Quality of health care, survival and health outcomes in Ghana

Journal Article

The impact of household- and community-level variables on child mortality and child growth was investigated through an analysis of data from the 1988 Ghana Living Standard Survey. Hazard analysis revealed child mortality is highly sensitive to variation in food prices, especially as concerns maize and cassava. A 10% increase in food prices reduces the median child survival time by 14.7%. The price effects are larger and more significant for children living in rural areas and for girls. Having a significant, positive impact on child survival was the availability (hours per week) of child health services. If rural child health service availability equaled the urban mean (11.5 hours/week), the mean survival time of rural children would increase by 9.3%, substantially reducing the rural-urban gap. In addition, child survival was significantly related to the composite measure of the quality of water and sanitation facilities. If these services in rural areas were upgraded to the level found in cities, child survival would increase by almost 10%. Child height for age, and, to a lesser extent, weight for height, was positively affected by health facility size, presence of child health services, and availability of essential drugs as well as the quality of water and sanitation facilities. Both anthropometric measures were highly sensitive to price variation in rural areas, in non-poor as well as poor households. Thus, stabilization and adjustment programs that lead to food price increases are likely to have an adverse effect on children from all income groups.

Full Text

Duke Authors

Cited Authors

  • Lavy, V; Strauss, J; Thomas, D; Vreyer, PD

Published Date

  • 1996

Published In

Volume / Issue

  • 15 / 3

Start / End Page

  • 333 - 357

PubMed ID

  • 10159445

International Standard Serial Number (ISSN)

  • 0167-6296

Digital Object Identifier (DOI)

  • 10.1016/0167-6296(95)00021-6