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The complementarity of MDG achievements : the case of child mortality in Sub-Saharan Africa

  • Lay, Jann
  • Robilliard, Anne-Sophie

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.

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Paper provided by The World Bank in its series Policy Research Working Paper Series with number 5062.

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Date of creation: 09 Sep 2009
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Handle: RePEc:wbk:wbrwps:5062
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  1. Saifuddin Ahmed & W. Mosley, 2002. "Simultaneity in the use of maternal-child health care and contraceptives: evidence from developing countries," Demography, Springer, vol. 39(1), pages 75-93, February.
  2. Brockerhoff, Martin & Derose, Laurie F., 1996. "Child survival in East Africa: The impact of preventive health care," World Development, Elsevier, vol. 24(12), pages 1841-1857, December.
  3. Jenkins, Stephen P, 1995. "Easy Estimation Methods for Discrete-Time Duration Models," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 57(1), pages 129-38, February.
  4. Kenneth Harttgen & Mark Misselhorn, 2006. "A Multilevel Approach to Explain Child Mortality and Undernutrition in South Asia and Sub-Saharan Africa," Ibero America Institute for Econ. Research (IAI) Discussion Papers 152, Ibero-America Institute for Economic Research.
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  6. Filmer, Deon & Pritchett, Lant, 1998. "Estimating wealth effects without expenditure data - or tears : with an application to educational enrollments in states of India," Policy Research Working Paper Series 1994, The World Bank.
  7. D. Omariba & Roderic Beaujot & Fernando Rajulton, 2007. "Determinants of infant and child mortality in Kenya: an analysis controlling for frailty effects," Population Research and Policy Review, Springer, vol. 26(3), pages 299-321, June.
  8. Maitra, Pushkar & Pal, Sarmistha, 2008. "Birth spacing, fertility selection and child survival: Analysis using a correlated hazard model," Journal of Health Economics, Elsevier, vol. 27(3), pages 690-705, May.
  9. Martin Brockerhoff, 1990. "Rural-to-Urban migration and child survival in Senegal," Demography, Springer, vol. 27(4), pages 601-616, November.
  10. Fay, Marianne & Leipziger, Danny & Wodon, Quentin & Yepes, Tito, 2005. "Achieving child-health-related Millennium Development Goals: The role of infrastructure," World Development, Elsevier, vol. 33(8), pages 1267-1284, August.
  11. Sarah Ssewanyana & Stephen D. Younger, 2008. "Infant Mortality in Uganda: Determinants, Trends and the Millennium Development Goals," Journal of African Economies, Centre for the Study of African Economies (CSAE), vol. 17(1), pages 34-61, January.
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