APPENDIX 5
Health Provider Knowledge and the Private Sector
To determine the effect of private sector growth, the study examined how change in the availability of private health clinics in a community is correlated with changes in diagnostic vignette scores. Variants of the following model are examined: ΔQjt = b1ΔPrivjt + b 2Qjt−1 + ΔX'γ + Sumatra + Other + e jt , where ΔQjt is the change in community j’s vignette score from 1997 to 2007, and ΔPrivjt is the change in number of private practices per 1,000 residents from 1997 to 2007. In different specifications, the effects of changing physician practices from midwife practices are examined separately. In recognition of the likely importance of convergence in quality shown earlier, a measure of the initial vignette score, Qjt−1, and also a vector of changes in other community covariates, ΔX, that may independently influence quality are included. These other correlates include the medical facility utilization rate, population per square mile, log per capita expenditure in the enumeration area, a dummy variable for availability of Askeskin/Jamkesmas insurance in 2007, and an indicator for whether the community had an asphalt road in 2007. Finally, to control for differences in provincewide growth, dummy variables for Sumatra and Other Provinces are included. 123