Education and the use of maternal health care in Thailand

This study analyses the impact of female education on the use of maternal and child health services by women in Thailand during their pregnancy. Three types of health service use were examined—the use of tetanus toxide inoculations, prenatal care, and assistance by formal sources during delivery. While most previous research in the area had focussed on the effects of schooling per se, the present study tries to assess the differential impact of various schooling categories on utilization outcomes. An additional issue examined was the interactive effects of education and residence on health care use in the schooling-utilization link. The results of the analysis indicate that the health consequences of maternal education cannot be taken for granted—maternal schooling does not have a uniform impact across all services; nor are these effects necessarily positive. While there is distinct positive effect of schooling in the use of prenatal care, the educational differentials in the use of delivery assistance start emerging only after secondary schooling. It is with respect to TT inoculations that the most surprising result was seen; while women with primary and secondary schooling maintain their advantage, women with higher education showed a lower likelihood of use compared to those with no schooling. Overall, secondary education emerges as the most consistent predictor of health service use showing higher likelihood of use of all three services. Schooling effects also vary across residence, though this interaction was significant only in the case of inoculations. While educational differentials are maintained in rural areas, urban residence tends to narrow down these differentials considerably. The study concludes by making suggestions for policy.