The effects of women's education on maternal health: Evidence from Peru
Section snippets
Women's education and maternal health
Historically, Peru has had one of the highest rates of maternal mortality in the Western hemisphere, though these rates have fallen precipitously in recent years (World Bank, 2015). The most common causes of maternal mortality2 in Peru include complications related to unsafe abortion (which is highly restricted), hemorrhage, preeclampsia, infections, and
Compulsory schooling in Peru
Understanding whether education improves maternal health, rather than being associated with better health, requires the use of causal inference methods that isolate the effects of education from confounders such as childhood socioeconomic status. In this study, I isolate the effects of education with an instrumented regression discontinuity that takes advantage of a change in Peruvian compulsory schooling laws in the 1990s. Compulsory schooling was first implemented in Peru in 1905 (Freeburger
Sample
I use nationally representative, cross-sectional data from the continuous Demographic and Health Surveys (DHS) collected in Peru every year between 2003 and 2009.4 To isolate the effects of education reform in Peru, I compare respondents who were aged just above and just below the average age of primary school completion in 1993. As depicted in Fig. 2, respondents who were just above the
First-stage results
For CS11 exposure to be a valid instrument for women's education, it must be strongly predictive of years of schooling. Specifically, the validity of the instrument rests on CS11 exposure having a t-value greater than 3.2 or a corresponding p-value below 0.0016; and an F statistic for the excluded instrument above 10 (Stock et al., 2002). Table 2 presents the results of the first-stage model estimating the relationship between respondents' CS11 exposure and highest year of education. The
Limitations
Despite its merits, this study faces several limitations. One is that the only measure of cognitive skills in the DHS—literacy—is basic and exhibits little variation across women. Further analyses are therefore needed to verify the extent to which cognitive skills are a plausible driver of changes in women's fertility practices, healthcare use, and maternal health. Another limitation is that DHS data do not provide a full employment history. This prevents me from controlling for childhood labor
Discussion
This study expands existing scholarship by using an exogenous source of variation to demonstrate a causal link between women's schooling and maternal health. The observed protective effects of education against complications such as fevers and hemorrhaging have important implications for women's risk of disability, morbidity, and mortality over the course of their reproductive years. In the aggregate, these effects may contribute to falling maternal mortality rates and extend women's life
Acknowledgements
The author would like to thank Julia Behrman, Liz Ela, and Anne Clark for their invaluable feedback on earlier drafts of this paper. This research was made possible with the support of an NIA training grant (T32 AG000221).
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