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Fertility Decline, Girls’ Well-being, and Gender Gaps in Children’s Well-being in Poor Countries

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Demography

Abstract

The influences of recent dramatic declines in fertility on girls’ and boys’ well-being in poorer countries are understudied. In panels of 67–75 poorer countries, using 152–185 Demographic and Health Surveys spanning 1985–2008, we examined how declining total fertility and women’s increasing median age at first birth were associated with changes in girls’ well-being and gender gaps in children’s well-being, as reflected in their survival, nutrition, and access to preventive healthcare. In adjusted random-effects models, these changes in fertility were associated with gains in girls’ survival at ages 1–4 years, vaccination coverage at ages 12–23 months, and nutrition at 0–36 months (for women’s later first childbearing). Declining total fertility was associated with similar gains for boys and girls with respect to vaccination coverage but intensified gender gaps in mortality at ages 1–4 years and malnutrition at ages 0–36 months, especially in higher-son-preference populations. Later increases in women’s median age at first birth—reflecting more equitable gender norms—were associated with declines in these gaps. Promoting equitable investments in children through family planning programs in higher-fertility societies is warranted.

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Notes

  1. Scholars discuss these reciprocal influences (Brewster and Rindfuss 2000; Huber 1991; Mason 1997; McDonald 2000) and explore them empirically in wealthier Western countries (Engelhardt et al. 2004; Engelhardt and Prskawetz 2004; Kögel 2004; Matysiak and Vignoli 2008).

  2. The total number of births a woman has in her reproductive lifetime.

  3. Children’s height-for-age z scores are more than 2 standard deviations below the median height-for-age z scores in the NCHS/CDC/WHO reference population (Rutstein and Rojas 2006).

  4. These states are Gujarat, Haryana, Maharashtra, Punjab, and Tamil Nadu.

  5. This ratio remained below 80 per 100 into the 2000s.

  6. For countries in earlier but not later DHS rounds, initial estimations of fixed-effects models with data on selected outcomes imputed from the Multiple Indicator Cluster Surveys (MICS) (UNICEF 2011) showed no meaningful differences in inferences.

  7. A measure for early childhood mortality averaged over a shorter interval of time was not available from the online national statistics database for the DHS.

  8. Population estimates from the 2008 revision of World Population Prospects were matched by year to each DHS (United Nations 2009) and averaged within country to create country-specific weights.

  9. For measures of girls’ well-being, the coefficients in weighted and unweighted models were similar in magnitude and significance. For measures of gender gaps in well-being, the associations of TFR were broadly similar across weighted and unweighted models, but those for AFB were attenuated toward zero and lost significance in the unweighted models.

  10. Robust standard errors were estimated for all fixed-effect models to account for country-level clustering (Dorius 2008). Robust standard errors were not estimable for random-effects models with population-average weights. Inferences from unweighted random-effects models with and without robust standard errors and from weighted random-effects models were comparable.

  11. This demarcation also arguably captures different regional patterns and timings of fertility change.

  12. Of the observations in this analysis, 18 % had initial sex ratios greater than 1.05.

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Acknowledgments

The authors thank the International Center for Research on Women (ICRW) and the Hewlett Foundation for their support. We also warmly thank members and consultants of the Fertility and Empowerment Research Network of ICRW for helpful comments on prior versions of this article. We especially thank Drs. Keera Allendorf, Sajeda Amin, Anju Malhotra, Karen Mason, and Amy Tsui. We also thank Ms. Emily Misch and Ms. Kimi Sato for their assistance with data preparation, and Ms. Francine Pope for assistance with manuscript preparation. This article was drafted while Drs. Nafisa Halim and Sarah Zureick-Brown were post-doctoral fellows and Ms. Kayla LaVilla was a Masters of Public Health student in the Hubert Department of Global Health, Rollins School of Public Health at Emory University. Any remaining errors are the responsibility of the authors.

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  1. Asa Griggs Candler Chair of Global Health, Hubert Department of Global Health and Department of Sociology, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA

    Kathryn M. Yount

  2. Department of Sociology, Emory University, Atlanta, GA, USA

    Sarah Zureick-Brown & Kayla LaVilla

  3. Department of International Health, Boston University, Boston, MA, USA

    Nafisa Halim

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Yount, K.M., Zureick-Brown, S., Halim, N. et al. Fertility Decline, Girls’ Well-being, and Gender Gaps in Children’s Well-being in Poor Countries. Demography 51, 535–561 (2014). https://doi.org/10.1007/s13524-014-0282-0

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