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Document Type
Working Papers
Publication Topic(s)
Child Health
Sarah C. Giroux and Macro International Inc. Calverton, Maryland, USA
Publication Date
August 2008
Publication ID

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Study Objectives. Two concurrent social changes in sub-Saharan Africa have the potential to improve the health of children in these countries. First, the dilution effect of fertility declines may result in the availability of more resources per child. Second, improvements in women’s education may additionally translate into improved child outcomes. This study estimates the human capital dividends associated with these dual transitions, especially those in the realm of child stunting. Data and Methods. This study uses data from six sub-Saharan countries. It examines the relationship between fertility change and stunting at both the macro- (cross-sectional and historical correlation) and micro- (regression) levels. Methodologically, it uses an analytical framework that permits aggregation of micro-level evidence and decomposition of dividends into the specific effects of fertility and educational transitions. Main Results. First, the cross-sectional findings suggest a relationship between stage in the fertility transition and stunting; however, the historical country-specific trends are less clear. This is partially due to the fact that in three of the six country periods, the number of children competing for resources within the household increased even as fertility declined. Second, the regression results suggest the importance of maternal education and sibsize in the majority of study settings. Lastly, the decomposition shows that changes in the baseline socioeconomic conditions and the effect of sibsize and maternal education are the dominant drivers of change. However, when the prevalence of stunting declines, changes in maternal education and sibsize play an important role. When the prevalence of stunting increases, changes in maternal education make a small, but still significant, contribution. Conclusions and Implications. The findings suggest that little reduction in stunting can be expected from fertility declines per se, but dividends are more likely when the actual numbers of children residing in households declines. In addition, the findings suggest that recent gains and reversals in women’s schooling are contributing to changes in the prevalence of stunting. Policies that promote women’s schooling, family-planning programs, and initiatives that channel resources to families with many children may thus help to reduce the prevalence of stunting.