Nationally and regionally representative analysis of 1.65 million children aged under 5 years using a child-based human development index: A multi-country cross-sectional study

Background: Education and health are both constituents of human capital that enable people to earn higher wages and enhance people’s capabilities. Human capabilities may lead to fulfilling lives by enabling people to achieve a valuable combination of human functionings—i.e., what people are able to do or be as a result of their capabilities. A better understanding of how these different human capabilities are produced together could point to opportunities to help jointly reduce the wide disparities in health and education across populations. Methods and findings: We use nationally and regionally representative individual-level data from Demographic and Health Surveys (DHS) for 55 low- and middle-income countries (LMICs) to examine patterns in human capabilities at the national and regional levels, between 2000 and 2017 (N = 1,657,194 children under age 5). We graphically analyze human capabilities, separately for each country, and propose a novel child-based Human Development Index (HDI) based on under-five survival, maternal educational attainment, and measures of a child’s household wealth. We normalize the range of each component using data on the minimum and maximum values across countries (for national comparisons) or first-level administrative units within countries (for subnational comparisons). The scores that can be generated by the child-based HDI range from 0 to 1. Conclusions: This study maps patterns and trends in human capabilities and is among the first, to our knowledge, to introduce a child-based HDI at the national and subnational level. Areas of chronic deprivation may indicate within-country poverty traps and require alternative policy approaches to improving child health in low-resource settings. In a multi-country cross-sectional study, Jan-Walter De Neve and colleagues use nationally and regionally representative individual-level data from 1.65 million children aged under 5 years to compute a child-based human development index.Why was this study done?: What did the researchers do and find?: What do these findings mean?: