant on facility
delivery. With respect to husbands’ characteristics, the area of land owned by the husband
is negatively associated with wife’s receipt of delivery care (both skilled birth attendantand facility delivery).
Of the variables reflecting household characteristics, the number of children
significantly decreases the likelihood of receiving the first antenatal care, skilled birth16attendants, and facility delivery. Household expenditure per capita is a positive
determinant of women’s receipt of health services except for facility delivery, indicatingthat women from richer households are more likely to access to reproductive health care.
Of the community-level factors, the number of first aid services per community is
positively correlated with an increased uptake of both antenatal and delivery care. In
contrast, most of the coefficients on the number of hospitals and women’s consultation
places per community are negative. Similarly, there are no consistent differences acrossregions in the utilisation of health services.

Determinants of female autonomy
Tables 5.a-5.c also provide the determinants of female autonomy estimated by thebivariate probit model. One of the major findings is that women’s working status isfavourably correlated with female autonomy at the less than 1% significance level, while
the area of land owned by women is not statistically significant. This result is consistent
with the findings from Anderson and Eswaran, 2009 which show that earned income ismore important than unearned income in enhancing women’s autonomy. Surprisingly,
coefficients on women’s educational attainments are not statistically significant, whereas
their knowledge about sexual matters is positively correlated with female autonomy. In
contrast, husbands’ educational achievements are associated with higher female autonomy,
implying the possibility that educated husbands are more generous and therefore female17members in the family become more likely to get involved into decision-making processes.
However, the insignificance of mother’s educational effect may be caused by a correlation
between women’s and husband’s education. To scrutinize this point, I estimate the effectsof couple’s education on women’s health care utilisation in separate regressions and still
confirm the insignificant effect of women’s education. Of the household-level factors, theeffects of household expenditure per capita are significant and positive, suggesting thatwomen from richer households are more autonomous than those who are not. Of thecommunity-level factors, the number of hospitals per community contributes to the higher
level of female autonomy.

6. Conclusions
In this paper I examine whether or not and how female autonomy within the household
affects women’s receipt of reproductive health services, using household survey data fromTajikistan. Estimation is conducted by the bivariate probit model in which woman’s use ofhealth services and the level of female autonomy in the household are recursive andsimultaneously determined. The empirical results provide important policy implications
for the improvement of maternal and child health in Tajikistan and other developing
countries.
First, the results provide new evidence that female autonomy within the household,controlling for its endogenous feature, has a significant and positive impact on the use of18

antenatal and delivery care. This finding reconfirms the widely-spread assertion thatgender equity is crucial to improving maternal health in developing countries and thenecessity of multi-sectoral approach. Policymakers in developing countries therefore needto implement not only direct health interventions but also broader social policies which
address women’s empowerment. Second, my analysis has also identified how othersocioeconomic factors such as education, working status, household expenditure, andcommunity health infrastructure are associated with women’s uptake of reproductive
health care, as well as with female autonomy. This kind of empirical evidence helps
policymakers to identify prioritised needs for specific health and social interventions toimprove population health and to reduce inequity inside the country.
There are some caveats to be considered when interpreting these results. The
empirical results do not fully support the validity of the assumption that women’s use of
reproductive health services is simultaneously determined with the level of female
autonomy within the household. Further research, using more accurate measures ofwomen’s autonomy, on the relationship between gender equity and maternal health careuse required to draw more robust empirical results. Despite this limitation, this paper is apioneering work to estimate the effects of female autonomy within the household on
reproductive health care use using a recursive and simultaneous model. It hence provides
important policy implications on the role of gender equity in improving women’s healthand it will also serve as a benchmark for further studies.

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24

Tables and Figures
Table 1. Indicators regarding maternal health and women’s status in Central Asia
CountryYear

Tajikistan

Kazakhstan

Kyrgyzstan

UkraineUzbekistan

Maternal Mortality Ratio (per100,000 live births)
Antenatal care (%): At least
once
Antenatal care (%): At least
four times
Delivery care coverage (%):
Skilled attendant at birth
Delivery care coverage (%):
Institutional delivery
Female earned income (PPPUS$)
Primary education enrolment
and attendance ratios:
Females as a % of malesLife expectancy: females as
a % of males
Contraceptive prevalence (%)
Total fertility rate

2005

170

140

150

18

24

2003-2008

89%

100%

97%

99%

99%

2003-2008

49%

70%

81%

75%

79%

2003-2008

88%

100%

98%

99%

100%

2003-2008

73%

100%

97%

99%

97%

2007

1,385

8,831

1,428

5,249

1,891

2003-2008

83%

100%

103%

102%

98%

2003-2007

108%

121%

112%

118%

110%

2003-2008
2003-2008

37%
3.4

51%
2.3

48%
2.5

67%
1.3

65%
2.3

Source: UNICEF, 201025

Table 2. Women’s decision-making in the household
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19

Variable
What to grow in house garden
What to grow on presidential land
Where to shop
Buying major items
Whether or not to borrow money
Lending month to others
Children's well being
Children's school attendance
Marriage of male household member
Marriage of female household member
Where male member should work
Where female member should work
How much to spend of household income
How much to save of household income
Where to invest household money
A household member migrating to seek work
How to use resources remitted from abroad
Whether and where to sell agricultural productHow to use the money from agricultural product
Total

26

Obs.
5117
5117
5117
5117
5117
5117
5117
5117
5117
5117
5117
5117
5117
5117
5117
5117
5117
5117
5117
5117

Mean
0.138
0.066
0.222
0.190
0.183
0.173
0.460
0.491
0.215
0.197
0.138
0.174
0.196
0.195
0.171
0.135
0.141
0.110
0.111
3.704

S.D.
0.345
0.248
0.415
0.392
0.387
0.378
0.498
0.500
0.411
0.398
0.344
0.379
0.397
0.396
0.376
0.341
0.349
0.312
0.314
5.352

Min
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Max
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
19

Table 3. Descriptive statistics
Variable
Obs.
Mean
S.D.
Min
Max
Women's autonomy
Women's decision on child's well being*
5117
0.460
0.498
0
1
Women's decision on buying major items†
5117
0.190
0.392
0
1
Women's decision on borrowing money‡
5117
0.183
0.387
0
1
Reproductive health care utilization
Antenatal care (At least once)
5117
0.862
0.345
0
1
Antenatal care (At least four times)
5117
0.526
0.499
0
1
Skilled birth attendant
5117
0.838
0.368
0
1
Facility delivery
5117
0.161
0.368
0
1
Woman's characteristics
Age
5117
33.76
8.23
16
49
Ethnic group: Others
5117
0.018
0.134
0
1
Ethnic group: Tajik
5117
0.798
0.401
0
1
Ethnic group: Uzbek
5117
0.184
0.387
0
1
Primary education
5117
0.231
0.422
0
1
Secondary education
5117
0.703
0.457
0
1
Higher education
5117
0.066
0.248
0
1
Worked in the last 14 days
5116
0.351
0.477
0
1
Plot area of land
5117
0.499
4.280
0
114
Wider knowledge about sexual matters
5117
0.268
0.443
0
1
Husband's characteristics
Age
4196
37.75
8.92
20
88
Ethnic group: Others
4196
0.012
0.110
0
1
Ethnic group: Tajik
4196
0.804
0.397
0
1
Ethnic group: Uzbek
4196
0.184
0.388
0.00
1
Primary education
4278
0.115
0.319
0
1
Secondary education
4278
0.687
0.464
0
1
Higher education
4278
0.198
0.399
0
1
Worked in the last 14 days
4196
0.785
0.411
0
1
Plot area of land
4196
6.734
25.6150604Household characteristics
Number of children
5117
3.432
1.885
1
14
Household expenditure per capita
5117
104.8
104.2
1 2568.4
Safer water
5117
0.521
0.500
0
1
Flush toilet
5117
0.177
0.382
0
1
Telephone
5117
0.222
0.415
0
1
Community characteristics
Dushanbe
5117
0.166
0.372
0
1
Sogd
5117
0.175
0.380
0
1
Khatlon
5117
0.313
0.464
0
1
RRP
5117
0.234
0.423
0
1
Gbao
5117
0.113
0.316
0
1
Number of hospitals
5117
0.404
0.799
0
10
Number of women's consultation place
5117
0.330
0.813
0
12
Number of first aid (ambulance)
5117
0.165
0.383
0
2
*Dichotomous variable representing whether the decision on children's well being within thehousehold is made by female member (=1) or not (=0)‡Dichotomous variable representing whether the decision on buying major items within thehousehold is made by female member (=1) or not (=0)†Dichotomous variable representing whether the decision on whether or not to borrow money
within the household is made by female member (=1) or not (=0)

27

Table 4.a. Results of the univariate probit estimates: Decision on child’s wellbeing
Variables

At least one
At least fourantenatal careantenatal care
Women's decision-making on-0.0210.006(0.706)(0.881)child's wellbeing
Woman's age
0.017
0.010
(0.011) **(0.072) *Woman's ethnicity: Tajik
0.292-0.132(0.352)(0.604)-0.095
Woman's ethnicity: Uzbek
0.654(0.058) *(0.729)0.217
Woman's education:
0.341(0.000) ***(0.000) ***Secondary
Woman's education: Higher
0.686
0.285
(0.000) ***(0.008) ***Woman worked in the last 14-0.091
0.055
days(0.111)(0.239)0.007
Woman's plot area of land
-0.002(0.779)(0.229)0.042
Woman's wider knowledge
0.113(0.068) *(0.381)
about sexual matters
Husband's age-0.017-0.012(0.002) ***(0.009) ***Husband's ethnicity: Tajik
0.133
0.158
(0.700)(0.581)0.304
Husband's ethnicity: Uzbek-0.119(0.751)(0.317)0.178
Husband's education:
0.196(0.022) **(0.018) **Secondary
Husband's education: Higher
0.154
0.204
(0.147)(0.021) **Husband worked in the last 14
0.034
0.096
days
(0.594)(0.061) *0.001
Husband's plot area of land
0.001
(0.303)(0.079) *0.009
Number of children-0.069(0.000) ***(0.530)Household expenditure per
0.002
0.001
capita(0.000) ***(0.000) ***0.007
Safer water
0.108(0.074) *(0.886)
0.107
Flush toilet
0.072(0.499)(0.157)
0.343
Telephone
0.480(0.000) ***(0.000) ***
Sogd
0.356
0.609
(0.013) **(0.000) ***-0.752
Khatlon-0.164(0.146)(0.000) ***-0.294
RRP-0.135(0.249)(0.001) ***Gbao-0.184-0.168(0.169)(0.094) *Number of hospitals
0.163
0.013
(0.009) ***(0.643)-0.017
Number of women's-0.107
consultation(0.022) **(0.663)0.126
Number of first aid
0.370(0.001) ***(0.066) *(ambulance)
Constant
0.244-0.351(0.370)(0.129)Pseudo R2
0.11330.1367
Sample size
4195
4195
p-value in parentheses, Significance: * p<0.1; ** p<0.05; *** p<0.0128

Skilled birthattendance
0.160(0.003)0.001(0.866)0.418(0.156)0.557(0.089)0.152(0.017)0.610(0.001)-0.075(0.172)0.006(0.463)-0.187(0.001)-0.001(0.912)-0.090(0.788)-0.066(0.855)0.214(0.010)0.582(0.000)0.039(0.521)-0.001(0.535)-0.091(0.000)0.001(0.000)0.138(0.016)0.382(0.000)0.363(0.000)0.441(0.002)-0.036(0.743)-0.157(0.170)-0.243(0.057)0.082(0.126)-0.085(0.086)0.280(0.004)0.286(0.294)0.1277
4195

***

*
**
***

***

**
***

***
***
**
***
***
***

*

*
***

Facility delivery
0.124(0.011)0.004(0.566)0.665(0.070)1.046(0.006)0.152(0.019)0.117(0.323)0.032(0.537)0.008(0.210)0.051(0.357)0.006(0.281)
0.096(0.810)-0.163(0.690)-0.172(0.047)-0.039(0.697)0.014(0.817)-0.003(0.021)-0.050(0.004)0.000(0.734)0.215(0.000)0.154(0.066)-0.070(0.312)0.166(0.114)0.205(0.031)
0.045(0.663)0.161(0.168)-0.008(0.823)-0.037(0.335)0.136(0.066)-2.237(0.000)0.0297
4195

**

*
***
**

**

**
***

***
*

**

*
***

Table 4.b. Results of the univariate probit estimates: Decision on buying major items
Variables

At least one
At least fourantenatal careantenatal care
Women's decision-making on-0.0650.005(0.408)(0.936)buying major items
Woman's age
0.017
0.010
(0.011) **(0.072) *Woman's ethnicity: Tajik
0.293-0.133(0.349)(0.603)-0.095
Woman's ethnicity: Uzbek
0.655(0.057) *(0.729)0.217
Woman's education:
0.341(0.000) ***(0.000) ***Secondary
Woman's education: Higher
0.684
0.285
(0.000) ***(0.008) ***Woman worked in the last 14-0.0900.055
days(0.117)(0.237)
0.007
Woman's plot area of land
-0.002(0.790)(0.229)0.042
Woman's wider knowledge
0.113(0.066) *(0.380)
about sexual matters
Husband's age-0.017-0.012(0.001) ***(0.009) ***Husband's ethnicity: Tajik
0.133
0.160
(0.701)(0.578)0.305
Husband's ethnicity: Uzbek-0.118(0.751)(0.315)0.179
Husband's education:
0.197(0.021) **(0.018) **Secondary
Husband's education: Higher
0.152
0.204
(0.150)(0.021) **Husband worked in the last 14
0.032
0.096
days
(0.624)(0.061) *0.001
Husband's plot area of land
0.001
(0.303)(0.077) *0.009
Number of children-0.069(0.000) ***(0.530)Household expenditure per
0.002
0.001
capita(0.000) ***(0.000) ***0.007
Safer water
0.106(0.079) *(0.888)
0.108
Flush toilet
0.071(0.504)(0.154)
0.343
Telephone
0.481(0.000) ***(0.000) ***
Sogd
0.358
0.610
(0.013) **(0.000) ***-0.752
Khatlon-0.160(0.155)(0.000) ***-0.295RRP-0.133(0.258)(0.001) ***Gbao-0.183-0.169(0.172)(0.093) *Number of hospitals
0.163
0.014
(0.009) ***(0.635)-0.017
Number of women's-0.107
consultation(0.023) **(0.664)0.126
Number of first aid
0.370(0.001) ***(0.067) *(ambulance)
Constant
0.246-0.350(0.365)(0.130)Pseudo R2
0.11340.1366
Sample size
4195
4195
p-value in parentheses, Significance: * p<0.1; ** p<0.05; *** p<0.0129

Skilled birthattendance
0.105(0.176)0.001(0.872)0.414(0.161)0.560(0.089)0.152(0.016)0.608(0.001)-0.068(0.215)0.006(0.460)-0.183(0.001)-0.001(0.841)-0.057(0.864)-0.044(0.903)0.220(0.008)0.591(0.000)0.037(0.551)0.000(0.644)-0.090(0.000)0.001(0.000)0.136(0.018)0.393(0.000)0.374(0.000)0.453(0.001)-0.051(0.642)-0.168(0.141)-0.247(0.052)0.090(0.094)-0.081(0.101)
0.271(0.006)0.321(0.238)0.1261
4195

*
**
***

***

***
***

***
***
**
***
***
***

*
*

***

Facility delivery
0.110(0.111)0.004(0.555)0.647(0.073)1.032(0.006)0.151(0.020)0.115(0.332)0.036(0.490)0.008(0.217)0.052(0.342)0.005(0.306)0.138(0.725)-0.126(0.756)-0.161(0.062)-0.026(0.792)0.012(0.840)-0.003(0.026)-0.050(0.004)0.000(0.787)0.212(0.000)0.170(0.041)-0.066(0.341)0.186(0.076)0.200(0.035)0.038(0.709)0.161(0.166)-0.002(0.947)-0.036(0.346)0.131(0.078)-2.230(0.000)0.0282
4195

*
***
**

*

**
***

***
**

*
**

*
***

Table 4.c. Results of the univariate probit estimates
Variables

At least one
At least fourantenatal careantenatal care
Women's decision-making on-0.0850.032(0.300)(0.625)borrowing money
Woman's age
0.017
0.010
(0.011) **(0.073) *Woman's ethnicity: Tajik
0.286-0.131(0.360)(0.607)-0.095
Woman's ethnicity: Uzbek
0.647(0.060) *(0.729)0.217
Woman's education:
0.342(0.000) ***(0.000) ***Secondary
Woman's education: Higher
0.686
0.284
(0.000) ***(0.008) ***Woman worked in the last 14-0.0900.054
days(0.118)(0.244)
0.007
Woman's plot area of land
-0.002(0.811)(0.238)0.042
Woman's wider knowledge
0.113(0.067) *(0.386)about sexual matters
Husband's age-0.017-0.012(0.001) ***(0.010) **Husband's ethnicity: Tajik
0.138
0.158
(0.690)(0.582)0.304
Husband's ethnicity: Uzbek-0.113(0.760)(0.316)0.179
Husband's education:
0.197(0.021) **(0.018) **Secondary
Husband's education: Higher
0.153
0.204
(0.149)(0.021) **Husband worked in the last 14
0.032
0.097
days
(0.623)(0.058) *0.001
Husband's plot area of land
0.001
(0.309)(0.078) *0.010
Number of children-0.070(0.000) ***(0.521)
Household expenditure per
0.002
0.001
capita(0.000) ***(0.000) ***0.007
Safer water
0.106(0.078) *(0.877)
0.108
Flush toilet
0.068(0.525)(0.152)
0.342
Telephone
0.483(0.000) ***(0.000) ***
Sogd
0.357
0.609
(0.013) **(0.000) ***-0.752
Khatlon-0.161(0.155)(0.000) ***-0.295RRP-0.132(0.260)(0.001) ***Gbao-0.185-0.168(0.167)(0.094) *Number of hospitals
0.162
0.013
(0.009) ***(0.645)-0.017
Number of women's-0.106
consultation(0.024) **(0.661)
0.126
Number of first aid
0.370(0.001) ***(0.066) *(ambulance)
Constant
0.248-0.353(0.361)(0.127)
Pseudo R2
0.11360.1366
Sample size
4195
4195
p-value in parentheses, Significance: * p<0.1; ** p<0.05; *** p<0.0130

Skilled birthattendance
0.017(0.830)0.001(0.858)0.416(0.158)0.567(0.084)0.152(0.017)0.605(0.001)-0.065(0.240)0.006(0.442)-0.181(0.001)-0.001(0.820)-0.056(0.866)-0.045(0.902)0.222(0.008)0.591(0.000)0.032(0.599)0.000(0.662)-0.091(0.000)0.001(0.000)0.132(0.022)0.394(0.000)0.374(0.000)0.457(0.001)-0.050(0.651)-0.168(0.141)-0.247(0.052)0.091(0.092)-0.081(0.103)0.271(0.006)0.332(0.222)0.1256
4195

*
**
***

***

***
***

***
***
**
***
***
***

*
*

***

Facility delivery
0.111(0.123)0.004(0.557)0.651(0.071)
1.035(0.006)0.151(0.020)0.112(0.345)0.036(0.491)0.008(0.242)
0.052(0.343)0.005(0.307)0.137(0.728)-0.124(0.758)-0.163(0.059)-0.028(0.780)0.010(0.861)-0.003(0.027)-0.049(0.004)0.000(0.783)0.211(0.000)0.171(0.040)-0.067(0.334)0.188(0.073)0.201(0.035)0.037(0.717)0.163(0.161)-0.003(0.930)-0.036(0.346)0.132(0.074)-2.227(0.000)0.0282
4195

*
***
**

*

**
***

***
**

*
**

*
***

Table 5.a. Results of the bivariate probit estimates: Decision on child’s well-being
Variables

At least one
Women'santenatal caredecision-making
Women's decision-making on
0.386(0.563)child's wellbeing
Woman's age
0.016
0.003
(0.018) **(0.555)
Woman's ethnicity: Tajik
0.316-0.248(0.311)(0.315)
Woman's ethnicity: Uzbek
0.645-0.059(0.060) *(0.822)
Woman's education:
0.330
0.027
(0.000) ***(0.607)
Secondary
Woman's education: Higher
0.686-0.092(0.000) ***(0.365)
Woman worked in the last 14-0.1150.161(0.086) *(0.000) ***days
Woman's plot area of land
-0.0030.005(0.703)(0.464)
Woman's wider knowledge
0.094
0.104
(0.181)(0.025) **about sexual matters
Husband's age-0.015-0.010(0.017) **(0.039) **Husband's ethnicity: Tajik
0.031
0.732
(0.935)(0.013) **Husband's ethnicity: Uzbek-0.1910.549(0.622)(0.074) *Husband's education:
0.164
0.194
(0.115)(0.009) ***Secondary
Husband's education: Higher
0.121
0.202
(0.318)(0.020) **Husband worked in the last 14
0.056-0.143days(0.441)(0.004) ***Husband's plot area of land
0.001
0.003
(0.561)(0.002) ***Number of children-0.068-0.001(0.000) ***(0.925)
Household expenditure per
0.002
0.000
(0.000) ***(0.042) **capitaSafer water
0.121-0.100(0.053) *(0.028) **Flush toilet
0.027
0.284
(0.837)(0.000) ***Telephone
0.446
0.160
(0.000) ***(0.006) ***
Sogd
0.279
0.450
(0.161)(0.000) ***Khatlon-0.144-0.107(0.222)(0.182)
RRP-0.119-0.087(0.322)(0.303)Gbao-0.1880.047(0.155)(0.632)
Number of hospitals
0.141
0.125
(0.060) *(0.000) ***Number of women's-0.1090.030
consultation(0.018) **(0.392)
Number of first aid
0.379-0.105(0.000) ***(0.102)(ambulance)
Constant
0.134-0.670(0.682)(0.004) ***σ: p-value
0.589
Sample size
4195
p-value in parentheses, Significance: * p<0.1; ** p<0.05; *** p<0.01

31

At least fourantenatal care
1.318
(0.000) ***0.007(0.209)0.003(0.990)-0.050(0.838)0.151(0.004) ***0.261(0.008) ***-0.041(0.352)0.003(0.548)-0.022(0.628)-0.005(0.296)-0.218(0.411)-0.031(0.912)0.048(0.503)0.063(0.453)0.148(0.001) ***0.000(0.841)0.006(0.657)0.001(0.000) ***0.058(0.179)-0.064(0.374)0.173(0.009) ***0.224(0.050) *-0.507(0.000) ***-0.168(0.046) **-0.148(0.105)-0.048(0.084) *-0.031(0.348)0.147(0.017) **-0.605(0.004) ***0.026 **
4195

Women's
decision-making

0.003(0.556)-0.189(0.430)0.020(0.939)0.026(0.618)-0.089(0.369)0.170(0.000)0.005(0.436)0.091(0.052)-0.009(0.044)0.669(0.019)0.463(0.125)0.191(0.009)0.187(0.030)-0.127(0.009)0.003(0.001)-0.001(0.938)0.000(0.041)-0.100(0.027)0.265(0.000)0.160(0.006)0.438(0.000)-0.123(0.120)-0.095(0.255)0.043(0.656)0.130(0.000)0.019(0.565)-0.099(0.118)-0.679(0.003)

***

*
**
**

***
**
***
***

**
**
***
***
***

***

***

Table 5.a. (continued) Results of the bivariate probit estimates: Decision on child’s wellbeing
Variables

Skilled attendant
Women's
at birth
decision-making
Women's decision-making on
1.155(0.000) ***child's wellbeing
Woman's age
0.000
0.004
(0.973)(0.489)
Woman's ethnicity: Tajik
0.444-0.228(0.103)(0.351)
Woman's ethnicity: Uzbek
0.492-0.051(0.108)(0.845)
Woman's education:
0.118
0.025
(0.059) *(0.642)
Secondary
Woman's education: Higher
0.566-0.089(0.001) ***(0.377)
Woman worked in the last 14-0.1290.159(0.015) **(0.000) ***days
Woman's plot area of land
0.003
0.004
(0.674)(0.486)
Woman's wider knowledge-0.2040.102(0.000) ***(0.027) **about sexual matters
Husband's age
0.003-0.010(0.531)(0.030) **Husband's ethnicity: Tajik-0.3420.698(0.287)(0.015) **Husband's ethnicity: Uzbek-0.2530.525(0.456)(0.082) *Husband's education:
0.110
0.196
(0.228)(0.009) ***Secondary
Husband's education: Higher
0.423
0.202
(0.002) ***(0.020) **Husband worked in the last 14
0.092-0.142days(0.119)(0.004) ***Husband's plot area of land
-0.001
0.003(0.097) *(0.002) ***Number of children-0.079-0.002(0.000) ***(0.892)
Household expenditure per
0.001
0.000
(0.000) ***(0.045) **capitaSafer water
0.161-0.098(0.002) ***(0.031) **Flush toilet
0.223
0.286
(0.066) *(0.000) ***Telephone
0.249
0.160
(0.012) **(0.006) ***
Sogd
0.207
0.452
(0.194)(0.000) ***Khatlon
0.011-0.107(0.911)(0.184)
RRP-0.099-0.089(0.359)(0.297)Gbao-0.2280.043(0.053) *(0.661)
Number of hospitals
0.020
0.123
(0.708)(0.000) ***Number of women's-0.0830.032
consultation(0.068) *(0.363)
Number of first aid
0.277-0.107(0.002) ***(0.096) *(ambulance)
Constant-0.008-0.654(0.976)(0.005) ***σ: p-value
0.283
Sample size
4195
p-value in parentheses, Significance: * p<0.1; ** p<0.05; *** p<0.01

32Facility delivery
1.727(0.000)0.001(0.884)0.531(0.042)0.675(0.016)0.074(0.156)0.140(0.143)-0.083(0.053)0.002(0.717)-0.036(0.420)0.009(0.037)-0.191(0.562)-0.263(0.438)-0.224(0.001)-0.149(0.067)0.097(0.039)-0.003(0.000)-0.030(0.035)0.000(0.106)0.184(0.000)-0.093(0.189)-0.148(0.008)-0.213(0.017)0.187(0.015)0.068(0.403)0.067(0.480)-0.082(0.004)-0.041(0.195)0.162(0.007)-1.985(0.000)0.000
4195

Women's
decision-making

***

**
**

*

**

***
*
**
***
**

***

***
**
**

***

***
***
***

0.003
(0.521)-0.273(0.243)-0.083(0.741)
0.003(0.946)-0.077(0.431)0.156(0.000)0.004(0.546)0.082(0.069)-0.010(0.029)0.760(0.007)0.593(0.044)0.194(0.006)0.195(0.018)-0.141(0.003)0.003(0.001)0.001(0.950)0.000(0.067)-0.130(0.003)0.274(0.000)0.147(0.010)0.473(0.000)-0.094(0.226)-0.087(0.290)0.105(0.264)0.139(0.000)0.021(0.518)-0.099(0.113)-0.666(0.004)

***

*
**
***
**
***
**
***
***

*
***
***
**
***

***

***

Table 5.b. Results of the bivariate probit estimates: Decision on buying major items
Variables

At least one
Women'santenatal caredecision-making
Women's decision-making on
0.970(0.013) **buying major items
Woman's age
0.013
0.011
(0.052) *(0.141)
Woman's ethnicity: Tajik
0.316-0.139(0.281)(0.626)
Woman's ethnicity: Uzbek
0.596
0.071
(0.068) *(0.813)
Woman's education:
0.304
0.031
(0.000) ***(0.644)
Secondary
Woman's education: Higher
0.654-0.125(0.000) ***(0.350)
Woman worked in the last 14-0.1300.171(0.022) **(0.002) ***days
Woman's plot area of land
-0.0050.010(0.451)(0.118)
Woman's wider knowledge
0.066
0.124
(0.309)(0.033) **about sexual matters
Husband's age-0.012-0.012(0.032) **(0.046) **Husband's ethnicity: Tajik
0.059
0.221
(0.857)(0.500)Husband's ethnicity: Uzbek-0.1720.175(0.624)(0.607)
Husband's education:
0.173
0.039
(0.040) **(0.668)
Secondary
Husband's education: Higher
0.157-0.049(0.118)(0.652)
Husband worked in the last 14
0.102-0.244days(0.144)(0.000) ***Husband's plot area of land
0.001
0.001
(0.520)(0.112)
Number of children-0.056-0.031(0.005) ***(0.093) *Household expenditure per
0.002
0.000
(0.000) ***(0.491)
capitaSafer water
0.142-0.179(0.016) **(0.002) ***Flush toilet
0.077-0.050(0.444)(0.597)
Telephone
0.415
0.068
(0.000) ***(0.364)
Sogd
0.253
0.265
(0.099) *(0.024) **Khatlon-0.1660.096(0.120)(0.369)RRP-0.1450.117(0.193)(0.293)Gbao-0.1850.091(0.144)(0.469)Number of hospitals
0.139
0.031
(0.023) **(0.356)
Number of women's-0.101
0.016
consultation(0.023) **(0.700)
Number of first aid
0.321
0.027
(0.004) ***(0.735)(ambulance)
Constant
0.066-1.078(0.804)(0.000) ***σ: p-value
0.145
Sample size
4195
p-value in parentheses, Significance: * p<0.1; ** p<0.05; *** p<0.01

33

At least fourantenatal care
0.002
(0.998)0.010(0.080) *-0.133(0.604)-0.095(0.729)0.217(0.000) ***0.285(0.009) ***0.055(0.310)0.007(0.254)0.042(0.421)-0.012(0.014) **0.160(0.580)0.305(0.318)0.179(0.018) **0.204(0.022) **0.096(0.153)0.001(0.089) *0.009(0.547)0.001(0.000) ***0.007(0.904)0.108(0.156)0.343(0.000) ***0.610(0.000) ***-0.752(0.000) ***-0.294(0.001) ***-0.168(0.095) *0.014(0.639)-0.017(0.666)0.126(0.068) *-0.349(0.188)0.026 **
4195

Women's
decision-making

0.009(0.210)-0.160(0.562)0.024(0.936)0.022(0.751)-0.129(0.337)0.171(0.002)0.010(0.116)0.129(0.028)-0.012(0.061)0.209(0.518)0.192(0.569)0.043(0.639)-0.052(0.637)-0.250(0.000)0.001(0.147)-0.030(0.112)0.000(0.467)-0.170(0.003)-0.050(0.596)0.069(0.351)
0.248(0.036)0.095(0.377)0.102(0.370)0.075(0.551)0.029(0.397)0.020(0.627)0.036(0.646)-1.013(0.001)

***

**
*

***

***

**

***

Table 5.b. (continued) Results of the bivariate probit estimates: Decision on buying major
items
Variables

Skilled attendant
Women's
at birth
decision-making
Women's decision-making on
1.156(0.009) ***buying major items
Woman's age-0.0010.008(0.821)(0.248)
Woman's ethnicity: Tajik
0.428-0.171(0.125)(0.546)
Woman's ethnicity: Uzbek
0.504
0.000
(0.110)(1.000)
Woman's education:
0.130
0.027
(0.041) **(0.690)
Secondary
Woman's education: Higher
0.579-0.128(0.001) ***(0.341)
Woman worked in the last 14-0.1100.176(0.050) *(0.001) ***days
Woman's plot area of land
0.002
0.010
(0.830)(0.117)
Woman's wider knowledge-0.2010.121(0.000) ***(0.036) **about sexual matters
Husband's age
0.002-0.012(0.697)(0.052) *Husband's ethnicity: Tajik-0.1160.265(0.713)(0.428)Husband's ethnicity: Uzbek-0.1020.250(0.766)(0.470)Husband's education:
0.192
0.053
(0.023) **(0.567)
Secondary
Husband's education: Higher
0.553-0.040(0.000) ***(0.714)
Husband worked in the last 14
0.106-0.254days(0.126)(0.000) ***Husband's plot area of land
-0.0010.001(0.378)(0.086) *Number of children-0.074-0.025(0.001) ***(0.192)
Household expenditure per
0.001
0.000
(0.004) ***(0.499)capitaSafer water
0.170-0.169(0.002) ***(0.003) ***Flush toilet
0.367-0.039(0.001) ***(0.678)
Telephone
0.314
0.071
(0.002) ***(0.340)
Sogd
0.333
0.268
(0.045) **(0.022) **Khatlon-0.0700.086(0.505)(0.424)
RRP-0.1790.120(0.096) *(0.281)
Gbao-0.2430.099(0.044) **(0.432)
Number of hospitals
0.073
0.033
(0.157)(0.325)
Number of women's-0.0790.019
consultation(0.088) *(0.649)Number of first aid
0.231
0.026
(0.021) **(0.740)(ambulance)
Constant
0.129-1.056(0.636)(0.000) ***σ: p-value
0.145
Sample size
4195
p-value in parentheses, Significance: * p<0.1; ** p<0.05; *** p<0.0134Facility delivery
1.861(0.000)0.000(0.957)0.658(0.049)0.926(0.008)0.132(0.029)0.141(0.205)-0.011(0.830)0.002(0.685)0.003(0.960)0.008(0.109)0.083(0.820)-0.141(0.706)-0.156(0.051)-0.008(0.932)0.085(0.127)-0.003(0.012)-0.033(0.055)0.000(0.977)0.231(0.000)0.165(0.035)-0.078(0.228)0.125(0.207)0.181(0.044)0.030(0.756)0.171(0.115)-0.008(0.794)-0.040(0.277)0.100(0.148)-2.293(0.000)0.997
4195

Women's
decision-making

***

**
***
**

*

**
*

***
**

**

***

0.004
(0.536)-0.138(0.610)-0.040(0.890)0.028(0.666)-0.087(0.496)0.169(0.002)0.009(0.149)0.092(0.106)-0.009(0.124)0.247(0.432)0.276(0.401)0.011(0.898)-0.072(0.489)-0.226(0.000)0.001(0.241)-0.012(0.526)0.000(0.726)-0.160(0.004)-0.073(0.431)0.089(0.206)0.301(0.008)0.097(0.352)0.117(0.278)0.208(0.089)0.034(0.280)0.004(0.934)0.040(0.595)-1.066(0.000)

***

***

***

***

*

***

Table 5.c. Results of the bivariate probit estimates: Decision on borrowing money
Variables

At least one
Women'santenatal caredecision-making
Women's decision-making on
1.013(0.004) ***borrowing money
Woman's age
0.013
0.011
(0.056) *(0.140)
Woman's ethnicity: Tajik
0.365-0.299(0.210)(0.281)
Woman's ethnicity: Uzbek
0.645-0.080(0.044) **(0.785)
Woman's education:
0.294
0.062
(0.000) ***(0.379)Secondary
Woman's education: Higher
0.601
0.040
(0.001) ***(0.760)
Woman worked in the last 14-0.1310.178(0.020) **(0.002) ***days
Woman's plot area of land
-0.0080.017(0.228)(0.004) ***Woman's wider knowledge
0.068
0.116
(0.286)(0.051) *about sexual matters
Husband's age-0.012-0.011(0.028) **(0.064) *Husband's ethnicity: Tajik
0.028
0.307
(0.932)(0.341)
Husband's ethnicity: Uzbek-0.1730.141(0.619)(0.674)
Husband's education:
0.161
0.087
(0.059) *(0.371)
Secondary
Husband's education: Higher
0.144
0.005
(0.156)(0.968)Husband worked in the last 14
0.089-0.204days(0.171)(0.001) ***Husband's plot area of land
0.001
0.001
(0.408)(0.463)
Number of children-0.053-0.040(0.008) ***(0.037) **Household expenditure per
0.002
0.000
(0.000) ***(0.627)
capitaSafer water
0.132-0.144(0.021) **(0.016) **Flush toilet
0.094-0.113(0.348)(0.236)
Telephone
0.394
0.117
(0.000) ***(0.119)
Sogd
0.272
0.182
(0.060) *(0.123)
Khatlon-0.1540.043(0.147)(0.691)
RRP-0.1530.143(0.165)(0.202)Gbao-0.156-0.019(0.219)(0.884)
Number of hospitals
0.128
0.061
(0.038) **(0.049) **Number of women's-0.1020.019
consultation(0.022) **(0.652)
Number of first aid
0.346-0.053(0.001) ***(0.509)(ambulance)
Constant
0.075-1.127(0.776)(0.000) ***σ: p-value
0.126
Sample size
4195
p-value in parentheses, Significance: * p<0.1; ** p<0.05; *** p<0.01

35

At least fourantenatal care
0.756
(0.207)0.009(0.143)-0.069(0.789)-0.061(0.823)0.204(0.000) ***0.270(0.013) **0.027(0.598)0.003(0.659)0.023(0.641)-0.011(0.036) **0.100(0.728)0.259(0.392)0.165(0.031) **0.201(0.022) **0.126(0.023) **0.001(0.109)0.014(0.349)0.001(0.000) ***0.024(0.612)0.122(0.105)0.314(0.000) ***0.569(0.000) ***-0.737(0.000) ***-0.304(0.000) ***-0.158(0.113)0.002(0.946)-0.020(0.606)0.132(0.052) *-0.448(0.059) *
0.392
4195

Women's
decision-making

0.011(0.133)-0.324(0.230)-0.141(0.624)0.068(0.336)0.054(0.680)0.180(0.002)0.017(0.005)0.111(0.065)-0.012(0.054)0.315(0.329)0.183(0.588)0.091(0.347)0.005(0.964)-0.206(0.001)0.001(0.422)-0.040(0.033)0.000(0.646)-0.132(0.027)-0.120(0.214)0.120(0.111)
0.176(0.138)0.061(0.577)0.154(0.179)-0.021(0.871)
0.059(0.064)0.021(0.626)-0.041(0.616)-1.107(0.000)

***
***
*
*

***

**

**

*

***

Table 5.c. (continued) Results of the bivariate probit estimates: Decision on borrowing
money
Variables

Skilled attendant
Women's
at birth
decision-making
Women's decision-making on
1.330(0.000) ***borrowing money
Woman's age-0.0020.009(0.691)(0.238)
Woman's ethnicity: Tajik
0.479-0.328(0.071) *(0.237)
Woman's ethnicity: Uzbek
0.535-0.160(0.071) *(0.586)
Woman's education:
0.104
0.067
(0.091) *(0.340)
Secondary
Woman's education: Higher
0.465
0.044
(0.008) ***(0.739)
Woman worked in the last 14-0.1180.181(0.022) **(0.001) ***days
Woman's plot area of land
-0.0040.018(0.616)(0.003) ***Woman's wider knowledge-0.1930.114(0.000) ***(0.053) *about sexual matters
Husband's age
0.003-0.012(0.568)(0.057) *Husband's ethnicity: Tajik-0.1670.364(0.582)(0.271)
Husband's ethnicity: Uzbek-0.1120.239(0.732)(0.488)Husband's education:
0.162
0.105
(0.047) **(0.279)Secondary
Husband's education: Higher
0.499
0.013
(0.000) ***(0.908)Husband worked in the last 14
0.106-0.218days(0.071) *(0.000) ***Husband's plot area of land
-0.0010.001(0.496)(0.359)Number of children-0.063-0.031(0.001) ***(0.107)
Household expenditure per
0.001
0.000
(0.004) ***(0.637)
capitaSafer water
0.157-0.136(0.003) ***(0.021) **Flush toilet
0.368-0.106(0.000) ***(0.263)
Telephone
0.253
0.121
(0.007) ***(0.106)
Sogd
0.303
0.182
(0.035) **(0.121)
Khatlon-0.0580.020(0.558)(0.854)
RRP-0.1900.136(0.066) *(0.221)
Gbao-0.195-0.025(0.097) *(0.842)
Number of hospitals
0.053
0.065
(0.282)(0.035) **Number of women's-0.0760.022
consultation(0.083) *(0.608)
Number of first aid
0.239-0.065(0.008) ***(0.423)(ambulance)
Constant
0.116-1.109(0.647)(0.000) ***σ: p-value
0.049 **
Sample size
4195
p-value in parentheses, Significance: * p<0.1; ** p<0.05; *** p<0.0136Facility delivery
2.152(0.000)-0.001(0.907)0.715(0.025)0.957(0.004)0.113(0.056)0.085(0.432)-0.025(0.606)-0.004(0.467)-0.002(0.965)0.008(0.088)0.034(0.924)-0.132(0.714)-0.168(0.031)-0.030(0.741)0.078(0.140)-0.003(0.018)-0.025(0.129)0.000(0.992)0.216(0.000)0.180(0.018)-0.092(0.139)0.136(0.159)0.183(0.036)0.012(0.898)0.195(0.064)-0.028(0.361)-0.043(0.227)0.140(0.037)-2.250(0.000)0.002
4195

Women's
decision-making

***

**
***
*

*

**

**

***
**

**

*

**
***
***

0.004
(0.526)-0.297(0.246)-0.225(0.412)0.041(0.530)0.052(0.670)0.158(0.004)0.017(0.002)0.086(0.120)-0.009(0.139)0.319(0.294)0.267(0.401)
0.055(0.530)-0.050(0.633)-0.159(0.006)0.000(0.689)-0.014(0.451)0.000(0.903)-0.117(0.030)-0.128(0.148)0.149(0.029)0.218(0.047)0.054(0.587)0.146(0.160)0.124(0.291)
0.052(0.079)-0.003(0.942)0.004(0.956)-1.115(0.000)

***
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**
**

*

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0

.05

Density.1.15

Figure 1. Distribution of the number of antenatal care visits

0

2

4

6

8 10 12 14 16 18 20 22 24 26 28 30 32 34 36
Antenatal visits37