Abstract
Female secondary school attendance has recently increased in sub-Saharan Africa, and so has the risk of becoming pregnant while attending school. We analyze the impact of teenage pregnancy on young women’s human capital using longitudinal data in Madagascar that capture the transition from adolescence to adulthood for a cohort aged 21–24 in 2012, first interviewed in 2004. We find that early childbearing increases the likelihood of dropping out of school and decreases the chances of completing secondary school. This pregnancy-related school dropout also has a detrimental impact on standardized test scores in math and French. We instrument early pregnancy with the young woman’s community-level access and her exposure to condoms since age 15 after controlling for pre-fertility socioeconomic conditions. Our results are robust to different specifications that address potential endogeneity of program placement and instrument validity.
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Notes
Complications during pregnancy and childbirth are the leading cause of death for girls aged 15–19 in low- and middle-income countries (World Health Organization 2011).
Modern methods include oral contraceptives (“the pill”), female and male sterilization, IUD, injectable contraceptives, implants, male and female condoms, diaphragm, and emergency contraception (INSTAT and ICF Macro 2010).
Abortion is illegal, and estimates put abortion rates at 1 per 10 live births. Abortion complications are one of the major contributors to maternal death in Madagascar (Sharp and Kruse 2011).
In a related study, Field and Ambrus (2008) found a negative effect of adolescent marriage on schooling in Bangladesh. In this context, female schooling is restricted by marriage; pregnancy comes after marriage. This is different from African countries, where out-of-wedlock pregnancy is common.
The 2004 survey defined a community as the catchment area for a primary school. These communities were chosen from a national school-based sampling frame (see Glick et al. 2009). The data are not strictly nationally representative of the entire population, but they closely reflect the main demographic characteristics of our cohort members.
Comparisons between female attritors and nonattritors in 2004 on socioeconomic characteristics used to predict early childbearing show that attrition is not a source of bias in our IV results. Results are available upon request.
In spite of the activities of the 1996 National Action Plan to encourage single mothers to resume education, government school rules in Madagascar stipulate that pregnant girls be expelled and not allowed back to school after childbirth (United Nations Economic Commission for Africa 2009). This evidence is consistent with our interviews with community-level various stakeholders, who acknowledged that school girls who get pregnant are socially pressured, often by the school principal, to leave the school to reduce reputational costs for the school.
The exact question is, “Can the residents obtain condoms in the community? Since when (year) were these available?”
In all of the communities with condom availability, community leaders report that condoms are available “at all times,” suggesting that stockouts might not be an issue.
We lack information on the age of sexual initiation in our surveys.
As a robustness check, we estimate our IV models with different measures of exposure: since age 10, and since the young woman’s birth year. We find that these instruments have lower correlation with ever-mother. The F statistic of exposure to condoms since age 15 is twice as large as the F statistic of these instruments.
The 2 SLS IV models that use exposure to condoms are available upon request. Results are similar to the IV probit models.
Using a dummy variable for whether the parents were alive when a young woman was 15 does not change the results.
Our IV results are robust to the estimation of the models including the young women who dropped out before age 13. Results using the full sample are available upon request.
The stable unit treatment value assumption (SUTVA) in our IV model would imply that there are no plausible social network or spillover effects resulting from community-level condom access. To the extent that young women who live in areas without condom access do benefit from condom availability, our first stage might be weakened. However, we do not expect that such spillovers would bias our main results because our IV estimates explore only differences in community-level access to condoms, which will still be positive even in the presence of such spillovers; it is very unlikely that condom distribution points benefit equally the communities that have no access to condoms.
Distance is indicated as a separate reason for not using modern contraception (INSTAT and ICF Macro 2010).
Despite the low HIV/AIDS prevalence in Madagascar, it remains a serious public health concern (Sharp and Kruse 2011).
From the 2007 commune census, information on the number of births and number of women who died during or after delivery in 2006 is available for only 68 and 66 of our 73 communities, respectively.
Only 71 of our 73 sample communities were included in the 2001 commune census.
Meekers et al. (2006) showed that young women aged 15–24 who self-reported condom access (defined as knowing a condom source within 10 min walking) are 1.8 times more likely than others to have ever used condoms.
Our IV results are qualitatively the same when we exclude the community-level controls. Results are available upon request.
Results using access to condoms are qualitatively similar. We keep the specifications with exposure to condoms.
We fail to reject the null hypothesis of exogeneity under the Haussmann and Durbin Watson test using access to condoms as an instrument.
Based on the Haussmann and Durbin Watson test, we reject the null hypothesis of exogeneity for both math and French standardized tests scores at the 5 % significance level, using access and exposure to condoms as IVs.
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Acknowledgments
The authors thank Günther Fink, George Jakubson, Ravi Kanbur, David Lam, Paul Schultz, anonymous reviewers and seminar participants at the 2013 Cornell Economics Seminar, the 2013 Population Association of America Conference, the 2013 Northeast Universities Development Consortium Conference-NEUDC, the 2014 Population and Reproductive Health Conference, and the 2015 Harvard Population Center seminar series for helpful comments and discussions. This study was funded by the IZA/DFID GLM | LIC Program under Grant Agreement GA-C1-RA4-067. This document is an output from a project funded by the UK Department for International Development (DFID) and the Institute for the Study of Labor (IZA) for the benefit of developing countries. The views expressed are not necessarily those of DFID or IZA. Herrera is very grateful for the support from the Hewlett Foundation/(IIE) Doctoral Dissertation Fellowship. The authors declare that they have no conflict of interest. Any errors are solely the responsibility of the authors.
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Herrera Almanza, C., Sahn, D.E. Early Childbearing, School Attainment, and Cognitive Skills: Evidence From Madagascar. Demography 55, 643–668 (2018). https://doi.org/10.1007/s13524-018-0664-9
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DOI: https://doi.org/10.1007/s13524-018-0664-9