Mother Education And Child Health Outcomes:Evidence From Pakistan Demographic And Health Survey 2012-13

Past studies point out the presence of nonlinearity and threshold in the association of mother education with infants' health.Despite its substantial implications on health policy measures,no effort has been made to investigate this issue.This research investigates the existence of threshold or non-linearity by employing the latest data set from Pakistan Demographic and Health Survey 2012-13.Successive eight educational plans and reforms in Pakistan over the period 1955-1998 record large variations in the educational policies and investment in education sector,showing a great focus on primary schooling.It motivates us to select the case study of Pakistan and construct the instrument for purging the coefficients of mother education from endogeneity bias along with the threshold impact.IV regression outcomes disclose that 1-5 and 6-10 years of mother education has insignificant connection with HAZ and WAZ while 11-16 years of education has significant impact on both infants' health outcomes,implying a threshold level at 6-10 years schooling.Thus,it is argued that low cognitive capability via lower level of education,poor educational quality,ineffective education for health even in the text books of 6-10 years of education leads to a permanent cost,and hence to the threshold in the relationship of mother education with child nutrition.Another concern of this study is to estimate whether the education for mothers impacts infants'LBW and malnutrition through their socio-demographic and behavioral pathways or not.This requires the following detail.Although medical achievements have increased the survival of newborns with low birth weight(LBW)even in the developing nations,the higher rate of LBW is still a risk for newborns in Pakistan.The higher rate of LBW among newborns has decreased the chances of child survival in Pakistan.This study proposed to find out the comparative contribution of socioeconomic,behavioral and demographic risk factors to LBW in order to format impressive policy measures for improved child health in future.The selected sample size of 1794 married Pakistani women is taken from Pakistan demographic and health survey 2012-13,who have birth cards containing birth weight of newborns.Descriptive,bivariate and multivariate logistic regression analyses are employed for data analysis.Recorded BW retained from health card shows that the average BW of newborn babies is 2.95 kg.Out of 1794 newborns,about 25%have LBW while 75%are with normal BW.The empirical outcomes exhibits that infants of primary passed and illiterate mothers have more likelihood of LBW.However.infants of urban mothers with zero and primary education are more likely to be with LBW than those of rural mothers.Infants of mothers belonging to poor and middle class family are more likely to have LBW.Infants resided in poor and moderate environmental conditions are more likely to have LBW.Moreover,Only urban mothers with poor and moderate environment settings and rural mothers with poor and moderate family economic status are paying the higher cost of LBW for their infants.Infant BW is significantly lower among less empowered mothers.Furthermore,newborns of urban mothers are less likelihood to face LBW problem as they are not empowered in household affairs.Among controlled predictors.empowerment.economic and residence are strong pathways by which mother education impacts LBW newborns.The interesting point is that mother education remains highly significant while controlling for demographic,socioeconomic and behavioral factors one by one.It suggests that these factors just elucidate a portion of the maternal education impact.However,health information,health-seeking behavior and moderate empowerment are recorded insignificant.Mother education and economic status should be added in the measures of public health arrangement for their consistent link with LBW of newborns.Malnutrition resulting from deficiencies or excesses of nutrients intake causes infant mortality/morbidity.The prevalence of malnutrition like stunting at 44%,and underweight at 3 1%is an alarming situation in Pakistan(NIPS,2012).Although several significant predictors of malnutrition have been outlined in various previous studies,most of them do not signify health knowledge,socioeconomic,empowerment,health seeking,reproductive attitude and community environment of mother as pathways link maternal education to infants,health in both short and long time span.Hence.this research employs logistic regression to see the impact of mother education and intervening pathways on likelihood of stunting and underweight by utilizing the latest data set of Pakistan Demographic and Health Survey 2012-13.Empirical outcomes reveal that wealth status is significantly a strong pathway through which her education impacts infants'stunting and underweight.However,mother empowerment and health seeking behavior are weak pathways.In a nutshell,education remains highly significant in all models,suggesting that the pathways just elucidate the portions of the maternal education.These outcomes suggest that mother education should be targeted in the public health strategies to make better short and long time span infant health.This study also closely analyzes maternal education,infants stunting and underweighting gradient in the context of comparison between urban-rural and male-female infants using binary logistic regression model.The rural infants are more likely to be stunted than urban infants as their mothers are without education and primary passed respectively.Urban mothers with moderate and rich economic positions have 48%and 56%relatively less chances of stunted infants than rural mothers with 23%and 55%respectively.Mothers' attitude toward avoiding from advanced medical amenities results in consistently more likelihood of infant stunting particularly in urban areas.However,rural infants are more susceptible to stunting as their mother has no health knowledge.Moderate environment condition in rural location is also causing more likelihood of stunting.Insignificant associations between rural mother attitude for health care,health knowledge of urban mothers and infant stunting are estimated.Moreover,moderate environment in urban location,mother-father working,empowerment in both rural-urban locations have inconsistent connection with chronic malnutrition.Rural infants are more likely to face acute malnutrition than urban infants as their mothers are with zero education relative to mothers with secondary/higher education.Only rural mothers with formal primary education are more susceptible to have underweighted infants.Rural mothers with moderate and rich economic position have relatively less chances of underweight infants.However,the impact of urban middle and rich class households on underweighted infants is insignificant.Only rural infants are more likelihood to be underweighted if,their mothers are not empowered.There are higher chances of underweight problem as rural mothers lack health knowledge.An inconsistent relationship between mother behavior for health seeking and underweight in both locations is estimated.Only moderate environment condition has a considerable effect on both rural-urban infants' survival in short period in such a way that rural infants with moderate environment condition are relatively more susceptible to acute malnutrition than urban infants.Only urban infants with father working are less underweighted relative to those with both father-mothers working.Interestingly,key empirical findings state that male infants have more likelihood of stunting than female ones as their mothers are illiterate and primary passed.It is also concluded that female infants belonged to middle and rich class households have relatively less likelihood of being stunted than male infants.Female infants' mothers without following and utilizing advanced medical care services are relatively more responsive to stunting for them than male infants'mothers.Female children whose parents are not working significantly call for more stunting than male children.However,only female kids without mother empowerment are more susceptible to chronic malnutrition.Only male children's mother with underweight and overweight BMI has significantly greater chances to have stunted kids.Nutritional level of mothers has no signified impact on their female infants' health.Only male kids with moderate environment are less victim of stunting.Surprisingly.female infants' mothers without health knowledge have less chances of stunting for their kids.Health knowledge of male kids' mothers has no significant relationship with child health.Mother reproductive behavior has inconsistent pattern of association with both male-fame infants stunting.Furthermore,empirical results also reveal that male infants are comparatively more underweighted than female ones when their mothers are illiterate.However,only male kids have more likelihood to be underweighted when maternal education is primary.Male infants with poor economic level have relatively more chances of underweight threat than female ones.However,only male kids belonged to middle economic ranking are more responsive to underweight.Moderate environment causes more chances of underweight among male infants than among female kids.It is concluded that only male infants without mother empowerment are highly underweighted.Only male children whose only fathers are working lead to less likelihood of underweight.Finally.an insignificant connection of mother nutrition,health-seeking attitude.health knowledge,poor environment and both mother-father working with acute malnutrition is estimated for both sexes of infants.This research also built binary logistical regression to analyze parent's education malnutrition of children under 5 relationships using the earlier discussed data.Among empirical outcomes,parent s education,household economic rank and environmental settings have significant influences on underweight and stunted infants.The interesting point is that the likelihood of stunting growth is relatively less reduced than that of underweight growth when one parent with secondary and second with primary level of education,but underweight hazard is decreased little less as only one parent is with primary level of education comparing with stunting risk.Highly educated parents have similar likelihood of acute and chronic malnutrition for their kids.Rich households are more effective to cause stunted kids than underweight ones.Furthermore,moderate environment setting significantly generates a higher risk of underweight relative to stunting hazard for the kids.These findings disclose that the parents' education has a significant nurturing impact on child health.It is also concluded that this nurturing impact of parents'education may also be attributed to higher income level,and better environmental setting.