Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-28T07:42:17.117Z Has data issue: false hasContentIssue false

Maternal education and the multidimensionality of child health outcomes in India

Published online by Cambridge University Press:  21 May 2019

Kriti Vikram*
Affiliation:
Department of Sociology, National University of Singapore, Singapore
Reeve Vanneman
Affiliation:
Department of Sociology, University of Maryland, College Park, USA
*
*Corresponding author. Email: [email protected]

Abstract

Maternal education plays a central role in children’s health, but there has been little research comparing the role of maternal education across health outcomes. It is important to distinguish child health outcomes from medical care outcomes. Health outcomes such as short-term morbidity and stunting are multifactorial in origin and determined by a range of factors not necessarily under a mother’s control. Mother’s education, given the necessary structural factors such as medical centres, is likely to lead to increased access to, and uptake of, medical services. Using data from the 2004–05 India Human Development Survey, eight separate logistic regressions were carried out on 11,026 women of reproductive age and their last-born child under five years of age. The results showed that maternal education had the strongest association with medical care, immunization (except polio) and iron supplementation for pregnant mothers, moderate association with underweight and weak association with short-term diseases and stunting. In addition, the study investigated whether maternal education impacts child health and medical care outcomes through the intervening roles of empowerment and human, social and cultural capital. These intervening linkages were found to be missing for short-term diseases and stunting, bolstering the argument that the influence of maternal education is limited for these outcomes.

Type
Research Article
Copyright
© Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Acharya, LB and Cleland, J (2000) Maternal and child health services in rural Nepal: does access or quality matter more? Health Policy & Planning 15(2), 223229.CrossRefGoogle ScholarPubMed
Adams, AM, Madhavan, S and Simon, D (2002) Women’s social networks and child survival in Mali. Social Science & Medicine 54(2), 165178.CrossRefGoogle ScholarPubMed
Amin, R and Li, Y (1997) NGO-promoted women’s credit program, immunization coverage, and child mortality in rural Bangladesh. Women & Health 25(1), 7187.CrossRefGoogle ScholarPubMed
Andrzejewski, CS, Reed, HE and White, MJ (2009) Does where you live influence what you know? Community effects on health knowledge in Ghana. Health & Place 15(1), 228238.CrossRefGoogle ScholarPubMed
Aslam, M and Kingdon, GG (2012) Parental education and child health– understanding the pathways of impact in Pakistan. World Development 40(10), 20142032.CrossRefGoogle Scholar
Babalola, S (2009) Determinants of the uptake of the full dose of diphtheria–pertussis–tetanus vaccines (DPT3) in northern Nigeria: a multilevel analysis. Maternal and Child Health Journal 13(4), 550558.CrossRefGoogle ScholarPubMed
Babalola, S and Fatusi, A (2009) Determinants of use of maternal health services in Nigeria – looking beyond individual and household factors. BMC Pregnancy and Childbirth 9(1), 43.CrossRefGoogle ScholarPubMed
Bain, RE, Gundry, SW, Wright, JA, Yang, H, Pedley, S and Bartram, JK (2012) Accounting for water quality in monitoring access to safe drinking-water as part of the Millennium Development Goals: lessons from five countries. Bulletin of the World Health Organization 90(3), 228235.CrossRefGoogle ScholarPubMed
Basu, A (1992) Culture, the Status of Women, and Demographic Behaviour: Illustrated with the Case of India. Clarendon Press, Oxford.Google Scholar
Bicego, GT and Boerma, JT (1993) Maternal education and child survival: a comparative study of survey data from 17 countries. Social Science & Medicine 36(9), 12071227.CrossRefGoogle ScholarPubMed
Black, RE, Morris, SS and Bryce, J (2003) Where and why are 10 million children dying every year? The Lancet 361(9376), 22262234.CrossRefGoogle ScholarPubMed
Block, SA (2007) Maternal nutrition knowledge versus schooling as determinants of child micronutrient status. Oxford Economic Papers 59(2), 330353.CrossRefGoogle Scholar
Bloom, SS, Wypij, D and Das Gupta, M (2001) Dimensions of women’s autonomy and the influence on maternal health care utilization in a north Indian City. Demography 38(1), 6778.CrossRefGoogle Scholar
Bourdieu, P (1977) Cultural reproduction and social reproduction. In Karabel, J and Halsey, AH (eds) Power and Ideology in Education. Oxford University Press, New York, pp. 487511.Google Scholar
Bourdieu, P (1986) The forms of capital. In Richardson, J (ed.) Handbook of Theory and Research for the Sociology of Education. Greenwood Press, Westport, pp. 241258.Google Scholar
Calder, PC and Jackson, AA (2000) Undernutrition, infection and immune function. Nutrition Research Reviews 13(1), 329.CrossRefGoogle ScholarPubMed
Caldwell, J (1979) Education as a factor in mortality decline an examination of Nigerian data. Population Studies 33(3), 395413.CrossRefGoogle Scholar
Cassell, JA, Leach, M, Fairhead, JR, Small, M and Mercer, CH (2006) The social shaping of childhood vaccination practice in rural and urban Gambia. Health Policy and Planning 21(5), 373391.CrossRefGoogle ScholarPubMed
Chen, Y and Li, H (2009) Mother’s education and child health: is there a nurturing effect? Journal of Health Economics 28(2), 413426.CrossRefGoogle Scholar
Chou, SY, Liu, JT, Grossman, M and Joyce, T (2010) Parental education and child health: evidence from a natural experiment in Taiwan. American Economic Journal: Applied Economics 2(1), 3361.Google ScholarPubMed
Cleland, JG (2010) The benefits of educating women. Lancet 376(9745), 933934.CrossRefGoogle ScholarPubMed
Cleland, JG and van Ginneken, GK (1988) Maternal education and child survival in developing countries: the search for pathways of influence. Social Science & Medicine 27(12), 13571368.CrossRefGoogle ScholarPubMed
Corsi, DJ, Mejía-Guevara, I and Subramanian, SV (2016) Risk factors for chronic undernutrition among children in India: estimating relative importance, population attributable risk and fractions. Social Science & Medicine 157, 165185.CrossRefGoogle ScholarPubMed
Das Gupta, M (1990) Death clustering, mothers’ education and the determinants of child mortality in rural Punjab, India. Population Studies 44(3), 489505.CrossRefGoogle Scholar
Desai, S and Alva, S (1998) Maternal education and child health: is there a strong causal relationship? Demography 35(1), 7181.CrossRefGoogle Scholar
Desai, S, Amaresh, D, Joshi, BL, Mitali, S, Abusaleh, S and Vanneman, R (2010) Human Development in India: Challenges for a Society in Transition. Oxford University Press, New Delhi.Google Scholar
De Silva, MJ and Harpham, T (2007) Maternal social capital and child nutritional status in four developing countries. Health & Place 13(2), 341355.CrossRefGoogle ScholarPubMed
Ewbank, DC (1994) Maternal education and theories of health behaviour: a cautionary note. Health Transition Review 4(2), 215223.Google Scholar
Fantahun, M, Berhane, Y, Wall, S, Byass, P and Högberg, U (2007) Women’s involvement in household decision-making and strengthening social capital– crucial factors for child survival in Ethiopia. Acta Paediatrica 96(4), 582589.CrossRefGoogle ScholarPubMed
Filmer, D and Pritchett, LH (2001) Estimating wealth effects without expenditure data—or tears: an application to educational enrollments in states of India. Demography 38(1), 115132.Google Scholar
Fink, G, Günther, I and Hill, K (2011) The effect of water and sanitation on child health: evidence from the Demographic and Health Surveys 1986–2007. International Journal of Epidemiology 40(5), 11961204.CrossRefGoogle ScholarPubMed
Frost, MB, Forste, F and Haas, DW (2005) Maternal education and child nutritional status in Bolivia: finding the links. Social Science & Medicine 60(2), 395407.CrossRefGoogle ScholarPubMed
Fuchs, R, Pamuk, E and Lutz, W (2010) Education or wealth: which matters more for reducing child mortality in developing countries? Vienna Yearbook of Population Research 8, 175199.CrossRefGoogle Scholar
Gittelsohn, J, Bentley, ME, Pelto, PJ, Nag, M, Pachauri, S, Harrison, A and Landman, LT (eds) (1994) Listening to Women Talk About Their Health: Issues and Evidence from India. Har Anand Publications, New Delhi.Google Scholar
Glewwe, P (1999) Why does mother’s schooling raise child health in developing countries? Evidence from Morocco. Journal of Human Resources 34(1), 124159.CrossRefGoogle Scholar
Goldman, N, Pebley, AR and Gragnolati, M (2002) Choices about treatment for ARI and diarrhea in rural Guatemala. Social Science & Medicine 55(10), 16931712.CrossRefGoogle ScholarPubMed
Government of India (2011) Millennium Development Goals – India Country Report 2011. Central Statistical Organization, Ministry of Statistics and Programme Implementation, Government of India, New Delhi. URL: http://www.in.undp.org/content/india/en/home/library (accessed 6th May 2019).Google Scholar
Grépin, KA and Bharadwaj, P (2015) Maternal education and child mortality in Zimbabwe. Journal of Health Economics 44, 97117.CrossRefGoogle ScholarPubMed
Gross, R, Schoeneberger, H, Pfeifer, H and Preuss, HJ (2000) The four dimensions of food and nutrition security: definitions and concepts. SCN News 20, 2025.Google Scholar
Güneş, PM (2015) The role of maternal education in child health: evidence from a compulsory schooling law. Economics of Education Review 47, 116.CrossRefGoogle Scholar
Handa, S (1999) Maternal education and child height. Economic Development and Cultural Change 47(2), 421–39.CrossRefGoogle Scholar
Harpham, T, De Silva, MJ and Tuan, T (2006) Maternal social capital and child health in Vietnam. Journal of Epidemiology & Community Health 60(10), 865871.CrossRefGoogle ScholarPubMed
Hatt, LE and Waters, HR (2006) Determinants of child morbidity in Latin America: a pooled analysis of interactions between parental education and economic status. Social Science & Medicine 62(2), 375386.CrossRefGoogle ScholarPubMed
Jalan, J and Ravallion, M (2003) Does piped water reduce diarrhea for children in rural India? Journal of Econometrics 112(1), 153173.CrossRefGoogle Scholar
Jamil, K, Bhuiya, A, Streatfield, K and Chakrabarty, N (1999) The immunization programme in Bangladesh: impressive gains in coverage, but gaps remain. Health Policy and Planning 14(1), 4958.CrossRefGoogle ScholarPubMed
Jeffery, P, Jeffery, R and Lyon, A (1989) Labour Pains and Labour Power: Women and Childbearing in India. Zed Books Ltd, London.Google Scholar
Jejeebhoy, SJ (1995) Women’s Education, Autonomy, and Reproductive Behaviour: Experience from Developing Countries. Clarendon House, Oxford and New York.Google Scholar
Jejeebhoy, SJ and Sathar, ZA (2001) Women’s autonomy in India and Pakistan: the influence of religion and region. Population and Development Review 27(4), 687712.CrossRefGoogle Scholar
Kim, R, Mejía-Guevara, I, Corsi, DJ, Aguayo, VM and Subramanian, SV (2017) Relative importance of 13 correlates of child stunting in South Asia: insights from nationally representative data from Afghanistan, Bangladesh, India, Nepal, and Pakistan. Social Science & Medicine 187, 144154.CrossRefGoogle ScholarPubMed
Klasen, S and Pieters, J (2012) Push or Pull? Drivers of Female Labor Force Participation during India’s Economic Boom. IZA Discussion Paper 6395. Institute for the Study of Labor (IZA), Bonn.Google Scholar
Kravdal, Ø (2004) Child mortality in India: the community-level effect of education. Population Studies 58(2), 177192.CrossRefGoogle ScholarPubMed
Kumar, S and Vollmer, S (2013) Does access to improved sanitation reduce childhood diarrhea in rural India? Health Economics 22(4), 410427.CrossRefGoogle ScholarPubMed
Lamont, M and Lareau, A (1988) Cultural capital: allusions, gaps and glissandos in recent theoretical developments. Sociological Theory 6(2), 153168.CrossRefGoogle Scholar
Lareau, A (2003) Unequal Childhoods: Race, Class, and Family Life. University of California Press, Berkeley.Google Scholar
LeVine, RA (1987) Women’s schooling, patterns of fertility, and child survival. Educational Researcher 16(9), 2127.CrossRefGoogle Scholar
LeVine, RA, LeVine, S and Schnell, B (2001) Improve the women: mass schooling, female literacy, and worldwide social change. Harvard Educational Review 71(1), 151.CrossRefGoogle Scholar
LeVine, RA, LeVine, S, Schnell-Anzola, B, Rowe, ML and Dexter, E (2011) Literacy and mothering: How Women’s Schooling Changes the Lives of the World’s Children. Oxford University Press, New York.Google Scholar
Mandelbaum, DG (1986) Sex roles and gender relations in north India. Economic and Political Weekly 21(46), 19992004.Google Scholar
Miller, JE and Rodgers, YV (2009) Mother’s education and children’s nutritional status: new evidence from Cambodia. Asian Development Review 26(1), 131165.Google Scholar
Moestue, H and Huttly, S (2008) Adult education and child nutrition: the role of family and community. Journal of Epidemiology & Community Health 62(2), 153159.CrossRefGoogle ScholarPubMed
Montgomery, MR and Hewett, PC (2005) Urban poverty and health in developing countries: household and neighbourhood effects. Demography 42(3), 397425.CrossRefGoogle Scholar
Nandi, A, Megiddo, I, Ashok, A, Verma, A and Laxminarayan, R (2017) Reduced burden of childhood diarrheal diseases through increased access to water and sanitation in India: a modeling analysis. Social Science & Medicine 180, 181192.CrossRefGoogle ScholarPubMed
Navaneetham, K and Dharmalingam, A (2002) Utilization of maternal health care services in Southern India. Social Science & Medicine 55(10), 18491869.CrossRefGoogle ScholarPubMed
Parashar, S (2005) Moving beyond the mother-child dyad: women’s education, child immunization, and the importance of context in rural India. Social Science & Medicine 61(5), 9891000.CrossRefGoogle ScholarPubMed
Pebley, AR, Goldman, N and Rodríguez, G (1996) Prenatal and delivery care and childhood immunization in Guatemala: do family and community matter? Demography 33(2), 231247.CrossRefGoogle ScholarPubMed
Perry, B and Gesler, W (2000) Physical access to primary health care in Andean Bolivia. Social Science & Medicine 50(9), 11771188.CrossRefGoogle ScholarPubMed
Prüss-Üstün, A, Bos, R, Gore, F and Bartram, J (2008) Safer Water, Better Health: Costs, Benefits and Sustainability of Interventions to Protect and Promote Health. World Health Organization, Geneva.Google Scholar
Raghupathy, S (1996) Education and the use of maternal health care in Thailand. Social Science & Medicine 43(4), 459471.CrossRefGoogle ScholarPubMed
Rowe, ML, Thapa, BK, LeVine, RA, LeVine, S and Tuladhar, SK (2005) How does schooling influence maternal health practices? Evidence from Nepal. Comparative Education Review 49(4), 512533.CrossRefGoogle Scholar
Rutherford, ME, Dockerty, JD, Jasseh, M, Howie, SR, Herbison, P, Jeffries, DJ and Hill, PC (2009) Access to health care and mortality of children under 5 years of age in the Gambia: a case-control study. Bulletin of the World Health Organization 87(3), 216224.CrossRefGoogle ScholarPubMed
Sastry, N (1996) Community characteristics, individual and household attributes, and child survival in Brazil. Demography 33(2), 211229.CrossRefGoogle Scholar
Semba, RD, de Pee, S, Sun, K, Sari, M, Akhter, N and Bloem, MW (2008) Effect of parental formal education on risk of child stunting in Indonesia and Bangladesh: a cross-sectional study. The Lancet 371(9609), 322328.CrossRefGoogle ScholarPubMed
Shin, H (2007) Child health in Peru: importance of regional variation and community effects on children’s height and weight. Journal of Health and Social Behavior 48(4), 418433.CrossRefGoogle ScholarPubMed
Smith-Greenaway, E (2013) Mothers’ reading skills and child survival in Nigeria: examining the relevance of mothers’ decision-making power. Social Science & Medicine 97, 152160.CrossRefGoogle ScholarPubMed
Smith-Greenaway, E, Leon, J and Baker, DP (2012) Understanding the association between maternal education and use of health services in Ghana: exploring the role of health knowledge. Journal of Biosocial Science 44(6), 733747.CrossRefGoogle Scholar
Steele, F, Diamond, I and Amin, S (1996) Immunization uptake in rural Bangladesh: a multilevel analysis. Journal of the Royal Statistical Society, Series A (Statistics in Society) 159(2), 289299.CrossRefGoogle Scholar
Story, WT (2014) Social capital and the utilization of maternal and child health services in India: a multilevel analysis. Health & Place 28, 7384.CrossRefGoogle ScholarPubMed
Story, WT and Carpiano, RM (2017) Household social capital and socioeconomic inequalities in child undernutrition in rural India. Social Science & Medicine 181, 112121.CrossRefGoogle ScholarPubMed
Streatfield, K, Singarimbun, M and Diamond, I (1990) Maternal education and child immunization. Demography 27(3), 447455.CrossRefGoogle ScholarPubMed
Subramanian, SV and Corsi, DJ (2016) Moving beyond a maternal perspective to child survival. Indian Pediatrics 53(10), 867869.CrossRefGoogle ScholarPubMed
Subramanian, SV, Mejía-Guevara, I and Krishna, A (2016) Rethinking policy perspectives on childhood stunting: time to formulate a structural and multifactorial strategy. Maternal & Child Nutrition 12, 219236.CrossRefGoogle ScholarPubMed
Sujarwoto, S and Tampubolon, G (2013) Mother’s social capital and child health in Indonesia. Social Science & Medicine 91, 19.CrossRefGoogle ScholarPubMed
Sunil, TS, Rajaram, S and Zottarelli, LK (2006) Do individual and program factors matter in the utilization of maternal care services in rural India? A theoretical approach. Social Science & Medicine 62(8), 19431957.CrossRefGoogle ScholarPubMed
Million Death Study Collaborators (2010) Causes of neonatal and child mortality in India: a nationally representative mortality survey. The Lancet 376(9755), 18531860.CrossRefGoogle Scholar
UNICEF (2013) Improving Child Nutrition: The Achievable Imperative for Global Progress. UNICEF, New York, pp. 1114.Google Scholar
Vikram, K (2015) Social capital and childhood malnutrition in India. PhD dissertation, Department of Sociology, University of Maryland, MD.Google Scholar
Vikram, K (2018) Social capital and child nutrition in India: the moderating role of development. Health & Place 50, 4251.CrossRefGoogle ScholarPubMed
Vikram, K, Vanneman, R and Desai, S (2012) Linkages between maternal education and childhood immunization in India. Social Science & Medicine 75(2), 331339.CrossRefGoogle ScholarPubMed
Wang, H, Liddell, CA, Coates, MM, Mooney, MD, Levitz, CE, Schumacher, AE et al. (2014) Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet 384(9947), 957979.CrossRefGoogle ScholarPubMed
WHO (1995) Physical Status: The Use of and Interpretation of Anthropometry. Report of a WHO Expert Committee. World Health Organization Technical Report Series No. 854. World Health Organization, Geneva.Google Scholar
WHO (2014) Preventing Diarrhoea Through Better Water, Sanitation and Hygiene: Exposures and Impacts in Low- and Middle-Income Countries. World Health Organization, Geneva.Google Scholar