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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.

Suggested Citation

  • Lay, Jann & Robilliard, Anne-Sophie, 2009. "The complementarity of MDG achievements : the case of child mortality in Sub-Saharan Africa," Policy Research Working Paper Series 5062, The World Bank.
  • Handle: RePEc:wbk:wbrwps:5062

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    References listed on IDEAS

    1. 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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    6. 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;Southern Demographic Association (SDA), vol. 26(3), pages 299-321, June.
    7. 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.
    8. Martin Brockerhoff, 1990. "Rural-to-Urban migration and child survival in Senegal," Demography, Springer;Population Association of America (PAA), vol. 27(4), pages 601-616, November.
    9. 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.
    10. Saifuddin Ahmed & W. Mosley, 2002. "Simultaneity in the use of maternal-child health care and contraceptives: evidence from developing countries," Demography, Springer;Population Association of America (PAA), vol. 39(1), pages 75-93, February.
    11. repec:aph:ajpbhl:2004:94:11:1926-1931_0 is not listed on IDEAS
    12. 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.
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    Cited by:

    1. Jann Lay, 2010. "MDG Achievements, Determinants, and Resource Needs: What Has Been Learnt?," GIGA Working Paper Series 137, GIGA German Institute of Global and Area Studies.
    2. Lofgren, Hans & Cicowiez, Martin & Diaz-Bonilla, Carolina, 2013. "MAMS – A Computable General Equilibrium Model for Developing Country Strategy Analysis," Handbook of Computable General Equilibrium Modeling, Elsevier.

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    Population Policies; Health Monitoring&Evaluation; Early Child and Children's Health; Early Childhood Development; Adolescent Health;

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