Glewwe MothersSchoolingRaise 1999

Why Does Mother's Schooling Raise Child Health in Developing Countries?
Evidence
from Morocco
Author(s): Paul Glewwe
Source: The Journal of Human Resources , Winter, 1999, Vol. 34, No. 1 (Winter, 1999),
pp. 124-159
Published by: University of Wisconsin Press
Stable URL: https://www.jstor.org/stable/146305
JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide
range of content in a trusted digital archive. We use information technology and tools to increase productivity and
facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.
Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at
https://about.jstor.org/terms
University of Wisconsin Press is collaborating with JSTOR to digitize, preserve and extend
access to The Journal of Human Resources
This content downloaded from

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
All use subject to https://about.jstor.org/terms
Why Does Mother's Schooling
Raise Child Health in Developing
Countries?
Evidence from Morocco
Paul Glewwe
ABSTRACT
Mother's education is often found to be positively correlate

health and nutrition in developing countries, yet the causal
are poorly understood. Three possible mechanisms are: (1)
tion directly teaches health knowledge to future mothers;
numeracy skills acquired in school assist future mothers in
and treating child health problems; and (3) Exposure to mo
from formal schooling makes women more receptive to mo
treatments. This paper uses data from Morocco to assess th
by these different mechanisms. Mother's health knowledge
to be the crucial skill for raising child health. In Morocco,
edge is primarily obtained outside the classroom, although
using literacy and numeracy skills learned in school; there
that health knowledge is directly taught in schools. This sugg
teaching of health knowledge skills in Moroccan schools co
tially raise child health and nutrition in Morocco.
I. Introduction
Child health is a key indicator of the quality of life in developing

countries. Mother's years of education is often positively associated with improved
child health and nutritional status (see Behrman, 1990). There are a variety of mecha-
Paul Glewwe is a Senior Economist in the Development Research Group at the The World Bank. He
would like to thank Hanan Jacoby, Martin Ravallion, and two anonymous reviewers for helpful com-
ments on previous drafts, and Nauman Ilias for excellent computational assistance. This research was
supported by a grant from the World Bank Research Committee (RPO 679-84). The findings, interpreta-
tions and conclusions expressed in this paper are entirely those of the author. They do not necessarily
represent the views of the World Bank, its Executive Directors, or the countries they represent. The
data used in this article can be obtained beginning May, 1999, through April, 2002, from Paul
Glewwe, The World Bank, 1818 H Street NW, Washington, DC 20433.
[Submitted October 1996; accepted February 1998]
THE JOURNAL OF HUMAN RESOURCES * XXXIV * 1

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Glewwe 125
nisms through which mother's education could raise child health: (1) Direct
sition of basic health knowledge in school may provide future mothers with in
mation useful for diagnosing and treating child health problems; (2) Literac
numeracy skills learned in school may enhance mothers' abilities to treat ch
nesses, conditional on health knowledge, and also should help mothers increase
stock of health knowledge after leaving school; and (3) Exposure to modem s
in general via schooling may change women's attitudes toward traditional me
of raising children and treating their health problems.
This paper attempts to assess the relative importance of these three mechani
using the 1990-91 Moroccan Enquete Nationale des Niveaux de Vie des Men
(ENNVM). Knowledge of the relative importance of these mechanisms can
important policy implications. For example, if the main impact of education
from directly raising mothers' basic health knowledge, such knowledge shou
taught in schools as early as possible (that is, before girls drop out) and per
should also be taught in special education courses for women of child-beari
who have already left school.
The paper is organized as follows. Section II reviews, in broad terms, the im
of mother's education on child health and briefly reviews the recent literature
tion III discusses the data and the estimation strategy. Section IV presents the em
cal results. Section V decomposes the total impact of mother's schooling on
health. Section VI summarizes the results.
II. Mother's Education and Child Health
A. General Discussion
Figure 1 provides a schematic framework for thinking about the determinants of

child health and nutritional status. As seen at the bottom of that figure, child health
is ultimately determined by three distinct sets of factors: 1. Health and nutritional
inputs provided by the household (arrow i); 2. The local health environment (arrow
f); and 3. The child's health endowment (arrow h). Health and nutritional inputs
provided by the household include prenatal care, breastmilk, breastmilk substitutes
such as infant formula, calories from adult foods (for weaned children), medicines,
and medical care. The quality of household drinking water sources, toilet facilities,
and other hygienic conditions can also be considered as health and nutritional inputs
provided by the household. The local health environment consists of all community
characteristics that directly affect child health and are generally beyond the control
of the parents, such as prevalence of parasites and the incidence of contagious disease
among the general population. Finally, the child health endowment consists of all
components of the child's genetic inheritance that have implications for his or her
health.
Household health and nutritional inputs are determined by household decisions
that reflect the characteristics of the household, the local community, and the child,
such as (initial) household assets, parental schooling, community economic and
health-related characteristics (such as the availability and prices of medical services),
and each child's health endowment. This paper focuses on parental schooling, partic-

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
r
Exogenous Parental Household
Variables Schooling Assets
d e
Education
Outcomes
a' \a a c' ca I
and
Endogenous
Parental Health Household
Variables
Knowledge Income
abc \ v I / acd c
4--
Household Health and
Nutritional Inputs
Health
Child Health
Outcome
Figure 1
The Determinants of Child Health

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Glewwe 127
ularly mother's schooling; father's schooling, apart from its income effect,
likely to be important for maintaining children's health.
Schultz (1984) argues that mother's education can influence child health in
ways:1 (1) Education may lead to a more efficient mix of health goods used t
duce child health; (2) Better educated mothers may be more effective at prod
child health for a given amount and mix of health goods; (3) Schooling can
parents' preferences in systematic ways-for example, educated mothers tend to
for fewer but healthier children; (4) More schooling should raise family inc
either through higher wages or increased productivity in self-employment,
should improve child health status; and (5) Education raises the opportunity
of time, which tends to increase the time mothers spend working outside the
and thus reduce time for child care-this effect of schooling could reduce
health by reducing both maternal time devoted to child care and duration
breastfeeding. In Figure 1, the third and fourth pathways are represented b
arrows a-a' (and also by a-a") and acd (via a-a"' and c-c"'), respectively.2 The
two pathways, which reflect the direct effect of the health knowledge and cog
skills that education imparts, have received little attention in the literature. W
it about schooling that makes mothers more efficient in producing child health
Figure 1 presents two mechanisms through which schooling could influenc
choice of health and nutritional inputs via the knowledge and skills it prov
First, schools may directly teach effective health care practices to students
pathway is denoted by b-abc. For example, the impact of diarrhea on child h
can be reduced by oral rehydration therapy (ORT), which can be taught eve
primary schools (see Cash 1983). Second, schooling can influence child health
through the cognitive skills imparted, such as literacy and numeracy. Literate
ers are better able to read written instructions for treating of childhood disease
numeracy enables mothers to better monitor illnesses and apply treatments
direct effect is shown by c-c" in Figure 1. Literacy and numeracy also enable m
to increase their health knowledge by enabling them to gather information
written sources. This indirect effect is path c-c'-abc in Figure 1.
Figure 1 also depicts how factors other than schooling influence child hea
Household physical assets raise household incomes (arrow d), which should ha
a positive effect on both nutritional inputs (such as calories) and environmenta
ditions around the home. The choice of health and nutritional inputs will a
affected by factors associated with the supply of these inputs in the comm
(arrow e). For example, the availability and quality of health and non-health co
nity facilities affects the decisions households make regarding health and nutr
1. Schultz's framework is primarily concerned with child mortality. Yet broadening it to includ
less severe, aspects of child health does not require significant modification.
2. The fifth pathway, via mother's time, could be added to Figure 1 but is omitted to reduce
Similarly, the impact of the third pathway via reduced family size could also be made more exp
a box labeled "family size," another endogenous variable), but this is also omitted to reduce clut
3. The distinction between pathways (1) and (2) in the previous paragraph is that the first conc
efficient mix of physical health inputs (for example, medicines) while the second adds efficien
non-physical inputs (such as care given to the sick child). In this paper, the distinction between phy
and nonphysical inputs is not of primary interest, rather the emphasis is on the different types of know
and skills learned in school, and how they affect efficient use of both types of inputs.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
128 The Journal of Human Resources
inputs. Finally, the child's health endowment will also affect household health a
nutritional inputs (via arrow g), since more sickly children usually receive lar
amounts of health and nutritional inputs.
B. Recent Empirical Evidence

Many recent studies have examined the impact of mother's (and father's) educat
on child health. For comprehensive reviews of the literature see Behrman and D
lalikar (1988), Behrman (1990), and Strauss and Thomas (1995). The discussion
here will be limited to an overview of a few recent studies, focusing on the impa
of mother's education on height-for-age and weight-for-height.
Studies of the determinants of child height and weight in many countries ha
found positive effects of mother's education. Most of these studies presented redu
form estimates, but a few went further, examining the pathways by which mothe
education improves child health. In the Philippines, Barrera (1990) found that bett
educated mothers tended to wean their children sooner, but they compensated for t
shortened breastfeeding time with better care; overall, their children were healthier a
measured by higher height-for-age z-scores.4 The only published study that focus
on the "information processing" attributes of schooling is by Thomas, Strauss,
Henriques (1991), which used Brazilian data that included variables for whethe
woman reads a newspaper, listens to the radio, or watches television. Mother
schooling was not significant when dummy variables were included for these "info
mation processing" activities; the newspaper and radio variables were significant
rural areas but only the television variable was significant in urban areas.
Among the most interesting studies are those based on the Cebu Longitudin
Health and Nutrition Survey. Several studies have used these data to model the pat
ways by which exogenous variables influence child nutritional status and morbidi
The Cebu Study Team (1991, 1992) found that mother's education leads to impro
waste disposal and higher non-breastmilk calorie intake, both of which reduce
incidence of diarrhea. Maternal education also leads to earlier weaning, which c
increase episodes of diarrhea, but the net effect of maternal education is to red
the incidence of diarrhea.
An important critique of findings that mother's education improves child health
is the hypothesis that education simply reflects unobserved maternal characteristics.
Wolfe and Behrman (1987) used Nicaraguan data on mothers' siblings to control
for unobserved family fixed effects. They found that applying these controls leaves
no significant effect of mother's education on child anthropometric status. However,
Strauss (1990) found in Cote d'Ivoire that mother's education raises child height-
for-age and weight-for-height, even after using family fixed effects estimators.
In summary, there is considerable evidence that mother's education improves child
health, and some evidence on how this occurs. Still, there are no studies that distin-
4. Height for age z-scores, which will be used in the empirical work below, are based on fitting a standard
normal distribution to the growth curves of a healthy population of children. A child with a z-score of
zero is exactly at the median in terms of height for age, while children with positive (negative) z-scores
are taller (shorter) than average. Low height for age z-scores indicate stunting due to repeated episodes
of malnutrition over the life of the child, while low weight for height z-scores indicate wasting (weight
loss) due to a current episode of malnutrition (see Gibson 1990).

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Glewwe 129
guish between the literacy and numeracy impacts of schooling and other, m
eral, impacts. Also, there are no studies that attempt to assess directly th
of mother's health knowledge on child health.
III. Analytical Framework, Data and Estimation

Strategy
A. Analytical Framework
Estimation of the pathways by which mothers' schooling affects child health is not
necessarily straightforward. This subsection provides a framework for thinking about
how to estimate these relationships. Recall Figure 1. The bottom of that figure shows
how health and nutritional inputs, the environment and a child's health endowment
jointly determine child health. This can be expressed in terms of a production func-
tion for child health:
(1) Hi = f(HIi, Ei, Ei)

where Hi is the health of child i, HIi is a vector of health inputs chosen by child i's
household, Ei is a vector summarizing the environmental conditions surrounding
child i, and Ei is the child's genetic health endowment. Parents take this technological
relationship into account as best they can when making decisions that affect their
children's health. Although Ei and Ei are outside the household's control,5 health and
nutritional input choices are chosen by the household.
Estimation of Equation 1 would require detailed information on a large number
of health inputs, which is not feasible with the 1990-91 ENNVM data. However,
as seen in Figure 1, one can substitute out these health inputs and obtain a reduced
form relationship that shows how exogenous variables (those shown at the top of
Figure 1) determine child health:6
(2) Hi = g(FSi, MSi, HAi, Ei, Ei)

where FSi and MSi are father's and mother's schooling, respectively, and HAi is the
initial assets of child i's household.
Although Equation 2 is much easier to estimate, and often has been estimated, it
does not indicate what aspects of mother's schooling lead to improved child health.
Referring again to Figure 1, one can obtain a better understanding of the impact of
mother's schooling by replacing it in Equation 2 with the educational outcomes it
directly affects, namely cognitive skills, parental values and health knowledge:
5. The local health environment is not chosen by parents if: a) migration for purposes of finding a better
health environment is rare; and b) households cannot pressure local authorities to improve the local health
environment. The former assumption is supported by migration data from the 1990-91 ENNVM; only
0.5 percent of respondents report that "health reasons" were the main reason for their most recent move.
The latter assumption, while harder to check, is plausible for Morocco because health care provision is
highly centralized, with few funds under the control of local governments (see World Bank 1994).
6. The assumption that parental education is exogenous seems reasonable for Morocco, where average
schooling for men and woman between the ages of 18 and 65 is only 4.7 and 2.3 years, respectively. Even
so, this assumption will be checked in Section IV.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
(3) Hi = h(FSi, Li, Ni, Vi, HKi, HAi, Ei, ?i)
where Li, Ni, Vi and HKi stand for mother's literacy, numeracy, values and health
knowledge, respectively. This equation is a conditional demand relationship because,
as explained below, health knowledge, and perhaps literacy and numeracy, may b
endogenous.
Estimation of Equation 3 would clarify the pathways by which mother's schooling
affects child health, but such estimation is complicated by several problems. First
it is difficult to observe mother's values (Vi), and indeed there are no such data in th
1990-91 ENNVM survey. Second, a child's health endowment (?i) is also virtually
impossible to observe. Third, because parents' treatment of their children's health
problems often causes them to acquire additional health knowledge, health knowl
edge is likely to be an endogenous variable. In particular, health knowledge is likely
to be negatively correlated with a child's (unobserved) genetic health endowment
because parents with "healthy" children need not acquire as much health knowledge
as parents with "sickly" children, ceteris paribus.7 Fourth, it is also possible tha
literacy and numeracy are endogenous because actions to acquire additional health
knowledge may lead to greater use of those skills, though the impact of a child'
genetic health endowment on these variables is likely to be considerably smaller
than its impact on health knowledge. The approaches taken to deal with these prob-
lems will be discussed in detail in Subsection IIIC below.
Another relationship of interest is a variation of Equation 3; when attempting to
assess the pathways by which mother's education affects child health one may wish
to isolate its impact on household income.8 In this case one can add household income
(Yi) to Equation 3 and remove household assets (since their impact on child health
would operate only through their impact on household income). This yields the fol-
lowing conditional demand relationship for estimation:
(4) Hi = h'(FSi, Li, Ni, Vi, HKi, Yi, Ei, ?i).

The relationships of primary interest in this paper are Equations 3 and 4.
A final issue to consider is the possibility that mother's education improves child
health by reducing the number of children women bear-with fewer children, the
mother should be able to allocate more time and health inputs per child. As men-
tioned in Section II, the desire for fewer children can be depicted as the impact of
schooling on parental values. Thus, one could modify Equations 3 and 4 by replacing
Vi with the number of children born or, more generally, by adding the latter variable
while retaining Vi (since values may affect child health in other ways). Of course,
since the number of children born is clearly an endogenous variable, estimation re-
7. This could be shown in Figure 1 by an arrow leading from the child's health endowment to parental
health knowledge.
8. One could go even further. Increased education can raise household income not only by increasing
wage rates but also by increasing the amount of time the mother works outside the home. Moreover,
increased time of the mother away from home may have a direct, negative impact on child health. Thus
one could add both household income and mother's time spent working to Equation 4. This was tried in
an earlier version of this paper (see Glewwe 1997), but it proved impossible to find instrumental variables
that could plausibly be excluded from Equation 4 and were also good predictors of mother's time spent
working. In this paper mother's time spent working has been substituted out of Equation 4.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Glewwe 131
quires plausible instrumental variables; this will be discussed further in Su

IIIC.
B. The Data
This paper uses data from the 1990-91 Enquete Nationale sur le Niveau de Vie
des Menages (ENNVM), which was implemented by Morocco's Direction de la
Statistique. The survey, which is based on the World Bank's LSMS surveys, covered
3,323 households from all areas of Morocco. The survey collected a variety of infor-
mation from each household, including household expenditures and income, employ-
ment, education, assets, agricultural activities, and much more. A key aspect of these
data for this paper is that they contain the height and weight of all household mem-
bers. Even more important is that a battery of tests was given to household members
in two thirds (2,171) of the sampled households. The tests included: 1. Five questions
on health knowledge; 2. Twelve questions on general knowledge (how to mail a
letter, how to read an electricity bill, and so on); 3. An oral mathematics test of ten
questions; 4. A set of written mathematics tests of varying degrees of difficulty;
5. A set of Arabic reading and writing tests; and 6. A set of French reading and
writing tests. The tests are described in detail in Glewwe (1997). The health knowl-
edge test is of particular interest, since it is rarely a part of any household survey.
It consists of five questions on vaccinations, treating infections, polio, diarrhea and
safe drinking water. The test is fully described in Appendix I.
All persons in the 2,171 selected households between the ages of 9 and 69 were
to be tested except: 1. Individuals with a baccalaureate degree9 or higher level of
education took only the health knowledge test since it was assumed that they could
obtain nearly perfect scores on all other tests; and 2. The health knowledge test was
taken only by individuals between the ages of 20 and 50. The 2,171 households who
participated contained 1,612 children age 5 or younger, of which 81 had mothers
who did not participate in the tests for one reason or another, leaving a sample of
1,531 children. It is assumed that the 39 mothers with a baccalaureate degree would
have received perfect scores on all the tests (except the health test, which they did
take), which boosts the sample size to 1,570. Dropping observations with missing
values leaves a sample of 1,495 children.
Table 1 provides descriptive statistics on all variables used in the analysis. Of
particular interest are the test score variables, which are defined as the number of
questions correctly answered by the respondent. They show substantial variation,
which is necessary to assess the underlying pathways by which mothers' schooling
raises child health. In addition, these scores should not be highly correlated with
years of schooling, or with each other; if they are, regression analysis is less likely
to identify the underlying mechanisms. Table 2 shows correlation of years in school
with the test scores (the table also includes a test on reading a medicine box-this
will be discussed in Section IV). Mathematics, French and Arabic scores are all
highly correlated with each other and with years in school (correlation coefficients
9. Roughly speaking, a baccalaureate degree lies somewhere between a U.S. high school degree and a
college degree. It is only awarded after passing a rigorous set of examinations.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Table 1
Descriptive Statistics of Variables Used
Standard
Variable Mean Deviation
Height for age Z-score -0.94 1.86

Per capita expenditure 5,398.82 5,081.68
Sex of child (female) 0.53 0.50
Age of child (in months) 35.86 20.00
Mother's height 157.02 6.20
Father's height 168.49 5.95
Father's height missing 0.31 0.46
Mother's years schooling 1.98 2.97
Father's years schooling 3.14 4.10
Health knowledge 2.89 1.57
General knowledge 1.53 3.18
Oral mathematics 1.71 1.90
Reading and writing mathematics 1.18 2.62
Arabic reading 2.33 4.98
Arabic writing 0.57 1.54
French reading 1.48 4.44
French writing 0.26 1.06
Rental income 1,460.79 13,920.17
Children overseas 0.01 0.09
Irrigated crop land (hectares) 2.36 12.62
Unirrigated crop land (hectares) 30.88 94.59
Tree crop land (hectares) 0.32 1.42
Mother's married sisters 1.88 1.56
Father's married sisters 1.51 1.56
Father's married sisters missing 0.22 0.41
Father born here 0.64 0.48
Number of televisions 0.55 0.58
Number of radios 0.89 0.55
Availability of newspapers 0.21 0.41
Mother's father's schooling 0.03 0.16
Mother's mother's schooling 0.01 0.10
Sample Size: 1,495.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Glewwe 133
Table 2
Correlation Among Schooling and Test Score Variables of Mothers
Reading
Years Arabic French Health Box of
Schooling Literacy Literacy Numeracy Knowledge Medicine
Years schooling 1.0000

Arabic literacy 0.8938 1.0000
French literacy 0.8869 0.8681 1.0000
Numeracy 0.8665 0.8695 0.8383 1.0000
Health knowledge 0.3343 0.3867 0.3138 0.4356 1.0000
Reading box of medicine 0.8152 0.8553 0.7775 0.8198 0.4387 1.0000
Note: All variables are in logarithms.
from 0.84 to 0.89).10 Health knowledge is less highly correlated with thes
variables (correlation coefficients from 0.31 to 0.44). Whether regression
can distinguish between the impacts of the most highly correlated skills is un
and will become clear only by examining estimation results.
C. Estimation Strategy: General
Consider estimation of equation (4) using the 1990-91 ENNVM.1 Child he

can be measured by the Z-score of child height for age (see endnote 4), whi
cates chronic malnutrition over a child's lifetime (stunting). In principle
could also use weight for height, but the 1990-91 ENNVM weight data s
from serious measurement error because weight was recorded only to the
kilogram.
Several estimation problems arise concerning the explanatory variables in Equa-
tion 4. Begin with the child's local health environment, Ei. Although the 1990-
91 ENNVM data contain information about local health clinics and other pertinent
variables, some of the data are missing and comparability is a problem. In addition,
the sampling procedure used for choosing the health facilities covered by the survey
is unclear. Because the main interest of this paper focuses on household level vari-
ables (the skills and education levels of mothers), a simple community fixed effects
procedure is used to avoid bias caused by omitted community level health environ-
ment variables. This is possible because the sampled households were drawn from
140 primary sampling areas.
Of the remaining explanatory variables in Equation 4, two are unobserved: mater-
nal values acquired in school (Vi) and the child's health endowment (e6). If the effect
10. For simplicity, in the remainder of this paper (the logarithms of) the two mathematics scores are
summed to create a single mathematics variable, and the reading and writing scores are summed for French
and Arabic. For an analysis of the more disaggregated scores, see Glewwe (1997), the findings of which
are basically the same as those in this paper.
11. The following paragraphs also apply to Equation 3, except the discussion on choosing instrumental
variables for household income is irrelevant (household income has been substituted out of Equation 3).

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
of schooling on maternal values is important, one could detect this by adding year
of schooling to Equation 4. A positive effect of years of schooling on height for a
would indicate that values (or perhaps some other aspect of schooling other th
literacy, numeracy, and health knowledge) is an important determinant of ch
health. If the years of schooling variable has no perceptible effect, it is unlike
that values acquired by mothers from schooling is an important pathway by whic
schooling affects child health.
The inability to directly observe a child's health endowment (E?) could lead t
biased parameter estimates due to its correlation with observed variables. One w
to reduce such bias is to enter the heights of both parents as explanatory variable
since taller parents are likely to have better health endowments, which in turn ar
inherited by their children. In addition, parents (and their children) display variati
in height that is not related to health status-healthy people can vary in heigh
Entering parental height in the regressions controls for this as well, purging t
dependent variable of variation in height that is not indicative of health statu
Note that father's height is missing for about one third of the children, either be
cause the father did not live with the children or was unavailable for measurement
at the time of the interview. To avoid losing this portion of the sample, which
could lead to sample selectivity biases, a dummy variable is created indicating
that father's height was missing; in such cases father's height variable is set equal
to the mean.
Even after adding parental height to reduce bias caused by unobserved child health
endowments, it is still possible that the inability to observe children's health endow-
ments could bias estimated impacts of observed variables. Health knowledge, house-
hold income, and perhaps literacy and numeracy, may well be endogenous. Particu-
larly worrisome is the fact that health knowledge may be negatively correlated with
the child's unobserved health endowment. In principle, using instrumental variable
methods can remove bias, but this requires plausible instruments. Household assets
can be used to instrument current income.12 The 1990-91 ENNVM contains data
that can be used to construct several household asset variables. The following are
used in this paper: 1. Three variables on agricultural land (in hectares) owned by
the household; 2. Household rental income (from land, buildings and durable goods);
and 3. The number of adult children of household members living overseas (who
may send sizable remittances).
Finding instrumental variables for mother's health knowledge is more difficult.
Three different types seem plausible: indicators of the existence of close relatives
who could be sources of health knowledge; exposure to mass media; and mother's
education (which can be excluded from Equation 4 if one finds that it is not needed
as a proxy of the impact of values on child health). One way that mothers can acquire
health knowledge is from close relatives, especially those who have had children.
The idea here is that mothers consult with other relatives concerning their children's
health, and by doing so they add to their stock of health knowledge. Most of these
relatives do not directly care for the mother's young children, except perhaps the
paternal grandmother, so their impact on the child's health comes about only by
12. In the estimates given in later sections, household expenditure is used instead of household income
because it is likely to be more accurate and more closely related to households' permanent incomes.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Glewwe 135
raising the mother's health knowledge (thus they can be excluded from E
3 and 4).13 The 1990-91 ENNVM contains data on the number of married
of the mother and of her husband. It can also be used to add a dummy
indicating whether the husband was born in the current place of residence; if
there should be several members of his family in the area from whom his w
obtain health knowledge. Finally, the education of the mother's own paren
also affect her health knowledge (and her cognitive skills as well), but ca
cluded from Equations 3 and 4 because the mother no longer lives with her p
Mass media is also a useful source of health knowledge information (see T
Strauss and Henriques, 1991). It is unlikely that these variables have any e
child health apart from their impact on mother's health knowledge; in parti
would be rare for parents to purchase televisions or radios in response to
sick child. The ENNVM data collect data on the number of radios and televisions
in the household and on the availability of local newspapers. These mass media
variables could also be used as instruments for numeracy and literacy.
Finally, this paper will also investigate whether part of the impact of mother's
education on child health works by reducing family size, and since family size is also
endogenous one needs instrumental variables for children ever born. It is particularly
difficult to find plausible instruments for this variable. Some possibilities are the
number of married sisters of both the woman and her husband, which could reflect
preferences for children on both sides of the family, the education levels of the
woman's parents, which again may reflect family preferences for children, and finally
the age of the woman, since older women will have had more time to bear children.
Of course, one can imagine plausible reasons for why these variables may directly
affect child health, but there are no better instrumental variables available from this
data set.
The instrumental variables described in the previous paragraphs generally appear
reasonable, but one cannot prove that they do not belong in Equation 4. This problem
plagues most, if not nearly all, applications of instrumental variables. Thus one
should apply a specification test to check the plausibility of the underlying exclusion
restrictions. This is done using standard overidentification tests (see Davidson and
MacKinnon 1993).
D. Estimation Strategy: Decomposing the Separate Impacts of

Mother's Education
Finally, consider how estimates of Equations 3 and 4 can be used to assess the
mechanisms by which mother's schooling leads to improved child health. As seen
in Equation 4, and Figure 1, the overall impact of mother's schooling on child health
can be decomposed as follows:
) (5)
aHi aHi HH
aLi a -- -+
aHi avi
aMSi aLi aMSi aNi aMSi av,i MSi
13. In Moroccan culture, when women marry they join their husband's household. Thus the mother moves
away from her parents and siblings, and her husband's married sisters have moved away from his family.
Only the husband's mother, his unmarried sisters, and the wives of any married brothers he may have
belong to his (and thus to his wife's) household.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
+ Hji (3HKi aHKi a3L aHKiaNi aHi 3Yi

aHK, i aMSi aLi aMSi aN Si a Yi MSi
The first, second, third, fourth, and fifth terms to the right of the equal
the impact of mother's schooling via its impact on literacy, numeracy, valu
knowledge, and income, respectively. Note that the impacts via literacy an
acy (the first and second terms) are direct effects only (arrow c" in Fig
indirect effects via the impact on health knowledge (arrow c' in Figure 1)
sented by the second and third terms inside the parentheses of the fourt
similar decomposition based on Equation 3 is identical except that the in
is dropped; the remaining partial derivatives may differ from those in
because the income effect is "divided up" among the remaining terms (for
the impact of literacy now incorporates both a direct effect and the indir
of literacy through its effect on household income).
Assume simple linear functional forms for Equations 2, 3, and 4:
(2') Hi = Po + FFSi + P2MSi + P3HAi + Ul

(3') Hi = Yo + ylFSi + y2Li + y3Ni + Y4Vi + y5HKi + y6HAi + u2
(4') Hi = 80 + 8lFSi + 82Li + 63Ni + 64Vi + 65HKi + 66Yi + U3.
In each specification, an error term is added to account for random me

error in child height and the child's unobserved health endowment (recall
munity fixed effects estimation allows one to drop Ei from each equation
tion 2', P2 estimates the overall impact of mother's schooling on chil
aHil/MSi, which is the left hand side of Equation 5. Estimates of all
derivatives on the right hand side of Equation 5 come from: 1. Equation 4
tion 3 if the income term is dropped from Equation 5; 2. Reduced form
of the impact of mother's schooling on literacy (Li), numeracy (Ni), va
health knowledge (HKi), and household income (Yi), which can be denot
aN, a o, (HK, and oty, respectively; and 3. Estimates of the impact of
and numeracy on health knowledge, which can be denoted as rL and TH
tively.14
Thus Equation 5 becomes:
(5') 12 = 620L + 63(aN + 64aV + S5(OHK + LaL + rTNO(N) + 66aY.
This decomposition is based on Equation 4' and thus explicitly accounts

impact of mother's education on income. If income is substituted out, as in E
3', the last term is dropped from Equation 5 and the decomposition becom
(5") 32 = Y2a2L + Y3aN + Y40v + Y_5(OHK + I1LaL + T_NAN).
14. These impacts (rL and 1nH) are shown as arrow c' in Figure 1. If literacy and numeracy can b
ered exogenous with respect to health knowledge, namely, literacy and numeracy change very li
one leaves school but health knowledge can change, then this relationship is a reduced form. On
hand, if literacy and numeracy are endogenous then this is a conditional demand function. T
further discussed when this relationship is estimated in Section IV.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Glewwe 137
Estimation of the different parameters of Equations 5' and 5" allows one to e
not only which pathways are important, but also to assess their relative contr
IV. Estimation Results
A. Reduced Form Estimates of the Determinants of Child Height
Table 3 presents ordinary least squares (OLS) and community fixed effects (FE)
estimates of Equation 2, that is reduced form estimates of the determinants of child
height for age.15 The OLS and FE estimates in Table 3 are similar, but specification
tests favor the fixed effects specification.16 Because of this, all remaining estimates
in this paper will incorporate community fixed effects.
Table 3 shows that mother's years of schooling has a significantly positive effect
on child height, which is consistent with evidence from other countries discussed
in Section II.17 This is the main finding of interest in Table 3; the rest of this paragraph
briefly discusses the other explanatory variables. A dummy variable for female chil-
dren is negative but insignificant, yielding no strong evidence of gender discrimina-
tion in child health. Child height for age varies substantially with child age (in
months); this reflects common patterns whereby malnutrition rises with age in the
first two years of life (until weaning ends) but then levels off (and may even decline).
Both mother's and father's height are positively correlated with height for age, which
picks up both variation in the child's unobserved health endowment (?i) and natural
variation in height among healthy children. Father's years of schooling is positive
but insignificant, which suggests little direct effect on child height. Perhaps a weak
indirect effect exists via household income; this will be checked below. The house-
hold asset variables are all insignificant, though three of the five have the expected
signs.
Before moving to conditional demand estimates, it is useful to check whether
mother's years of schooling can really be specified as exogenous, and whether part
of the effect of mother's schooling on child health works through reduced family
size. To investigate the former, mother's years of education was instrumented using
the educational levels of both her parents, as well as the number of married sisters
she has. These instruments were good predictors of mother's schooling (joint F-
statistics over 20 for both OLS and fixed effects estimates, with p-values of 0.000).
15. All years of schooling and test score variables are specified in logarithmic form because: 1. It seems
reasonable to assume that attainment of the most basic skills would have larger impact than would attain-
ment of additional skills among persons who already have basic skills; and 2. In general, taking the logs
of these variables almost always fit the data better (as measured by R2 statistics). If years of schooling or
any test score is zero, the log of it is set to zero, and the same applies to rental income.
16. A Hausman test of fixed effects versus the null hypothesis of random effects yields a X2(d.f. 13) statistic
of 20.29, which is statistically significant at the 10 percent level. Since Hausman tests often have low
power to reject the null, it is prudent to reject the random effects specification. In turn, that specification
(not shown in Table 3, but similar to the OLS results) is favored over OLS; the Breusch-Pagan Lagrange
multiplier test has a X2(d.f. 1) statistic of 46.70, clearly rejecting the null hypothesis of homoscedasticity.
17. In regressions not shown here, a squared term of (the logarithm of) mother's years of schooling was
added to both specifications in Table 3 to allow for a more flexible functional form. The linear term
remained significant (at the 10 percent level), but the squared term was completely insignificant. In the
rest of this paper only the linear term is used.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Table 3
Reduced Form Estimates of Determinants of Height for Age Z-Scores
Community
OLS Fixed Effects
Variable Coefficient t-Statistic Coefficient t-Statistic
Constant -16.931 -10.83

Sex (female) -0.149 -1.69 -0.116 -1.31
Age (months) -0.081 -9.14 -0.076 -8.55
Age2 (months) 0.001 7.70 0.001 7.11
Mother's height 0.066 8.95 0.052 6.39
Father's height 0.041 5.39 0.041 4.96
Father's height missing 0.155 1.61 0.167 1.60
Log mother's schooling 0.226 3.17 0.165 1.97
Log father's schooling 0.076 1.43 0.050 0.82
Log rental income 0.020 1.03 -0.016 -0.74
Children overseas 0.517 0.99 0.659 1.21
Irrigated crop land -0.001 -0.28 0.001 0.14
Unirrigated crop land 0.001 1.21 0.000 0.61
Tree crop land -0.038 -1.23 -0.014 -0.39
R2 0.170 0.299
Lagrange multiplier
Hausman test (rando
Sample size: 1,495.
The of moth impact

significantly differen
the standard errors
so that standard Haus
variable estimates w
Regarding the impac
mates (not shown he
significantly negativ
variable that had a s
for two distinct fert
first birth. The fixe
variable separately, an
In each case, the fert
estimate for mother
although mother's ed
family size on child h

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Glewwe 139
B. Conditional Demand Estimates of Child Height (not Conditioning

on Income)
Table 4 presents estimates of Equation 3, the conditional demand determina

child height where income is not one of the conditioning variables. Three ki
estimates are shown: community fixed effects (FE); two stage least squares
community fixed effects (2SLSFE) with only health knowledge specified as e
nous; and 2SLSFE with all four skills test (mathematics, Arabic, French, and
knowledge) specified as endogenous. The last two kinds were estimated twice
with mother's education and once without it, for reasons explained below.
The FE estimates shown in Table 4 are identical to the FE estimates in Tab
except that the four test score variables have been added as (exogenous) explana
variables. Mother's schooling is now completely insignificant, and even slightly
ative, which suggests that the four test score variables fully capture the im
mother's education on child health. However, although all four test score va
show positive effects none is even close to being statistically significant, and n
are they jointly significant. These results are quite puzzling. One problem with
specification is that health knowledge, and perhaps the other test score variable
be endogenous. The remaining specifications in Table 4 use 2SLSFE specificati
address this problem.
The second and third columns of Table 4 are identical to the first except that
knowledge is specified as endogenous, using the instrumental variables descr
subsection IIIB. The one difference between the second and third columns is th
the former includes mother's schooling (to account for the impact of values
the latter excludes it (to provide an additional instrumental variable for health
edge). The main finding when health knowledge is specified as endogenous
such knowledge has a strong and statistically significant impact on child h
Indeed, in the specification that includes mother's education the point estim
creases 50-fold and is significant at the 1 percent level."8 When mother's edu
is excluded from the specification the impact of health knowledge is som
smaller, but still highly significant (t-value of 2.48). None of the other test
variables (mathematics, Arabic, and French) have significantly positive effec
in fact both Arabic and mathematics have negative effects.
One issue that arises at this point is what is meant by health knowledge. The
questions that comprise the health knowledge test are shown in Appendix I.
it be that what really matters is only a subset of these questions? Of the five ques
the one concerning vaccinations provided very little information because 95 pe
of the women answered it correctly. The percentage of women answering the
four questions correctly varied between 44 percent and 54 percent. These four
tions were also fairly highly correlated with each other, with correlation coeff
between 0.40 and 0.50. To check whether some questions mattered more than o
the regression in the second column of Table 4 was reestimated five times,
time with the response to a single question replacing the health knowledge var
18. At the suggestion of one reviewer, separate regressions were run by sex and age (the two age cat
being 0-35 months and 36-71 months) to see whether the impact of health knowledge varied by
age. Although there were some differences (the impact was larger for girls than for boys, and larg
younger children), they were not statistically significant.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Table 4
Conditional Demand Estimates of Determinants of Height for Age Z-Scores
Two Stage Lea

(Including Commun
Community
Fixed Only Health Knowledge All
Effects Endogenous End
Father's schooling 0.012 -0.114 -0.073

(0.20) (-1.32) (-0.96)
Arabic 0.048 -0.129 -0.033
(0.63) (-1.04) (-0.34)
French 0.046 0.199 0.216
(0.45) (1.37) (1.60)
Math 0.024 -0.370 -0.221
(0.27) (-1.97) (-1.52)
Mother's schooling -0.012 0.357
(-0.08) (1.40)
Mother's health knowledge 0.037 2.020 1.452
(0.41) (2.71) (2.48)
Sex (female) -0.109 -0.076 -0.084
(-1.25) (-0.72) (-0.85)
Age (months) -0.075 -0.072 -0.073
(-8.06) (-6.84) (-7.43)
Age2 (months) 0.001 0.001 0.001
(6.92) (5.73) (6.19)
Mother's height 0.052 0.040 0.043
(6.69) (3.70) (4.46)
Father's height 0.041 0.040 0.040
(5.33) (4.01) (4.33)

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Father's height missing 0.136 0.262 0.220
(1.34) (1.96) (1.81)
Rental income -0.017 -0.030 -0.026
(-0.66) (-1.13) (-1.06)
Children overseas 0.224 0.354 0.290
(0.39) (0.53) (0.46)
Irrigated crop land (hectares) -0.001 -0.002 -0.002
(-0.13) (-0.38) (-0.34)
Unirrigated crop land (hectares) 0.000 0.001 0.001
(0.70) (1.29) (1.16)
Tree crop land (hectares) -0.019 0.048 0.029
(-0.51) (0.96) (0.65)
Overidentification test (d.f.) 10.16(8) 14.07(9)
[0.254] [0.120]
F-tests of identifying instruments
Mother's health knowledge 4.42 5.76
[0.000] [0.000]
Arabic
French
Math
Hausman tests (d.f.) 7.16(1) 5.95(1)

(Endogenous parameters only) [0.007] [0.015]
Notes:
1. Sample size is 1,451. This is lower than in Table 3 because scores on the health knowledge test were missing for 22
missing at least one test score for the mathematics, Arabic and French tests.
2. Asymptotic t-statistics shown in parentheses.
3. P-values of specification tests shown in brackets.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
As one would expect given its lack of variation, the answer to the vaccination ques-
tion had no significant effect on child health. In contrast, each of the four othe
questions had a significantly positive effect on child health, with t-statistics ranging
from 1.71 to 1.99 and parameter estimates ranging from 1.24 to 1.79. This suggests
that the health knowledge embedded in each of these questions is important, and
because the different types of health knowledge are fairly highly correlated with
each other they may well reflect the impact of other types of basic health knowledge
not measured in this test. In addition, these results also suggest that specifying the
overall impact of health knowledge as the sum of the scores on this test is a reason-
able way to aggregate health knowledge into a single variable.
Given how the results change when health knowledge is specified as endogenous
in the second and third columns of Table 4, it is worthwhile to apply some specifica-
tion tests to these regressions. In general, instrumental variables must not be corre-
lated with the error term of the equation of interest (u2 in equation 3'), and the
must provide strong explanatory power for the endogenous variable(s). The firs
requirement can be checked by an overidentification test. In both columns the exclu-
sion restrictions are not rejected (the p-values being 0.254 and 0.120 in the second
and third columns, respectively). The second requirement is verified by F-tests on
the explanatory power of the identifying instruments, the null hypothesis of no ex-
planatory power is resoundingly rejected (see Appendix II for the first stage regres-
sions and partial R2 statistics, the latter of which are recommended by Bound, Jaeger
and Baker 1993). Finally, a Hausman test is used to examine whether the 2SLSFE
specification is preferred to the FE specification. This test rejects the FE specifica-
tion.19 Overall, the specification tests indicate that health knowledge should be treate
as endogenous and that the instrumental variables used satisfy both requirements.
There is one more set of regressions to check before concluding that health knowl-
edge is the most important pathway by which mother's education leads to improved
child health. Perhaps the mathematics, Arabic and French test score variables in
Equation 3 are also endogenous, so that when they are specified as such during
estimation they will also yield significant impacts on child health. This is examined
in the last two columns of Table 4, using the same instrumental variables used fo
health knowledge. The basic results are unchanged-health knowledge has a large,
positive and statistically significant impact on child health, and none of the othe
variables does. This is true regardless of whether mother's education is included a
an explanatory variable.
More specifically, when mother's education is included as a regressor (Column
4) Arabic has a small (relative to the impact of health knowledge) positive effect,
but it is completely insignificant (t-statistic of 0.16); when mother's education i
excluded (Column 5) the impact is slightly negative and even less significant
(t-statistic of -0.00). French language skills have implausible negative effects in
both Columns 4 and 5, and are completely insignificant. Finally, the impact of mathe-
matics is stronger (in terms of the size of the coefficient) than Arabic or French, but
19. This Hausman test examined only the coefficient on health knowledge in order to increase the power
of the test to reject the null hypothesis. All Hausman tests in the remainder of this paper are applied only
to the parameters associated with potentially endogenous variables, for the same reason. Hausman tests
were also run on the entire set of explanatory variables; in every case they failed to reject the null hypothe-
sis, which probably reflects their low power when jointly testing a large number of parameters.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Glewwe 143
it is still statistically insignificant (t-statistics of 0.92 and 0.57 in Columns 4

respectively). To see whether the statistical significance of mathematics skill
improve if only it and health knowledge were instrumented, the regression in
4 was reestimated (not shown here) with only these two test score variables as
enous. The coefficient on mathematics skills drops to half its value (0.402)
t-statistic is correspondingly much lower (0.55). Thus specifying mathematic
bic, and French as endogenous does not change the basic results found wh
health knowledge is treated as endogenous.
The specification tests done for Columns 2 and 3 were also done for Column
5. Both specifications passed the overidentification test, indicating that the
restrictions are reasonable and the explanatory power of the identifying inst
is quite good (especially when mother's education is not used as a regressor
the specifications when only health knowledge is endogenous, Hausman tests
joint endogeneity of the four test score variables only weakly reject the FE sp
tion (p-values of 0.065 and 0.073 for Columns 4 and 5, respectively). In
Hausman test of the joint endogeneity of the mathematics, Arabic, and Fren
scores does not reject the null hypothesis of exogeneity (the x2 statistic with
of freedom is 3.83, which has a p-value of 0.280). Thus it is not clear that the
cation with all test scores endogenous is preferable to that with only health
edge endogenous.
A final issue to consider regarding Table 4 is whether part of the effect of m
education works through reductions in the number of children born. Usin
the mother, and its square, as additional identifying variables, the regression
last four columns of Table 4 were reestimated twice, once adding the number of
children and again trying age of mother at first birth. Neither variable was significant
at the 5 percent level, and the impact of mother's health knowledge did not change
appreciably (though in one of the eight cases it lost statistical significance). More-
over, the same results hold when these two variables are treated as exogenous. Thus
there is no evidence that most, or even some, of the effect of mother's education
on child health operates through reductions in family size.
To summarize the results of Table 4, it appears that health knowledge is the main
pathway by which mother's education leads to healthier children. This was seen
only when mother's health knowledge was specified as endogenous; treating it as
exogenous greatly underestimated its impact on child health. Numeracy and literacy
skills never showed any significantly positive impact, whether they were specified
as endogenous or exogenous. In the three specifications that included mother's
schooling as a regressor, its coefficient was never significant, which casts doubt on
the hypothesis that an important pathway by which mother's schooling affects child
health is by changing the values of the mother.
C. Conditional Demand Estimates of Child Height (Conditioning on Income)
Turn now to the final pathway to investigate, that via household income. Table 5
shows three regressions that estimate Equation 4, the conditional demand for child
health that includes income as a conditioning variable. The FE estimates in the first
column are in many ways similar to those in Table 4; in particular, although all four
test score variables show positive effects none is close to being statistically signifi-

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Table 5
Conditional Demand Estimates, Conditioning on Income, of Height for Age Z-Scores
Two-Stage L
(Including Comm
Community Expenditures and Health Expe

Fixed Effects Knowledge Endogenous Va
Father's schooling -0.009 -0.134

(-0.15) (-1.59)
Arabic 0.071 -0.027
(0.93) (-0.23)
French 0.025 0.113
(0.25) (0.84)
Math 0.013 -0.295
(0.15) (-1.84)
Mother's schooling -0.051 0.159
(-0.32) (0.68)
Mother's health knowledge 0.025 1.443
(0.28) (2.47)
Expenditures per capita 0.224 0.587
(2.14) (1.79)
Sex (female) -0.105 -0.070
(-1.21) (-0.71)
Age (months) -0.074 -0.071
(-8.03) (-7.28)

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Age2 (months) 0.001 0.001
(6.89) (6.05)
Mother's height 0.050 0.037
(6.31) (3.55)
Father's height 0.040 0.038
(5.27) (4.10)
Father's height missing 0.140 0.218
(1.39) (1.79)
Overidentification test (d.f.) 11.46(12)
[0.490]
Mother's health knowledge 3.74
[0.000]
Income 14.89
[0.000]
Arabic
French
Math
Hausman tests (d.f.) 7.32(2)

(Endogenous parameters only) [0.026]
Notes:
1. Sample size is 1,451.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
cant, and mother's schooling has no explanatory power. Household expenditures per
capita has a significantly positive effect, as expected. Of course, household income
health knowledge, and possibly mathematics, Arabic and French, may be endoge
nous. The second and third specifications in Table 5 allow for this.20
The second column of Table 5 treats both health knowledge and household per
capita expenditures as endogenous, using the instrumental variables described in
Subsection IIIB. As in Table 4, health knowledge has a significantly positive effec
on child health, but the other test scores are insignificant and/or negative. Household
income has a positive effect that is significant at the 10 percent level, and more than
twice as large as the effect shown in the FE estimates of Column 1.21 The same
specification tests shown in Table 4 are also shown here. The overidentification test
does not reject the exclusion restrictions implied by the choice of instruments, and
those instruments have strong explanatory power. Finally, the Hausman test shows
that the 2SLSFE results are significantly different from the FE results (p-value o
0.026). Thus, assuming that mother's education affects household income (which i
verified below), there is a pathway other than health knowledge by which mother's
education affects child health.
The third column of Table 5 treats all test score variables, as well as per capita
expenditures, as endogenous. As in Table 4, this does not change the general finding
that health knowledge is the key skill that educated mothers possess that raises their
children's health. The specification tests show that the instrumental variables appear
reasonable, and the Hausman test does not support the hypothesis that all five endog-
enous variables are indeed endogenous. Indeed, when only the mathematics, Arabic,
and French test scores are specified as endogenous, the Hausman test cannot reject
the null hypothesis of exogeneity (the x2 statistic with 3 degrees of freedom is 2.57,
which has a p-value of 0.463). Note finally that the coefficient on per capita expendi-
tures is almost the same in Column 3 as in Column 2, though no longer significant
at the 10 percent level (the t-statistic is 1.45). Overall, the results in Table 5 show
that household income is another pathway by which mother's education can affect
child health (and the only pathway by which father's schooling affects child health,
since the first stage regressions in Table Al of Appendix II show a significant impact
of father's schooling on household expenditures). The relative magnitudes of the
different impacts of mother's schooling will be examined in Section V.
D. Health Knowledge or the Ability to Read a Medicine Box?:

A Brief Digression
As mentioned in Section III, another test given to respondents in the 1990-91
ENNVM was one on "general knowledge." This test consisted of 12 questions
20. In addition to the three specifications shown, analogous regressions were run in which mother's educa-
tion was omitted as an explanatory variable. They were very similar to the results shown here and thus
are not presented to reduce clutter in this table.
21. To check for nonlinearities, this regression was repeated with a squared expenditures term added
(not shown here). The squared term was completely insignificant. Because adding a squared term has the
disadvantage of adding another endogenous variable to the regression, the squared term was not used in
the estimation results reported here.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Glewwe 147
concerning everyday life in which a common object is handed to the respo

two or three questions are asked about it. The objects were a national ident
a letter, a box of medicine, a newspaper and an electricity bill. Of particul
for this study are the questions concerning a box of medicine. The three
asked were: 1. Where does it show how many pills are in the box?; 2. Wher
instructions for using the medicine?; and 3. Where is the date of expiration
Presumably, mothers who are more able to answer these questions corr
provide better health care for their children.
For purposes of this paper, two questions arise. Do the medicine box q
measure something that the other tests do not? And if they do, what are t
tions regarding the relationship between mothers' health knowledge and ch
A mother's ability to read a medicine box may simply reflect her abilit
Arabic (all writing on the medicine box was in Arabic), the impact of
child health has already been examined. Alternatively, it may be that the a
read a medicine box is a form of health knowledge. In this case, it would b
ing to examine whether reading a medicine box is the "most important
health knowledge (in which case that ability would "displace" most of th
tory power of health knowledge) or whether it plays only a small role
would not "displace" the explanatory power of health knowledge). The c
shown in Table 2 suggest that the ability to read a medicine box may be li
than another version of the test for Arabic literacy, since the correlation
between these two variables is 0.85. However, it is also fairly highly correl
health knowledge (correlation coefficient of 0.44). Further investigation re
gression analysis.
The role of the ability to read a medicine box is examined in Table 6. In
focus on the relationship between that ability and health knowledge, the ma
French and Arabic test score variables have been omitted (recall that the
explanatory power in Tables 4 and 5). The first two columns show FE e
with (Column 1) and without (Column 2) mother's schooling. As usual with FE
estimation, mother's health knowledge is completely insignificant. However, moth-
er's ability to read a medicine box is significant at the 10 percent level when mother's
schooling is included as a regressor and nearly at the 1 percent level when mother's
schooling is excluded. Thus this variable appears to be capturing more than just the
ability to read Arabic, which was never significant in any of the previous regressions.
Because the previous regressions presented fairly convincing evidence that moth-
er's health knowledge is endogenous, that variable should be instrumented. In addi-
tion, it is prudent, and intuitively plausible (parents with sickly children have more
experience reading medicine boxes), to specify the ability to read a medicine box
as endogenous. These regressions are shown in Columns 3 and 4 of Table 6. When
mother's education is included in the regression, both mother's health knowledge
and the ability to read a medicine box have much larger effects.22 While neither is
significant at the 5 percent level, health knowledge is significant at the 10 percent
22. Note that mother's ability to read a medicine bottle has not been transformed into logarithms because
the original variable ranges only from 0 to 3. Moreover, transforming it to logs would have equated re-
sponses of 0 and 1, which together accounted for 85 percent of the responses.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Table 6
Conditional Demand Estimates of Height for Age Z-Scores, Health Knowledge
and Ability to Read a Medicine Box
Two Stage Least

(Including Comm
Fixed Effects)
Health Knowledge
and Ability to
Community Read Medicine
F 'ixed Effect s Box Endogenous
Father's schooling 0.01 28 0.027 -0.205 -0.105

(0.41 ) (0.47) (-1.82) (-1.19)
Mother's health knowledge 0.01 34 0.036 1.563 2.223
(0.3C 9) (0.41) (1.69) (2.82)
Mother's ability to read a medicine box 0.1 54 0.149 1.670 -0.120
(1.82 7) (2.53) (1.40) (-0.83)
Mother's schooling -0.01 27 -1.743
(-0.2,
2) (-1.51)
Sex (female) -0.1] 14 -0.114 -0.088 -0.084
(-1.3: 3) (- -1.33) (-0.79) (-0.78)
Age (months) -0.0, 76 0.076 -0.071 -0.074
(-8.2 5) -8.26) (-6.30) (-6.96)
Age2 (months) 0.0( 01 0.001 0.001 0.001
)I
(7.1
3) (7.14) (5.15) (5.90)
Mother's height 0.0' 51 0.051 0.036 0.037
(6.6, 7) (6.68) (3.15) (3.33)
Father's height 0.0' 41 0.041 0.038 0.040
(5.5' i) (5.55) (3.65) (3.97)
Father's height missing 0.1' 55 0.156 0.202 0.278
(1.5' 5) (1.57) (1.37) (2.07)
Rental income -0.0] 15 0.014 -0.017 -0.022
8) (- -0.58) (-0.59) (-0.83)
(-0.51
Children overseas 0.6& 0.688 0.968 0.414
(1.1I 2) (1.11) (1.25) (0.63)
Irrigated crop land (hectares) -0.0( 0 -0.000 -0.001 -0.002
(-0.04 3) -0.00) (-0.18) (-0.36)
Unirrigated crop land (hectares) 0.0( )0 0.000 0.001 0.001
(0.7: 7) 4 (0.77) (1.48) (1.39)
Tree crop land (hectares) -0.01 14 -0.014 0.013 0.059
(-0.4 1) (- -0.41) (0.22) (1.18)
Overidentification tests (d.f.) 5.89(7) 8.99(8)

[0.553] [0.343]
Mother's health knowledge -4.41 7.66
[0.000] [0.000]
Ability to read a medicine bottle -2.37 100.08
[0.012] [0.000]
Hausman tests (d.f.) - 9.59(2) 7.83(2)
(Endogenous parameters only) [0.008] [0.020]
Notes:
1. Sample size is 1,473.


58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Glewwe 149
level, and the estimated coefficient is about the same magnitude as it wa

regressions in Tables 4 and 5. Note, however, that mother's education has
large negative coefficient, with a t-statistic of -1.51. This suggests possib
inearity problems. When mother's education is dropped from the regress
impact of the ability to read a medicine box becomes completely insign
and even becomes slightly negative, while health knowledge remains st
significant.
Overall, the results shown in Table 6 do not alter the conclusion reache
that health knowledge is the key aspect of mothers education that leads to i
child health. Although the ability of mothers to read a medicine box initially
to contain information not picked up in health knowledge, 2SLSFE estimat
serious doubt on this proposition. In contrast, as long as health knowledge is
as endogenous it yields statistically significant results (at least at the 10 perc
and the parameter estimates are fairly stable.
To summarize Section IV, the fundamental result is that mother's health
edge is the key mechanism by which mother's education leads to improv
health. A second finding is of a more methodological nature: ignoring the en
ity of mother's health knowledge may seriously underestimate its role in pr
child health.
V. Decomposing the Impact of Mother's Schooling

on Child Health
The finding in the previous section that mother's health knowledge

plays by far the most important role in determining child health does not necessarily
imply that literacy and numeracy do not matter. As explained in Section II, mother's
health knowledge may develop after leaving school, and in a way that will depend
on mother's literacy, and perhaps on numeracy as well. This section attempts to
decompose the overall impact of mother's schooling on child health by decomposing
the parameter [2 given in Equation 2' in Section III.
Recall from Section III that the overall effect of mother's education on child health
in (2'), 32, can be decomposed in two ways. If one explicitly includes the pathway
that operates via household income, the decomposition is that given in Equation 5'
of Section III. If income effects are substituted out, the decomposition is that in
Equation 5". The results in Section IV indicate that the direct effect of literacy,
numeracy and values on child health (that is the coefficients 82, 63 and 84) on child
health were not statistically significant from zero. The 2SLSFE estimates in Table
5 indicate that the impact of household income on child health (measured by 66)
was approximately equal to 0.59.23 Finally, the best point estimates for the impact
23. Tables 4, 5, and Al present several specifications. Based on the results of the previous section, the
specifications used in this section are those where: 1. Heath knowledge is endogenous but Arabic, French,
and mathematics skills are exogenous; and 2. The direct effect of years of schooling on child health is
constrained to equal zero. An alternative is to be more agnostic, taking averages across different specifica-
tions, yet doing so produced results very similar to those given here.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
of health knowledge on child health (65) are 1.44 when income effects are expl
and 1.45 when income effects are substituted out.
To complete the decomposition of 32 one needs estimates of the impact of school-
ing on health knowledge (either directly via aHK or indirectly via TrLacL and rlNtN)
and the impact of mother's schooling on household income (cay). Table Al in the
Appendix provides a point estimate of 0.153 for ay. The remaining parameter esti-
mates are shown in Table 7. The first three columns present reduced form estimates
of the determinants of health knowledge under the assumption that Arabic, French,
and mathematics scores can be considered as exogenous.24 The regression in column
1 shows that Arabic and mathematics skills have significantly positive impacts on
health knowledge. French skills have an unexpected negative effect, but this is sig-
nificantly different from zero only at the 10 percent level. Finally, after controlling
for these effects years in school has a significantly negative effect. Taking these
estimates at face value implies that cHK = -0.185, rN = 0.184 and the two parts
of TrL are 0.088 and -0.052 for Arabic and French, respectively. Estimates of the
impact of years of schooling on literacy (otL) and numeracy (aN) skills are shown
in columns 4-6 of Table 7. Briefly, aN = 1.268 and the two parts of aL are 1.734
and 1.266 for Arabic and French, respectively.
Using the estimates of aHK, TL and aN given in the first column of Table 7 yields
an estimate of 32 of 0.196, as shown in the first row of the last column of Table 8.
Given the simple functional forms used and the imprecision of the estimates, this
is surprisingly similar to the estimated figure of 0.165 from the FE reduced form
estimate in Table 3. The other columns in Table 8 show how this is decomposed
according to Equation 5". Perhaps the most unusual finding is that years in school
does not raise health knowledge; indeed, it has a strongly significant negative effect.
Is this plausible? It may be. In Moroccan schools, basic health knowledge is not
part of the standard curriculum,25 so one should not be surprised that the impact
of schooling is not positive. Even a negative impact may occur-because school
attendance reduces the time girls spend at home with their mothers, it may reduce
opportunities for them to acquire health knowledge at home. That is, time girls spend
at home is an omitted variable that is negatively correlated with girls' schooling;
schooling itself does not reduce health knowledge, but it implies an allocation of
time that results in lower health on knowledge.
Turning to the rest of the decomposition, the main avenue by which schooling
raises health knowledge is by raising Arabic and mathematics skills, particularly the
latter, which can in turn be used to acquire health knowledge. In contrast, French
skills have a small negative impact, based on a parameter that was significantly
different from zero only at the 10 percent level. While the positive impact of Arabic
24. Intuitively, while it is plausible that a sickly child will increase parents' health knowledge, there is
less reason to think that parents obtain greater literacy and numeracy skills in response to bouts of sickness
in their children. This is consistent with the findings in Section IVB; the Hausman tests clearly rejected
the exogeneity of health knowledge but could not reject the joint exogeneity of mathematics, Arabic and
French skills. Finally, as a practical matter it is very difficult to find instrumental variables for these three
skills in the 1990-91 ENNVM that do not also affect the acquisition of health knowledge.
25. This statement is based on discussions with World Bank staff who have worked on health and education
issues in Morocco.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Glewwe 151
literacy is plausible (literate women can acquire health knowledge be reading vari
lnpwritten materials), the positive impact of numeracy is less intuitive. It is prob
the case that mathematical skills help mothers monitor their children's illnesses
more accurately apply medicines and treatments. In addition, it may be that mat
matical skills develop mothers' abstract reasoning abilities, which in turn helps t
to organize and refine the health knowledge they acquire.
Given the high colinearity between schooling, literacy and numeracy, as sho
in Table 2, more precise estimates might be obtained by dropping insignificant v
ables. Thus in the second regression reported in Table 7 the French literacy varia
was dropped. The resulting decomposition is shown in the second line of Tab
Overall, the results do not change very much. In particular, the significantly neg
impact of years in school does not "go away." Dropping years of schooling as
which is hard to justify econometrically, was done in the third column of Tab
and the associated decompositions are shown in the third row of Table 8. The ove
result is not very satisfying because now Arabic skills have no significant effect
health knowledge, and the estimate of 32 shown in the last column of Table 8 (0
is much larger than the estimate given in Table 3 (0.165).
The bottom half of Table 8 examines decompositions based on Equation 5', wh
includes the impact of income. The first row (that is, the fourth row of Table 8
based on the first regression in Table 7. The total impact of education is estim
to be 0.285. This is also much higher than the estimate of 0.165 in Table 3, so
decompositions underlying it may not be very precise. That being said, the deco
sition indicates that the effect of education via its effect on income is 0.089, whi
is about one third of the total effect. The rest of the decomposition (that is,
different impacts via health knowledge) is very similar to the case where incom
substituted out. Thus the previous discussion applies here.
The findings of this section can be summarized as follows. The evidence sugg
that education improves child health primarily by increasing health knowledg
also has an impact by raising household income, but rough estimates indicate
this income effect is only about one third of the total effect. This is similar to
findings of Thomas, Strauss, and Henriques (1991), who found little impact thro
improved household income. There is no direct effect of either Arabic or Fr
literacy skills, nor of numeracy skills, on child health. Neither is there evidence
other aspects of schooling, particularly changes in mothers' values, have any d
effect. The question then arises as to how mothers obtain health knowledge. Sch
ing alone has no contribution, and may even have a negative effect (due to red
time spent at home by girls in school). The lack of a positive effect is consis
with the fact that Moroccan schools do not teach health knowledge to students
stead, children acquire health knowledge by acquiring literacy and numeracy s
in school, which they then use to attain health knowledge outside of school. O
Arabic literacy appears to matter; French literacy has no significant effect.
Overall, these findings are quite interesting and have some immediate policy im
plications. However, further research to confirm, or possibly refute, these find
is in order. The decompositions here are based on simple functional forms and
point estimates are not particularly precise. They should be treated as suggestive
not definitive.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Table 7
Direct and Indirect Impacts of Schooling on Health Knowledge
Determ
Determinants of Health Knowledge Mathem
Constant 0.001 0.014 0.078 0.031

(0.00) (0.03) (0.17) (0.07)
Arabic 0.088 0.077 0.011
(3.19) (2.78) (0.47)
French -0.052
(-1.77)
Math 0.184 0.175 0.133
(5.53) (5.38) (4.39)
Mother's schooling -0.185 -0.220 1.268
(-3.35) (-4.38) (34.41)
Mother's height 0.004 0.004 0.004 0.002
(1.44) (1.42) (1.29) (0.67)
Mother's father's schooling 0.036 0.035 -0.020 0.054
(0.48) (0.45) (-0.26) (0.47)

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Mother's mother's schooling -0.146 -0.150 -0.205 -0.230
(-1.36) (-1.42) (-2.05) (-0.91)
Father born here 0.067 0.065 0.072 -0.042
(1.66) (1.58) (1.76) (-0.89)
Number of radios -0.028 -0.028 -0.029 0.003
(-0.83) (-0.82) (-0.87) (0.09)
Number of televisions 0.086 0.084 0.091 0.121
(2.28) (2.22) (2.37) (2.99)
Availability of newspapers 0.184 0.191 0.168 0.058
(2.91) (3.03) (2.65) (0.72)
Mother's married sisters 0.015 0.014 0.016 0.003
(1.42) (1.36) (1.48) (0.24)
Father's married sisters -0.006 -0.007 -0.005 0.022
(-0.58) (-0.62) (-0.44) (1.66)
Father's married sisters missing -0.005 -0.009 0.010 0.114
(-0.09) (-0.17) (0.18) (2.14)
R2 0.468 0.466 0.458 0.843
Sample size 884 884 884 904
Notes:
1. All regressions incorporate community fixed effects.


58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Table 8
Decompositions of Impact of Mother's Schooling on Child Health
Through Health Knowledge
Via Via Via Through

Direct Arabic French Numeracy Income Total
(aHK) (T1L L) (ILaOL) (rINaN) (66o 4) Effect
Not conditioning on income -0.268 0.221 -0.095 0.338 - 0.196

-0.319 0.194 - 0.322 - 0.197
0.028 - 0.245 - 0.273
Conditioning on income -0.267 0.220 -0.095 0.337 0.090 0.285
-0.317 0.193 - 0.320 0.090 0.286
0.028 - 0.243 0.090 0.361
VI. Summary and Conclusion
Three major conclusions can be draw

this paper. First, health knowledge appears to
(indirectly) obtain from their schooling that
dren's health. Second, estimating the impa
could suffer from substantial endogeneity bi
if one does not instrument the health knowl
that schooling contributes to mother's he
rectly-health knowledge is not directly l
using literacy and numeracy skills acquired
The above conclusions have direct policy
suggest that health knowledge should be dire
should be taught at an early age because girl
sufficient numeracy and literacy skills to
on their own. Many girls in Morocco leave sc
of women aged 18-20 in the 1990-91 ENN
primary school. Even more disturbing is th
tended school at all-this latter fact sugges
young women basic health knowledge in ad
These results and their policy implication
countries. If the finding that health knowle
health is confirmed in other countries (an im
country where a large proportion of women
26. One objection to this policy recommendation is th

displace health knowledge obtained elsewhere, so that ev
Yet if literacy and numeracy skills acquired in school
knowledge later in life. Moreover, for women who lea
a higher "initial stock" of health knowledge will allow t
than they would have reached with a low or nonexisten

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Glewwe 155
add basic health education to its primary school curriculum. In addition, if a

proportion of women do not even attend primary school, health education prog
for women of child-bearing age should also receive high priority. Finally, the
ings here support two general policy recommendations for developing coun
1. Education of girls should be a high priority; and 2. School quality must n
neglected, since women will not be able to raise their level of health knowl
after their schooling is completed if they leave school without basic literac
numeracy skills.
Appendix 1
Description of Health Knowledge Test
The health knowledge test used in the 1990-91 Moroccan Enquete Nationale des
Niveaux de Vie des Menages (ENNVM) consisted of the following five questions,
given to the respondent in his or her maternal language:
1. Is it possible to get vaccinations for children without paying money? If yes,

where?
(Answer: Yes, at public hospitals, Red-Cross centers, or visits by nurses to
villages).
2. What should one do to a wound to avoid infection?
(Answer: Wash it well with soap, apply alcohol and cover it).
3. What is the best way to prevent children from getting polio?
(Answer: Vaccination).
4. If a child develops diarrhea, what should one do if no doctor is available?
(Answer: Use boiled water, feed rice or carrots, give salts, avoid milk and fats).
5. In places where the water is not safe to drink, what should one do to it before
drinking?
(Answer: Boil it or add drops of "javel").

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Appendix 2
Supplementary Tables
Table Al
First Stage Regressions for Test Score Variables
Health Knowledge Expenditures Per Cap
Including Excluding Including Exclud

Arabic, Arabic, Arabic, Ara
French, and French, and French, and Fre
Mathematics Mathematics Mathematics Mathe
.~ q I-_ lC4 1 tx t n Ix xi n ix "t ixix
iatmer
U.U3Z) U.UOu
s (U.U11
scno
(3.22) (3.27) (5.11)
-0.195
Mother's 0.125 0.153
sch
(-4.17) (6.43) (3.51)
0.997
Arabic -0.053
(4.07) (-2.45)
-0.073
French 0.044
(-2.65) (1.75)
Mathematics 0.186 0.039
(6.80) (1.54)
Sex -0.015 -0.013 -0.029 -
(-0.60) (-0.51) (-1.40) (-
Age -0.002 -0.001 -0.002 -
(-0.66) (-0.45) (-0.84) (-
Age2 0.000 0.000 0.000
(0.44) (0.23) (0.74)
Mother's height 0.005 0.006 0.009
(2.28) (2.43) (4.84)
Father's height 0.001 0.001 0.002
(0.51) (0.53) (1.00)

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Father's height missing -0.046 -0.041 0.029
(-1.33) (-1.15) (1.05) (1
Rental income 0.007 0.003 0.010 0.0
(1.12) (0.53) (2.15) (2.4
Children overseas -0.133 -0.001 0.072 0.
(-1.69) (-0.01) (0.61) (1.
Irrigated crop land 0.001 0.001 0.006 0.
(0.62) (0.76) (6.89) (6.7
Unirrigated crop land -0.000 -0.000 0.000 0
(-1.82) (-2.01) (1.95) (1.
Tree crop land -0.033 -0.034 0.015 0.
(-2.13) (-2.35) (1.57) (1
Mother's father's schooling 0.053 0.092 0.136
(0.64) (1.06) (1.40) (1.
Mother's mother's schooling -0.228 -0.315 -0.059
(-2.49) (-3.37) (-0.55) (-0
Father bor here 0.059 0.069 -0.082 -0
(1.72) (2.24) (-2.69) (-2
Mother's married sisters 0.015 0.014 0.003 0
(1.75) (1.66) (0.45) (0.7
Father's married sisters -0.018 -0.013 0.017
(-1.93) (-1.31) (1.99) (2
Father's married sisters missing -0.038 -0.009 -0.02
(-0.84) (-0.19) (-0.75) (-0
Number of radios -0.023 -0.014 0.118 0.
(-0.85) (-0.51) (5.36) (5.
Number of televisions 0.057 0.069 0.211
(1.93) (2.24) (7.69) (8.
Availability of newspapers 0.207 0.195 0.035
(3.78) (3.56) (0.65) (0.
R2 0.469 0.424 0.653 0.651
Notes:
1. Asymptotic t-statistics in parentheses.

2. All regressions incorporate community fixed effects.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Table A2
Partial R2 Statistics for Instrumented Variables
Instrument Sets
Nine Health
Nine Health Knowledge
Nine Health Knowledge Instruments
Knowledge Instruments Plus Plus Five Income
Instrumented Variable Instruments Mother's Schooling Instruments
Health knowledge 0.143 0.179 0.158

Mathematics 0.273 0.773 0.283
French 0.218 0.788 0.224
Arabic 0.200 0.808 0.203
Income - -0.394
Reading a medicine bottle 0.231 0.682
Notes:
1. The nine health knowledge instruments are: mother's married sisters, father's married sisters, father's
married sisters missing, father born here, number of televisions, number of radios, availability of newspa-
pers, mother's father's schooling, and mother's mother's schooling.
2. The five income instruments are: rental income, number of children living overseas, irrigated crop land,
unirrigated crop land, and tree crop land.
References
Barrera, Albino. 1990. "The Interactive Effects of Mother's Schooling and Unsupple-
mented Breastfeeding on Child Health." Journal of Development Economics 34(1):81-
98.
Behrman, Jere. 1990. "The Action of Human Resources and Poverty on One Another:
What We Have Yet to Learn." Living Standards Measurement Study Working Paper
No. 74. The World Bank. Washington, D.C.
Behrman, Jere, and Anil Deolalikar. 1988. "Health and Nutrition." In Handbook of Devel-
opment Economics, Vol. I, ed. Hollis Chenery and T.N. Srinivasan, 631-711. Amster-
dam: North Holland.
Bound, John, David Jaeger and Regina Baker. 1993. "The Cure Can Be Worse than the
Disease: A Cautionary Tale Regarding Instrumental Variables." Technical Paper No.
137. Cambridge, Mass.: National Bureau of Economic Research.
Cash, Richard A. 1983. "Oral Rehydration in the Treatment of Diarrhea: Issues in the Im-
plementation of Diarrhea Treatment Programs." In Diarrhea and Malnutrition: Interac-
tions, Mechanisms, and Interventions, ed. Lincoln Chen and Neville Scrimshaw. New
York: Plenum Press.
Cebu Study Team. 1991. "Underlying and Proximate Determinants of Child Health: The
Cebu Longitudinal Health and Nutrition Study." American Journal of Epidemiology
133(2): 185-201.
. 1992. "A Child Health Production Function Estimated from Longitudinal Data."
Journal of Development Economics 38(2):323-51.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00
Glewwe 159
Davidson, Russell, and James MacKinnon. 1993. Estimation and Inference in Econ
rics. Oxford University Press.
Gibson, Rosalind. 1990. Principles of Nutritional Assessment. Oxford University P
Glewwe, Paul. 1997. "How Does Schooling of Mothers Improve Child Health? E
from Morocco." Living Standards Measurement Study Working Paper No. 128.
ington, D.C.: The World Bank.
Schultz, T. Paul. 1984. "Studying the Impact of Household Economic and Commun
Variables on Child Mortality." Population and Development Review 10(suppl.)
Strauss, John. 1990. "Households, Communities and Preschool Child Nutrition Ou
Evidence from Cote d'Ivoire." Economic Development and Cultural Change 38
61.
Strauss, John, and Duncan Thomas. 1995. "Human Resources: Household Decisions and
Markets." In Handbook of Development Economics, ed. Jere Behrman and T.N. Sriniva-
san, Volume 3.
Thomas, Duncan, John Strauss, and Maria Helena Henriques. 1991. "How Does Mother's
Education Affect Child Height?" The Journal of Human Resources 26(2): 183-211.
Wolfe, Barbara, and Jere Behrman. 1987. "Women's Schooling and Children's Health:
Are the Effects Robust with Adult Sibling Control for the Women's Childhood Back-
ground?" Journal of Health Economics 6:239-54.
World Bank. 1994. "Kingdom of Morocco, Public Expenditure: Issues and Outlook."
Washington, D.C.: Middle East and North Africa Region, World Bank.

58.27.202.37 on Mon, 29 Jan 2024 10:24:06 +00:00

Glewwe MothersSchoolingRaise 1999

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Glewwe MothersSchoolingRaise 1999

Uploaded by

Copyright:

Available Formats

Why Does Mother's Schooling Raise Child Health in Developing Countries?

Stable URL: https://www.jstor.org/stable/146305

This content downloaded from

Mother's education is often found to be positively correlate

Child health is a key indicator of the quality of life in developing

THE JOURNAL OF HUMAN RESOURCES * XXXIV * 1

This content downloaded from

II. Mother's Education and Child Health

Figure 1 provides a schematic framework for thinking about the determinants of

This content downloaded from

This content downloaded from

This content downloaded from

B. Recent Empirical Evidence

This content downloaded from

III. Analytical Framework, Data and Estimation

(1) Hi = f(HIi, Ei, Ei)

(2) Hi = g(FSi, MSi, HAi, Ei, Ei)

This content downloaded from

(3) Hi = h(FSi, Li, Ni, Vi, HKi, HAi, Ei, ?i)

(4) Hi = h'(FSi, Li, Ni, Vi, HKi, Yi, Ei, ?i).

This content downloaded from

quires plausible instrumental variables; this will be discussed further in Su

This content downloaded from

Height for age Z-score -0.94 1.86

Sample Size: 1,495.

This content downloaded from

Years schooling 1.0000

Note: All variables are in logarithms.

C. Estimation Strategy: General

Consider estimation of equation (4) using the 1990-91 ENNVM.1 Child he

This content downloaded from

This content downloaded from

D. Estimation Strategy: Decomposing the Separate Impacts of

This content downloaded from

+ Hji (3HKi aHKi a3L aHKiaNi aHi 3Yi

(2') Hi = Po + FFSi + P2MSi + P3HAi + Ul

In each specification, an error term is added to account for random me

(5') 12 = 620L + 63(aN + 64aV + S5(OHK + LaL + rTNO(N) + 66aY.

This decomposition is based on Equation 4' and thus explicitly accounts

(5") 32 = Y2a2L + Y3aN + Y40v + Y_5(OHK + I1LaL + T_NAN).

This content downloaded from

IV. Estimation Results

A. Reduced Form Estimates of the Determinants of Child Height

This content downloaded from

Variable Coefficient t-Statistic Coefficient t-Statistic

Constant -16.931 -10.83

Sample size: 1,495.

The of moth impact

This content downloaded from

B. Conditional Demand Estimates of Child Height (not Conditioning

Table 4 presents estimates of Equation 3, the conditional demand determina

This content downloaded from

Two Stage Lea

Father's schooling 0.012 -0.114 -0.073

This content downloaded from

Hausman tests (d.f.) 7.16(1) 5.95(1)

This content downloaded from

This content downloaded from

it is still statistically insignificant (t-statistics of 0.92 and 0.57 in Columns 4

C. Conditional Demand Estimates of Child Height (Conditioning on Income)

This content downloaded from

Community Expenditures and Health Expe

Father's schooling -0.009 -0.134