The Complementarity of MDG Achievements : The Case of Child Mortality in Sub-Saharan Africa

This paper analyzes complementarities between different Millennium Development Goals, focusing on child mortality and how it is influenced by progress in the other goals, in particular two goals related to the expansion of female education: universal primary education and gender equality in education. The authors provide evidence from eight Sub-Saharan African countries using two rounds of Demographic and Health Surveys per country and applying a consistent micro-econometric methodology. In contrast to the mixed findings of previous studies, for most countries the findings reveal strong complementarities between mothers educational achievement and child mortality. Mothers schooling lifts important demand-side constraints impeding the use of health services. Children of mothers with primary education are much more likely to receive vaccines, a crucial proximate determinant of child survival. In addition, better educated mothers tend to have longer birth intervals, which again increase the chances of child survival. For the variables related to the other goals, for example wealth proxies and access to safe drinking water, the analysis fails to detect significant effects on child mortality, a finding that may be related to data limitations. Finally, the study carries out a set of illustrative simulations to assess the prospects of achieving a reduction by two-thirds in the under-five mortality rate. The findings indicate that some countries, which have been successful in the past, seem to have used their policy space for fast progress in child mortality, for example by extending vaccination coverage. This is the main reason why future achievements will be more difficult and explains why the authors have a fairly pessimistic outlook.

Bibliographic Details

Main Authors:	Lay, Jann, Robilliard, Anne-Sophie
Language:	English
Published:	2009-09-09
Subjects:	ACCESSIBILITY OF HEALTH SERVICES, AGED, ALLOCATION OF RESOURCES, BASIC HEALTH SERVICES, BIRTH SPACING, BIRTHS, BREASTFEEDING, CHANCES OF SURVIVAL, CHILD CARE, CHILD DEATH, CHILD HEALTH, CHILD HEALTH CARE, CHILD IMMUNIZATION, CHILD LABOR, CHILD MORTALITY, CHILD MORTALITY ESTIMATES, CHILD MORTALITY RATE, CHILD MORTALITY RATES, CHILD REARING, CHILD SURVIVAL, CHILDHOOD, CHILDHOOD DISEASES, CHILDHOOD MORTALITY, COMMUNITY HEALTH, DEMOGRAPHIC FACTORS, DEPENDENCY RATIO, DEVELOPMENT STRATEGIES, DIARRHEA, DIET, DIPHTHERIA, ECONOMIC STATUS, EDUCATED MOTHERS, EDUCATION OF WOMEN, EDUCATIONAL ATTAINMENT, EPIDEMIC, ETHNIC GROUP, ETHNIC GROUPS, EXERCISES, FEMALE EDUCATION, FERTILITY, FERTILITY REGULATION, FEWER HOUSEHOLDS, FOOD PREPARATION, GENDER, GENDER EQUALITY, GIRLS, HEALTH CENTERS, HEALTH FACILITIES, HEALTH FACILITY, HEALTH INFRASTRUCTURE, HEALTH OUTCOMES, HEALTH POLICY, HEALTH SECTOR, HEALTH SERVICES, HEALTH SYSTEM, HIV, HIV/AIDS, HOUSEHOLD INCOME, HOUSEHOLD LEVEL, HOUSEHOLD SIZE, HYGIENE, ILLNESS, IMMUNIZATION, IMMUNIZATION COVERAGE, INCOME-GENERATING ACTIVITIES, INFANCY, INFANT, INFANT DEATH, INFANT MORTALITY, INFECTION, INFECTIONS, INJURIES, INTERVENTION, IRON, LEVELS OF CHILD MORTALITY, LONGER BIRTH INTERVALS, LOW-INCOME COUNTRIES, MALARIA, MALARIA PROPHYLAXIS, MALNUTRITION, MATERIAL RESOURCES, MATERIAL WEALTH, MATERNAL FACTORS, MATERNAL HEALTH, MEASLES, MIGRANTS, MILLENNIUM DEVELOPMENT GOALS, MODERN HEALTH, MORTALITY DIFFERENTIALS, MORTALITY LEVELS, MORTALITY RATE, MORTALITY REDUCTION, MORTALITY REDUCTIONS, MORTALITY RISK, MOTHER, NATIONAL LEVELS, NURSE, NUTRITION, NUTRITION OUTCOMES, NUTRITIONAL REQUIREMENTS, NUTRITIONAL STATUS, OLDER CHILDREN, POLICY CHANGE, POLICY RESEARCH, POLICY RESEARCH WORKING PAPER, POLIO, POPULATION GROWTH, PREGNANCY, PRENATAL CARE, PREVENTIVE HEALTH, PREVENTIVE HEALTH CARE, PRIMARY SCHOOL, PRIMARY SCHOOLING, PROGRESS, PROPHYLAXIS, PUBLIC HEALTH, PUBLIC HEALTH SERVICES, PUBLIC SERVICES, PUBLIC TAPS, QUALITATIVE APPROACH, RACIAL INEQUITIES, RADIO, REPRODUCTIVE BEHAVIOR, REPRODUCTIVE CHOICES, RESOURCE REQUIREMENTS, RESPECT, RICHER COUNTRIES, RURAL AREAS, RURAL POPULATION, SAFE DRINKING WATER, SAFE WATER, SANITATION, SECONDARY EDUCATION, SERVICE UTILIZATION, SOCIAL NORMS, TELEVISION, TETANUS, TUBERCULOSIS, UNEDUCATED MOTHERS, UNEDUCATED WOMEN, UNIVERSAL IMMUNIZATION, UNIVERSAL PRIMARY EDUCATION, URBAN AGGLOMERATIONS, URBAN AREAS, URBAN BIAS, URBAN MIGRATION, USE OF HEALTH SERVICES, USER FEES, VACCINATION, VACCINES, WHOOPING COUGH, YOUNG MOTHERS,
Online Access:	http://www-wds.worldbank.org/external/default/main?menuPK=64187510&pagePK=64193027&piPK=64187937&theSitePK=523679&menuPK=64187510&searchMenuPK=64187283&siteName=WDS&entityID=000158349_20090923134848 https://hdl.handle.net/10986/4253
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