Improving Birth Outcomes of Vulnerable Children Through Home Visiting: Evidence from Mexico City

This paper evaluates a program that promotes maternal and fetal health during pregnancy: Doctor at Your Home (Médico en Tu Casa). This program was adopted by Mexico City’s Ministry of Health in 2014. Through the program, social workers visit households looking for pregnant women without prenatal care and refer them to a health center for prenatal care consults. Whenever women do not attend to the health center, physicians visit them to provide a pregnancy diagnosis and refer them to a health center for follow-up prenatal care consults. Using data from birth certificates and administrative records over 2008-2017, this paper provides estimates on the effect of this intervention on two birth outcomes associated with prenatal care: prematurity and low birth weight. The empirical approach takes advantage of the program’s roll out. In particular, it uses variation in the time the program began operating in each Mexico City county to estimate a differences-in-differences model. In addition, this paper exploits plausible exogenous variation in prenatal care stemming from the pregnancy stage a woman is found by the program. This study aims to shed light on health policy interventions that could decrease preterm birth and low birth weight, which are leading causes of infant death (Mathews and Driscoll 2017) and strong predictors of long-term outcomes (Aizer and Currie 2014; Rossin-Slater 2013).