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.