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The causal effect of increased primary schooling on child mortality in Malawi: Universal primary education as a natural experiment
Authors: M. Makate, and C. Makate
Source: Social Science and Medicine, 168:72-83. doi: 10.1016/j.socscimed.2016.09.003
Topic(s): Childhood mortality
Children under five
Neonatal mortality
Country: Africa
Published: SEP 2016
Abstract: The primary objective of this analysis is to investigate the causal effect of mother's schooling on under-five health - and the passageways through which schooling propagates - by exploiting the exogenous variability in schooling prompted by the 1994 universal primary schooling program in Malawi. This education policy, which saw the elimination of tuition fees across all primary schooling grades, creates an ideal setting for observing the causal influence of improved primary school enrollment on the under-five fatality rates of the subsequent generation. Our analysis uses data from three waves of the nationally representative Malawi Demographic and Health Surveys conducted in 2000, 2004/05, and 2010. To address the potential endogeneity of schooling, we employ the mother's age at implementation of the tuition-free primary school policy in 1994 as an instrumental variable for the prospect of finishing primary level instruction. The results suggest that spending one year in school translated to a 3.22 percentage point reduction in mortality for infants and a 6.48 percent reduction for children under age five years. For mothers younger than age 19, mortality was reduced by 5.95 percentage points. These figures remained approximately the same even after adjusting for potential confounders. However, we failed to find any statistically meaningful effect of the mother's education on neonatal survival. The juvenile fatality estimates we find are weakly robust to several robustness checks. We also explored the potential mechanisms by which increased maternal schooling might help enhance child survival. The findings indicate that an added year of motherly learning considerably improves the prospect of prenatal care use, literacy levels, father's educational level, and alters fertility behavior. Our results suggest that increasing the primary schooling prospects for women might help reduce under-five mortality in less-industrialized regions experiencing high under-five fatalities such as in sub-Saharan Africa.