Maternal education is associated with reduced female disadvantages in under-five mortality
in sub-Saharan Africa and southern Asia |
Authors: |
Christiaan WS Monden, and Jeroen Smits |
Source: |
International Journal of Epidemiology, 42: 211–218; DOI: 10.1093/ije/dys201 |
Topic(s): |
Childhood mortality Children under five Gender Infant mortality Maternal health Neonatal mortality
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Country: |
More than one region
Multiple Regions
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Published: |
DEC 2012 |
Abstract: |
Background The male:female (M:F) mortality ratio for under-five mortality
varies considerably across and within societies. Maternal education
has been linked to better outcomes for girls, but the evidence
is mixed. We examined how the M:F ratio for under-five mortality
varies by maternal education in sub-Saharan Africa and
southern Asia.
Methods We used recent Demographic and Health Surveys from
31 sub-Saharan African and 4 southern Asian countries. M:F mortality
ratios were determined using information on 49 769 deaths
among 521 551 children. We estimate M:F ratios for under-five
(month 0–59), neonatal (month 0), post-neonatal (month 1–11)
and child mortality (month 12–59) by maternal education while
controlling for demographic and household characteristics. M:F
ratios for under-five mortality and child mortality are compared
with more ‘gender neutral’ thresholds (of 1.25 and 1.17, respectively)
estimated on the basis of the Human Mortality Database.
Results In sub-Saharan Africa, the M:F ratio for under-five mortality is 1.09
[95% confidence interval (CI) 1.06–1.13] among non-educated
mothers, 1.14 (95% CI 1.09–1.19) among mothers with some primary
education and 1.25 (95% CI 1.16–1.34) among mothers with
some secondary or more education. For southern Asia, the ratios are
0.88 (95% CI 0.82–0.95), 1.10 (95% CI 0.97–1.25) and 1.13 (95% CI
1.02–1.26), respectively. The M:F ratio for child mortality also
shows an educational gradient in both regions, with the M:F
ratio being lower among non-educated mothers. In southern Asia,
the M:F ratio for child mortality is particularly low among mothers
with no education, M:F ratio¼0.54 (95% CI 0.41–0.72).
Conclusions Among mothers with more education, the difference in the mortality
chances of boys and girls more closely resembles a ‘gender
neutral’ situation than among women with no or little education.
Girls benefit both in absolute and relative terms from having a
more educated mother.
Keywords Under-five mortality, neonatal mortality, post-neonatal mortality,
child mortality, gender bias, maternal educational status, southern
Asia, sub-Saharan Africa |
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