Hospitals, Maternal and Infant Health: Impact of the Opening of Public Hospitals in Mexico

We examine the impact of public hospitals openings in Mexico on maternal and neonatal mortality. Using administrative data from 2001 to 2019 and taking advantage of the variation in the timing of the opening of public hospitals across Mexican municipalities, we estimate a staggered difference-in-differences (DiD) model using the Callaway and SantAnna (2021) (CS) estimator. In doing so, we compare municipalities where a public hospital started to operate to municipalities without a hospital in operation, before and after the opening. Preliminary results show that openings substantially reduced the maternal mortality rate (by 24 maternal deaths per 100,000 births, which amounts to a 40% decrease) and neonatal mortality rate (by 107 infant deaths per 100,000 births, which amounts to a 13% decrease). We provide evidence that the decrease in maternal and neonatal mortality is driven by an increase in institutional deliveries. In addition, we show heterogeneity by type of hospital and the existence of previous medical infrastructure. In particular, the effect is driven by the opening of the first hospital in a municipality, and, in the case of maternal mortality, by the opening of level II hospitals. This research closes a gap in our understanding of the health effects of expanding health care infrastructure in the developing world and suggests policy priorities for scarce public spending on maternal and infant health care.