RESUMO
OBJECTIVES: Early life interventions are considered essential for reducing the burden of health inequalities over the life course. This paper tests this issue empirically focusing on whether access to antenatal care can later reduce children's health and educational inequalities. METHODS: Data came from the Young Lives Project for Ethiopia, Peru, Vietnam, and the State of Andhra Pradesh in India. We selected children born in early 2001/2002 and who were followed longitudinally in 2006/2007. We used multilevel mixed effects linear regression models to estimate the parameters of interest. RESULTS: We found a positive and significant relationship between mothers' access to antenatal care and their children's cognitive development in all countries. In addition, we found a positive and significant relationship between antenatal care and children's cognitive development for stunted children but only in Peru and Vietnam. CONCLUSIONS: We conclude that (1) antenatal care has the potential to change the negative consequences of early nutritional deficiencies on later cognitive development in Peru and Vietnam; (2) differentials in the quality of antenatal care services could explain the cross-country differentials in the role of early life interventions found here.
Assuntos
Desenvolvimento Infantil , Cognição , Acessibilidade aos Serviços de Saúde , Cuidado Pré-Natal , Criança , Pré-Escolar , Etiópia , Feminino , Humanos , Índia , Lactente , Estudos Longitudinais , Peru , Cuidado Pós-Natal , Gravidez , VietnãRESUMO
Both public and private resources contribute to the nutritional status of children. In addition, the investments made by one household may contribute to the health of other households in the neighborhood through improvements in the sanitation environment and through increases in shared knowledge. This paper measures the externalities of investments in nutrition by indicating the impact of the education of women in Peruvian neighborhoods on the nutrition of children in other households, after controlling for the education and income of those households. We find that in rural areas this shared knowledge has a significant impact on nutrition, with the coefficient of an increase in the average education of women in the neighborhood being appreciable larger than the coefficient of education in isolation. In addition, we indicate the impact of the water and sanitation environment in the neighborhood, again controlling for the household's own access to sanitation and water. In both urban and rural areas, we observe externalities from investments in such household level infrastructure with the evidence particularly strong for sanitation made by neighboring households.