Direct and Indirect Effects of a Maternal and Child Health Program in Rural Bangladesh

This study is on the impact evaluation of a maternal and child health program in rural Bangladesh. The program was administered in a treatment area with an equally impoverished area retained as a control area. Using a standard utility maximization framework and data from Matlab Health and Socio-Economic Survey of 1996, treatment effects are estimated without the standard problems of endogenous program placement and selection. Results find not just a strong direct effect on the health of targeted individuals but also a significant spillover effect on the health of some non-targeted individuals. Results indicate that the externality is generated within the household and not through a community effect. Thus, this study raises important issues for the design of public policy programs.