The role of maternal education in child health evidence from china​

The result shows that maternal education strength affects children’s health, and household wealth as well as gender and living area slightly impact on child health.. Both household wealt

VIETNAM – THE NETHERLANDS PROGRAMME FOR M.A IN DEVELOPMENT ECONOMICS

THE ROLE OF MATERNAL EDUCATION IN CHILD HEALTH: EVIDENCE FROM CHINA

BY

NGUYEN THI HONG CAM

MASTER OF ARTS IN DEVELOPMENT ECONOMICS

HO CHI MINH CITY, December 2017

VIETNAM - NETHERLANDS PROGRAMME FOR M.A IN DEVELOPMENT ECONOMICS

THE ROLE OF MATERNAL EDUCATION IN CHILD HEALTH: EVIDENCE FROM CHINA

A thesis submitted in partial fulfilment of the requirements for the degree of

MASTER OF ARTS IN DEVELOPMENT ECONOMICS

DECLARATION

“I certify the content of this dissertation has not already been submitted for any degree and is not being currently submitted for any other degrees I certify that, to the best of my knowledge, any help received in preparing this dissertation and all source used, have been acknowledged in this dissertation.”

Signature

Nguyen Thi Hong Cam Date: 1 January, 2018

ACKNOWLEDGEMENT

Foremost, I would like to express my sincere gratitude to my supervisor Dr Vo Tat Thang, for his patience, motivation, enthusiasm, sympathy, immense knowledge, and for giving me valuable advice His guidance helped me at all the time of research and writing of this thesis

In addition, I would like to thank Prof Nguyen Trong Hoai, Dr Pham Khanh Nam and Dr Nguyen Luu Bao Doan who have their expertise view with me, the valuable experience in research, and Dr Truong Dang Thuy who has provided the practical econometric technique, a valuable knowledge in research

Furthermore, I would also like to thank all lecturers and staff at the Vietnam Netherlands Program who already supported me wholeheartedly during my studying time in there

In particular, I would like to express my gratitude and affection towards my family for providing me with unfailing support and continuous encouragement throughout my years of study My sincere thanks to all members in K22, who always devotes all love and all the best interest for me I am grateful for my best friends in encouraging me to start the thesis, persevere with it and finally to complete it They always beside by me during difficult moment and sharing ups and downs with me and making my burdens lighter

Finally, I take this opportunity to express gratitude to Dr Bach Nguyen I am extremely thankful and indebted to him for sharing expertise, and sincere and valuable guidance and encouragement extended to me

ABSTRACT

Children healthcare and gender discrimination are a real challenge to China in the process of achieving its Millennium Development Goals (MDGs) In this study, we investigate the influence of mothers’ education on the health status of their children in the context of China The data are derived from the China Family Panel Studies (CFPS) which comprises information from 16,000 households and individuals collected from 25 provinces across China except for autonomous zones The result shows that maternal education strength affects children’s health, and household wealth as well as gender and living area slightly impact on child health The study is one of the first research to estimate the influence of maternal education on child health by quantile regression while the historical papers used OLS or fixed effect to research those influences Quantile regression is employed to analyze the impacts of mothers’ education on child health under different quantiles of the child’s body index variable

JEL classification: I14, I24

Keywords: Child health, maternal education, household wealth, BMI, China.

CHAPTER 3 RESEARCH METHODOLOGY and DATA RESOURCES 22 3.1 Analytical framework 22 3.2 Econometric models 23 3.3 The constructed model 25

3.4.1 The background of data set 28 3.4.2 Characteristics 28

3.4.4 Process 29 CHAPTER 4 EMPIRICAL RESULTS 31

4.2.1 Maternal education 33 4.2.2 Household wealth 34 4.2.3 Gender and living area 34 CHAPTER 5 CONCLUSIONS AND POLICY IMPLICATIONS 41

5.2 Policy implications 42 5.3 Limits of the study 42

List of variables using in data set 47

LIST OF TABLES

Table 1: Descriptive variables 32 Table 2: Correlation within variables 35 Table 3: OLS estimates of determinants of child weight and height 37 Table 4: Quantile regression for Child Weight and Height 38 Table 5:Simultaneous quantile regression results of Child BMI 39 Table 6:Simultaneous quantile regression of child weight for age on all covariates 40 Table 7: Quantile regression for Child BMI 48

LIST OF FIGURES

Figure 1: Bronfenbrenner’s Ecological systems theory 12 Figure 2: The linkage between maternal education and child health (UNICEF, 1998) 22

CHAPTER 1 INTRODUCTION

1.1 Research problem

Nowadays, improving women and children healthcare is the goal of development for global economies In assessing the level of children development, the health of child is used as a major indicator for child development (WHO, 2004), thus indirectly imposing child health as a key factor to determine the level of economic development

Women education plays an important role in child health, especially in developing countries Caldwell (1979) supported that maternal education is the most crucial factor in different child health outcomes The recent trend in governmental policy making is to use resources (generated by economic development) to invest in education When the level of education is improved, parental care-giving is advanced which shall indirectly lead to an improvement in child health

However, education is not the only factor impacting parenting and child health Child health is affected by other determinants such as paternal education, health service availability, and socioeconomic status (Trussell et al 1983 and Edmonston et al., 1983) (Dong et al., 2010) indicated that the relation between economic growth and household wealth is positive, thus implying that the maternal health and parental care-giving can be improved through resources and services It can be concluded that wealth production is the pathway through which economic development can leave positive effect on parental care-giving and child health

Developing countries tend to have a concave association between child health and household wealth Evidences from developing countries have shown that household wealth and child health tend to have a concave association since the diminishing returns to life expectancy is linked to the growth of income (Belli et al., 2002) Both household wealth and maternal education are the pathways for economic development process and child health benefits (Stewart et al., 2000) Furthermore, many of these strategies are interdependent so researchers can analyze the influence of

each variable on child health to find out the magnitude of each strategy toward child health and women’s education policy within the host country

On the other hand, many studies concerned about the effect of environment and social contexts on child health For example, local health environment has significant contribution toward child health (Glewwe, 1999) However, the relation between household wealth and child health was less evident by current research In 2000, Wagstaff estimated the levels of household consumption related with child mortality The result shows that three over nine developing countries have no relationship between five levels of household exhaustion and mortality In addition, political context is another important factor that impacts child health Based on evidence from

22 developing economies, the analysis concluded that the relationship between maternal education and child height for age is significant in cross-national discrepancies (Desai and Alva, 1998)

However, developing countries are still facing other vital issues such as inequality in income as well as unbalanced healthcare and poor living conditions in rural areas Many recent research evaluated the relation between maternal education and child health in developing countries because of difficult challenge in development progress The important issue in developing countries is gender discrimination (Pearson, 1995), regional diversity result in health inequality (Dong et al., 2010)

Gender discrimination is the most critical issue that effect parental care-giving, especially in China Male members can earn more money in compare to their female counterparts; thus, the rights of women within the household are misappropriated (Anker and Hein, 1985) even though many evidences show that women also contributed to the labor force In addition, parental education has strong effect on child health, but the impact of maternal education is greater than the effect of father’s education (Peng et al., 2006)

China is considered the world’s most populated and the second largest developing country As a result, the Chinese government faces many difficulties and challenges on its developing process One of the first challenges for the Chinese government is to improve child health and woman health progress, which have

achieved more significant achievements over the past decades in China The gap in infant and maternal mortality ratios between urban and rural areas is still large although these rates have been reduced to lower levels in recent years Looking at the case of Western China, the most important law in the West of China is that the qualities of the human population must always be increased That is the reason the Chinese authorities distributes teaching role and management for each level based on

a hierarchical network of maternal and child health services

The second development challenge for China is the unbalanced gender ratio and inequality household income In China, the number of women employed in fulltime jobs could be limited because the employers prefer male employees than by women (due to their child-care obligations) Many rural Chinese households are stem families, in which three generations live under the same roof The adult-to-child ratio

in these families is quite large since Chinese birth control policies in the past limit the number of children for each couple to one In addition, gender discrimination is one of the the most critical issues in urban China (Feng et al., 1992)

The larger the size of the production market, the more competitive between firms to attain skilled and experienced workers A greater number of private and collective firms instead of state-owned firms indicates a greater population of companies competing with one another for resources As the result, labor markets will

be more developed in regions and localities that have more developed commodity and production markets It could be argued that labor markets for non-agricultural work are simply a functional level of industrialization, since in the absence of industry the only source of employment for rural people is agriculture and small-scale commerce

As a result, the Chinese society created the household income inequality

1.2 Research objective

This dissertation focuses on analyzing the influence of the level of women education (mother) on child health, with controlling the effect of economic growth, household wealth and father’s educational level as well as heredity factors and children gender

Consequently, the main objectives are considered consist of:

First, analyzing the relation between body mass index of both children and

their parent and parent’s education level

Second, estimating the household wealth association with child health

Third, evaluating how the influence of gender discrimination as well as

economy of living area

1.3 Scope of the study

The thesis analyses the interaction between mother’s education and child health, which is measured by the children’s body mass index (BMI) is calculated by the ratio of height of age and the weight of age Moreover, the study controls external factors consist of environment, household income, the educational father, heredity factors, age and gender of children The research in term of 25 provinces in China in

The body mass index for the analysis was objectively measured, reducing possible misclassification, although there a number of papers examined the child health through either the weight of age or the height of age of children

1.5 Thesis structure

The paper is organized as follows Chapter II is Empirical studies which briefly reviewed the recent literature Then, details estimation strategy in chapter III After that, chapter IV will analyze the current the data and determine the empirical results Finally, conclusion and implication policy are included in chapter V

CHAPTER 2 LITERATURE REVIEW

2.1 Theoretical background

Children health is a part of children development researches The thesis based

on two theoretical frameworks

Ecological systems theory: This theory looks at a child’s development within the context of the system of relationships that form his or her environment Bronfenbrenner’s theory defines complex “layers” of environment, each having an effect on a child’s development This theory has recently been renamed “bioecological systems theory” to emphasize that a child’s own biology is a primary environment fueling their development The interaction between factors in the child’s maturing biology, their immediate family or community environment, and the societal landscape fuels and steers its development Changes or conflict in any one layer will ripple throughout other layers To study a child’s development then, we must look not only at the child and her immediate environment, but also at the interaction of the larger environment as well

Figure 1: Bronfenbrenner’s Ecological systems theory

Bronfenbrenner’s theory includes the following layers:

First, the microsystem is the layer closest to the child and contains the structures with which the child has direct contact The microsystem encompasses the relationships and interactions a child has with her immediate surroundings (Berk, 2000) Structures in the microsystem include family, school, neighborhood, or childcare environments At this level, relationships have impact in two directions - both away from the child and toward the child For example, a child’s parents may affect his beliefs and behavior; however, the child also affects the behavior and beliefs

of the parent Bronfenbrenner calls these bi-directional influences, and he shows how they occur among all levels of environment The interaction of structures within a layer and interactions of structures between layers is key to this theory At the microsystem level, bi-directional influences are strongest and have the greatest impact

on the child However, interactions at outer levels can still impact the inner structures

Second, the mesosystem is the layer provides the connection between the structures of the child’s microsystem (Berk, 2000) Examples: the connection between the child’s teacher and his parents, between his church and his neighborhood, etc

Third, the exosystem is the layer defines the larger social system in which the child does not function directly The structures in this layer impact the child’s development by interacting with some structure in her microsystem (Berk, 2000) Parent workplace schedules or community-based family resources are examples The child may not be directly involved at this level, but he does feel the positive or negative force involved with the interaction with his own system

After that, the macrosystem is layer may be considered the outermost layer in the child’s environment While not being a specific framework, this layer is comprised

of cultural values, customs, and laws (Berk, 2000) The effects of larger principles defined by the macrosystem have a cascading influence throughout the interactions of all other layers For example, if it is the belief of the culture that parents should be solely responsible for raising their children, that culture is less likely to provide resources to help parents This, in turn, affects the structures in which the parents

function The parents’ ability or inability to carry out that responsibility toward their child within the context of the child’s microsystem is likewise affected

Finally, the chronosystem which is a system encompasses the dimension of time as it relates to a child’s environments Elements within this system can be either external, such as the timing of a parent’s death, or internal, such as the physiological changes that occur with the aging of a child As children get older, they may react differently to environmental changes and may be more able to determine more how that change will influence them

From Bronfenbrenner’s (1986) ecological theory, these factors include maternal education (microsystem level), maternal and family involvement in children’s home activities (microsystem level), maternal and family involvement in children’s school activities (mesosystem level), and the social support (exosystem level)

Also, the ecological theory views child outcomes as dependent upon the characteristics of the child, parent, family, school, community, and larger society, as well as the interactions among these variables However, some researchers have argued that this traditional ecological framework is limited because it does not adequately consider variables such as social position (e.g., social class, ethnicity, race, and gender), social stratification (e.g., racism, prejudice, discrimination, and segregation), and adaptive culture (e.g., traditions and cultural legacies, migration and acculturation, economic and political histories) experienced by family members of color who are born in the United States or other countries To address this problem, Garcia Coll et al (1996) proposed an integrative model to study the development of competence in children of color, by considering both social position and social stratification constructs at the core rather than at the periphery of a theoretical formulation of children’s development In this model, the researchers address some important factors omitted or neglected in mainstream ecological models, such as experiences of racism and segregation, intragroup variability and diversity within minority group families, and the effects of social stratification and acculturation on the developmental competencies of minority group children

Children inhabit both families and child-care microsystems, and these systems are linked Parents select particular types of child care, of varying quality, for children

of different ages—and these decisions vary with family structure, parental characteristics, geographical location, and other factors Singer, Fuller, Keiley, and Wolf (1998) argued that child-care researchers must consider these selection effects if they are to accurately model the impact of child care on children’s development over time In the research, the authors refer to the effects of family-level and community-level factors on child-care

In this study, the main hypothesis is that maternal education may affect children health at least in the following two ways First, women with more years of education have higher production and allocation efficiencies in their children’s health production (Grossman, 2006) Production efficiency means better health condition with given health production input, while allocation efficiency means optimal combination of different health inputs with given budget Maternal education can raise both production and allocation efficiencies, and thus improve children’s health Second, higher maternal education can also affect the amount of inputs of children’s health production More educated women have higher labor market income (labor market effect) and “match” with better educated and higher income husbands (assortative mating effect), while more family resources and better family environment contribute to children’s health human capital accumulation (McCrary and Royer, 2011)

2.2 Empirical reviews

2.2.1 The impact of maternal education on child health

The mother’s education in most of papers are measured by the number of year

of schooling

The relation between mother’s education and child health has long been supported by many evidences Barrera (1990) researched the impact of mother’s education on child health in which the indicator for good or bad child health is determined by height – for – age scores The regression result shows a positive effect

of maternal education on child nutritional outcomes Also, mother’s education improves children’s height – for – age

Similarly, the effect of maternal education on three markers of child health is examined in 22 developing countries (Desai and Alva, 1998) The markers of child health consist of the probability of infant death, children’s height – for – age, and immunization status The ranking of level educational mother includes 2 levels, mother not educated and secondary educational level The result indicates that there is

a consistent association between mother’s education and infant mortality Meanwhile, the correlation between maternal education and children’s height – for – age is positive and significant Although the coefficient correlation of mother’s education on immunization status is small, this effect is statistically significant in sample countries

Moreover, the effect of mother’s schooling on child health is can also be seen

in the case of Morocco (Glewwe, 1999) The study also suggests that there is a positive relationship between education and child health However, in this case, the evidences indicated that it is not only education but also the effect of household wealth that leave an impact on child health

The association of maternal education with child health may arise because educated mothers are considered more efficient “producers” of good child health (“productive efficiency”) by adopting better child-care practices or superior hygiene standards Alternatively, it could be because they choose health input mixes that generate more health output (“allocative efficiency”) than selected by less-educated mother

Another studies used natural experiments to identify mother’s education-child health relationship Breierova and Duflo (2004) used the 1995 intercensal survey of Indonesia and school data from the Sekolah Dasar program to investigate the impact

of parents’ education on fertility and child mortality The results show a positive and significant effect of the school program on parents’ education and a negative effect on fertility Both father’s and mother’s education were found to reduce child mortality The authors found little evidence to support the intuition that the mother’s education effect is stronger than the father’s Similarly, using a natural experiment from Taiwan

(a new compulsory education law), Chou et al found evidence of a causal relationship between parents’ education and child health, but contrary to the previous study, mother’s education was found to be stronger effect than father’s education No pathway investigation was attempted in either study

Maternal education in child health functions may therefore be affected by different factors (at the level education of the father, household welfare and place where child born) A study by (Thomas, Strauss et al., 1990) in Brazil analyses the role of income, mother’s literacy and information processing, and the interaction of maternal schooling with community services The authors find that for most of time all the impact of maternal schooling on child height can be explained through mother’s access to information (i.e exposure to media)

Besides, some authors have found a significant effect of maternal education on child health status while others argue that there is little or no evidence of a causal relationship For instance, Frongillo, de Onis, and Hanson (1997) ran cross-country OLS regressions of child height-for-age (stunting) and weight-for-height (wasting) on education variables, food security, geographic region and other variables They found that the female literacy rate had a significantly negative effect on stunting The main shortcoming of this study is that it did not address the heterogeneity in child health endowment and did not use instrumental variables methods to address the endogeneity

of female literacy rate While Martorell, Leslie, and Moock (1984) found no evidence

of an impact of parents’ education on child health outcomes Baya (1998), using data from a town in Burkina Faso, found that after controlling for father’s education, the effect of mother’s education on child survival loses significance He concludes that studies on parents’ education and child health status should not focus on mother’s education

Handa (1999) examined six pathways through which mother’s education might affect child health outcomes: income effects, interactions with household characteristics, interactions with community services, information processing,

unobserved household heterogeneity1, and intrahousehold bargaining power Using data from Jamaica, Handa found that information processing is found to be a pathway through which mother’s education affects child health outcomes Handa argued that he was able to control for unobserved household heterogeneity He used the fact that in Jamaican households there are usually children from different mothers, and women in the same household care for all children whether the children are their own or not This is questionable because there is likely to be mother heterogeneity The other limitations of this study include treating parents’ education as exogenous, and using unobserved household heterogeneity as a pathway; it is really an estimation problem, not a pathway

Webb and Block (2004), using household survey data from Central Java, Indonesia, found that a mother’s nutritional knowledge is a determinant of child short-term nutritional status (weight-for-height) whereas her schooling is a determinant of long-term nutritional status (height-for-age) These authors could not find plausible instrumental variables for maternal nutritional knowledge and household expenditures, so they used proxy variables to estimate reduced form equations for child nutritional status Webb and Block did not account for the possibility of omitted variable bias that would result from the heterogeneity of child health endowment Appoh and Krekling (2005), using data from the Volta Region in Ghana, found that mother’s nutritional knowledge is more important than mother’s schooling in determining child weight–for-age However, these authors accounted neither for the simultaneity of inputs choices, nor the endogeneity of mother’s health knowledge

After all, recent research on the relationship between maternal schooling and child health has moved towards underpinning the ‘pathways’ in which mother’s education translates into the improvement in child health While a majority of the evidence has not directly controlled for the endogeneity of maternal schooling, introducing different ‘pathways’ is one way of isolating the ‘true’ impact of maternal education from the effect of confounding factors In a recent study, (Glewwe, 1999)

1 Correlation between mother’s education and unobserved household characteristics Possible sources

of unobserved household heterogeneity: food preparation methods, knowledge of symptoms of ill health, different minimum levels of acceptable sanitation and cleanliness, and different tastes for child health

identifies three channels: 1) direct acquisition of basic health knowledge in school, 2) literacy and numeracy skills learned in school and 3) exposure to modern society The study finds that mother’s health knowledge alone impacts child health outcomes

According to (Boyle Racine et al., 2006), the linkages between maternal education and child health is cross-national difference; child health risks are reduced

at higher levels of household wealth despite the unbalanced relationship between child health and levels of education with the pattern of household wealth However, this research has some limitations, including the model is distributed with some unnecessary variables for improving on policies in population health; the limited regression for variation

2.2.2 The role of household wealth

Household wealth plays an important role in child health (Filmer and Pritchett, 1999) The construction of household wealth index includes the following indicators: first, consumer durables (family owns a radio, television, bike or motorbike or car, etc); second, drinking water sources; third, type of toilet; fourth, household has electricity or not; fifth, the number of bed room; sixth, type of material for floor in house Some factors are used as control variables to analyze the effect of other factors such as maternal education (Boyle, Racine et al., 2006)

Meanwhile, household wealth is measured by net worth, values of businesses and private accounts (Shanks, 2007) The result shows that wealth is a relevant factor associated with child development

The effect of household wealth on child health is similar to the impact of economic development level on child health It can be explained that improving the material status of the family and purchasing goods and services can lead to better health It can be considered that poverty is an important determinant of mortality and poor health in all countries (Wagstaff, 2002) Furthermore, the evidence advocates that there are likely to be positive monotonic relationships between household wealth and child health in most developing countries (Gwatkin, 2000)

2.2.3 The effect of development economic on health

Following a number of previous studies, the level of regional economy is measured by the income of a nation, particularly by GDP per capita based on purchasing power parity In some countries, there would be a negative relation between life expectancy and income inequality (Preston, 1975) Surprisingly, mortality rate in Jamaica is better than Brazil even though the country’s GDP per capita is lower, which has mortality worse than expectation (Filmer and Pritchett, 1999)

The region inequality in health system was demonstrated in Lorenz curve and Kuznets hypothesis (Fang Dong et al., 2010) The Lorenz curve shows that regional health inequality in China is related to socioeconomic factors and health system Also, the Kuznets hypothesis to test the influence of GDP per capita on health distribution The result of testing of Kuznets hypothesis indicated that health inequality had not reached its peak, meaning that China is still laying on the left side of the Kuznets curve

Deaton (2003) captured evidences for the association between national income and health The results indicate that GDP per capita is significantly related to the probability of death in developed countries Besides, the effect of income inequality

on health in developing countries is bigger than in developed countries This study used National Health Interview Survey (NHIS) with observation sample of approximately 50,000 households in every year, the National Health and Nutritional Examination Survey (NHANES) which surveyed more than 14,000 people in the first round between 1971 and 1975, and the Panel Study of Income Dynamics (PSID) which has followed around 5,000 households (and their children and split-offs) since

1968 The author used all data to find out the interaction among mortality, income, and income inequality A logit model was applied to estimate the log odds of death during the ten-year follow up as a linear function of age including dummy variables for each of the seven income groups These logits are estimated for white males and females separately, using data only for those aged 18 to 75 at the time of first interview (The log odds of mortality are approximately linear in age over this range.)

In order to conduct a state-level analysis, each of these models is fitted to data for a single state, thus allowing inequality or any other state-level produce an unrestricted effect on the relationship between mortality and income In findings, income inequality becomes relatively more important as a cause of death at higher income levels

2.3 Summary

From the recent researches, the weight of age and the height of age are only measured method for the health of children However, I suggest BMI is an accuracy health measurement to determine the child health

In this study, the model organizes contexts of child health into 3 levels of external influence, including the family impact the child health directly, the environment elements and the physiological indirect affect child health

A major factor affecting the limited research in China is the lack of papers examining that issue Furthermore, the study contributes to the literature as one of the first research employing CFPS dataset The availability of rich recent data from CFPS allows us to overcome this gap in the literature

CHAPTER 3 RESEARCH METHODOLOGY and

DATA RESOURCES

3.1 Analytical framework

Figure 2: The linkage between maternal education and child health (UNICEF, 1998)

The conceptual framework guiding this study is based on the linkage between maternal schooling, childcare, and the health of children Above figure shows the possible linkages between maternal education and child health that this study explores The possible pathway through which maternal education can affect the health of children is through skill acquisition that leads to improved knowledge about healthcare and parental knowledge Therefore, it is expected that women with more education are more aware of the benefits of feeding children at the appropriate times and in right quantities, and preventing the BMI ‘s child overweight These practices can improve child health

Numbers of studies have modeled the effects of maternal education on child health outcomes through four non-excluded models: socioeconomic status, women

Maternal education

Maternal demographic

factors:

- Mother's education

- Mother's body index

- Time spending for child

Socioeconomic factors:

- Residence (urban or rural)

- Household wealth index

- Husband's education

Child health factors:

- The weight of age

- The height of age

- The body mass index

Child demographic factors:

- Child sex

- Child age

empowerment and autonomy, health knowledge and attitudes, and health and reproductive behavior

According to this model, maternal education is a proxy for socioeconomic status at the individual and household levels (Cleland and Van Ginneken, 1988; Frost

et al., 2005) The most educated women come from high socioeconomic strata of the society They tend to have better work opportunities and high incomes compared to non-educated women Educated women are also more likely to marry husbands with high education level, and belonging to high socio-economic class of the society (Cleland and Van Ginneken, 1988; Barrett and Browne, 1996) In addition, they tend

to live in more economically developed areas such as urban areas with access to safe water, sanitation systems, and health facilities In parallel, children from high socio-economic households with mothers working in formal sectors are well fed, less exposed to infectious diseases, and have access to health services (preventive and curative cares) Therefore, there is an inverse relationship between the mother’s education and child under-nutrition (Frost et al., 2005; Mukuria et al, 2005)

These variables were chosen on the basis of their associations with the likelihood of women’s education and child nutrition status as observed in previous studies in sub-Saharan Africa (Desai and Alva, 1998)

From empirical evidences, the thesis constructs 3 hypotheses as following: H1: The maternal education positive effect on child health

H2: The household wealth positive impact on child health

H3: The interaction influence of both gender discrimination and living area on child health positive significantly

3.2 Econometric models

The main method for regression is quantile regression2, which extends a picture

of the correlation within the independent variables and the dependent variables, it has

2 The quantile regression model introduced by Koenker, R and G Bassett (1978) "Regression quantiles Econometrica 46 33–50." Mathematical Reviews (MathSciNet): MR474644 Digital Object Identifier:

doi 10: 1913643