The Impact of “Mother‐Friendly Care” Accreditations on Patient Choice: Evidence From Brazil

ABSTRACT

We examine the impact of Brazil's “Mother‐Friendly Care” accreditation program on hospital choice. Using administrative data on births in the Brazilian public health system from 2008–2019, we estimate a nested logit demand model that allows for differential substitution patterns based on existing Baby‐Friendly Hospital Initiative (IHAC) accreditation. We find that “Mother‐Friendly Care” accreditation significantly increases hospital utility, raising the aggregate market share of accredited hospitals by an average of 4.1 percentage points (p.p.) across municipalities. Counterfactual analysis reveals that restricting accreditation to IHAC hospitals substantially limited the program's impact on hospital choice: distributing accreditation across both IHAC and non‐IHAC hospitals would have resulted in aggregate market share gains of 10.2 p.p., demonstrating how existing IHAC certification shapes substitution patterns and limits policy reach.