Maternal Education, Community Factors and Fertility in Relation to Child Health in Developing Countries

This thesis, comprising three research papers, studies the three important relationships in the field of child survival: (a) the relationship between maternal education and child survival; (b) the relationship between community factors and individual characteristics and how they impact child health; and (c) the relationship between fertility and child survival. These three relationships have been well studied but gaps remain in the literature. First, unlike the wealth advantage , the behavioral advantage of maternal education has suffered from lack of empirical evidence. Second, the knowledge of the interaction between individual or household level variables and community level factors is limited and mixed. Third, few studies examine the impact of the price of child survival on fertility. This thesis applies the theory of household health production function in behavioral economics to examine how maternal education, community factors and fertility behavior interact with the child health producing process in a household. Paper 1 uses data from the Mali Demographic and Health Survey (DHS) 1996 and 2000 to unpack the gap in child survival between educated women and uneducated women into the gap in household wealth and the gap in household behaviors. The findings indicate both the wealth advantage and behavioral advantage, due to improved maternal education, significantly contribute to better child survival, and the share of the behavioral advantage contribution to child survival has increased from 1996 to 2000. Paper 2 analyzes data from the China Nutrition and Health Survey (CNHS) 1993 to examine how a list of community-level variables including infrastructure, health services, food market availability, water and sanitation, and the family planning policy, interacts with the individual-level variables such as wealth, education and occupation. The results suggest that increased access to local infrastructure, basic health services, plus the knowledge brought by the improved access, help the disadvantaged households more. On the other hand, local services, which require a certain level of knowledge and skill with which to comply, benefit the advantaged households better. Paper 3 operationalizes the "price of child survival" as the strength of the relationship between economic resources and child survival. Based on fifteen Demographic and Health Survey data from nine western African countries, this paper concludes that regions where wealth has a greater impact on child health are the same regions where it pays to limit family size in order to invest on quality to a smaller set of children.

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