The Long Road to Health: Healthcare Utilization Impacts of a Road Pavement Policy in Rural India
By Shilpa Aggarwal
Journal of Development Economics | June 2021
Journal of Development Economics | June 2021
Citation
Aggarwal, Shilpa. (2021). The Long Road to Health: Healthcare Utilization Impacts of a Road Pavement Policy in Rural India Journal of Development Economics www.sciencedirect.com/science/article/pii/S0304387821000468.
Copyright
Journal of Development Economics, 2021
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Abstract
Despite demand-stimulation efforts, coverage rates of many essential health services remain low in developing countries, suggesting that there may be binding supply constraints, such as poor access to healthcare facilities. This paper utilizes quasirandom variation in road-pavement intensity to study the impact of improved access on adoption of reproductive health services. I find that road construction led to more institutional antenatal visits and deliveries, which translated into better medical care and vaccination coverage, with larger gains for girls. Better ante-natal care resulted in fewer miscarriages, although much of this decline is due to delayed, rather than averted mortality as infant mortality went up. Overall mortality, including in-utero, stillbirths, and during infancy, is unimpacted. Most gains in natal and ante-natal care accrue from repeat visits by existing patients, and some from new entrants into the formal health sector. Evidence suggests that beneficiaries travel farther to see better providers.
Shilpa Aggarwal is an Associate Professor of Economics and Public Policy at the Indian School of Business (ISB). She is a development economist, whose research aims to explore market linkages in developing countries. For her PhD dissertation, she examined the effects of a road construction programme in India that connected remote rural areas to nearby markets. Her ongoing research is focused on agricultural supply chains in India and East Africa. She also works on issues pertaining to domestic trade, microfinance, and food policy.
Professor Aggarwal holds a PhD from the University of California, Santa Cruz, an MA from the Delhi School of Economics, and a BA from Shri Ram College of Commerce, University of Delhi.

Shilpa Aggarwal