Year: 2015
Type: dissertation
Abstract: This thesis formalizes the interaction between income and fertility outcomes using a \nfertility model taking account of mediation. Despite the diversity of studies concerned \nwith the determinants of fertility, one consistent nding is that the timing and the \nnumber of children born to a couple are ultimately determined by the interaction \nbetween a couple's fecundity and their contraceptive behaviour. For example, fecund \nindividuals may or may not be sexually active, may or may not be using contraception, \nwhich would in \nuence their degree of risk for pregnancy. In this context, fecundity \nis a necessary but insu cient cause of fertility. The two variables, fecundity and \ncontraception, are mediator variables in the causal path between income and fertility \n(Baron and Kenny, 1986). It follows that, understanding the interaction between \nbiological and behavioural determinants of fertility holds the key to understanding \nfertility trends in any society. \nWith our understanding of causal-mediation in place, this thesis extends the health \ninvestment model to develop a model of the sequential nature of the human reproductive \nprocess. Because reproductive health is commonly understood as the capability \nto procreate and the freedom to decide if, when and how often to do so, poor reproductive \nhealth outcomes have long been acknowledged as a main cause of economic \nhardship for women and their children, accounting for 18% of the total global burden \nof disease and representing 32% of the burden among women of reproductive age. \nThus, the presented theoretical model of the demand for reproductive health services is a derived demand for reproductive health (with adjustment costs). Our theory \nsuggests that the relationship between family planning services, their marginal costs, \nthe stock of reproductive health capital and the woman's earnings volatility is essentially \nnonlinear. The theoretical predictions arising from the model are empirically \nsupported from individual level South African data. \nBecause a number of the health costs are associated with `mistakes', in the sense \nthat childbearing might be ill-timed, because the reproduction process cannot be \ncompletely controlled, at least yet, the previous model is extended to account for \nuncertainty in the process. In other words, an assumption that contraception gives \nwomen perfect control over their fertility outcomes is considered to be too simplistic. \nTherefore, the focus remains on the e ectiveness of contraceptive use in controlling \nfertility, but in a setting of uncertainty. The model developed ts nicely into the analysis \nof the sequential nature of the human reproductive process, as it makes use of the \ncontinuation or option value of contraception, which is assumed to depend on potential \nfuture labor market prospects, and the uncertainty inherent in the reproduction \nprocess. The model naturally leads to a mixed hitting time (MHT) empricial model; \na woman becomes pregnant when the underlying stochastic reproductive health process \n rst crosses a threshold in zero. We nd empirical support for our theoretical \nanalysis.
Author: Gauthier Tshiswaka-Kashalala
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1422702606