Association of remittances with skilled delivery and child health in Uganda, 2015-2020

There are significant disparities in maternal and child mortality ratios between high-income and low- and middle-income countries (LMICs). Despite large decreases in maternal and child mortality in recent decades, with programs such as the Safe Motherhood Initiative, the Sustainable Development Goals and the Millennium Development Goals, maternal and child mortality rates remain very high in LMICs. The objective of this study is to examine the association between the receipt of remittances received by households and skilled delivery among women reporting a recent birth.There are significant disparities in maternal and child mortality ratios between high-income and low- and middle-income countries (LMICs). Despite large decreases in maternal and child mortality in recent decades, with programs such as the Safe Motherhood Initiative, the Sustainable Development Goals and the Millennium Development Goals, maternal and child mortality rates remain very high in LMICs. The objective of this study is to examine the association between the receipt of remittances received by households and skilled delivery among women reporting a recent birth.This study uses data from the household, woman, and community modules of the Uganda National Panel Survey (UNPS) from rounds 2015/2016 and 2019/2020 to examine skilled delivery and skilled delivery with the use of safe birthing kits, child stunting, wasting, and underweight, and childhood malaria, pneumonia, and any report of illness. In the first paper, women of reproductive age with a birth within the last 3 years of data collection were included in the analysis. In the second paper, child health outcomes were assessed using two methods: cross-sectional analysis of pooled data from both years and a panel analysis over both years of survey data. Child illness outcomes use a panel analysis to follow children over time who had changes in their household receipt of remittances. Lastly, a dose-response analysis was performed in both papers to visually assess whether the effects of remittances on all outcomes fluctuated by the amount of money received. The logistic regressions analyses demonstrated no statistically significant associations between receipt of remittances on skilled delivery, child illness, and child growth. However, dose-response analyses demonstrated non-linear changes in the estimated probabilities all outcomes in this study. Recommendations for future research in this area emerged related to examining mechanisms of money transfer, utilizing longitudinal data with larger sample sizes, and using analytic methods that can properly account for the non-linear relationships between remittances and maternal and child health outcomes.