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Free keywords:
International Monetary Fund; education; child health; development; structural adjustment
Abstract:
Parental education is located at the center of global efforts to
improve child health. In a developing-country context, the International
Monetary Fund (IMF) plays a crucial role in determining how
governments allocate scarce resources to education and public
health interventions. Under reforms mandated by IMF structural
adjustment programs, it may become harder for parents to reap
the benefits of their education due to wage contraction, welfare
retrenchment, and generalized social insecurity. This study assesses
how the protective effect of education changes under IMF programs,
and thus how parents’ ability to guard their children’s health
is affected by structural adjustment. We combine cross-sectional
stratified data (countries, 67; children, 1,941,734) from the Demographic
and Health Surveys and the Multiple Indicator Cluster Surveys.
The sample represents ∼2.8 billion (about 50%) of the world’s population
in year 2000. Based on multilevel models, our findings reveal
that programs reduce the protective effect of parental education on
child health, especially in rural areas. For instance, in the absence of
IMF programs, living in an household with educated parents reduces
the odds of child malnourishment by 38% [odds ratio (OR), 0.62;
95% CI, 0.66–0.58]; in the presence of programs, this drops to 21%
(OR, 0.79; 95% CI, 0.86–0.74). In other words, the presence of IMF
conditionality decreases the protective effect of parents’ education on
child malnourishment by no less than 17%. We observe similar adverse
effects in sanitation, shelter, and health care access (including immunization),
but a beneficial effect in countering water deprivation.
