Effects of tuition-free primary education on women's access to family planning and on health decision-making: A cross-national study
Effects of tuition-free primary education on women's access to family planning and on health decision-making: A cross-national study
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DOI：
10.1016/j.socscimed.2019.112478
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发表时间：
2019-10-01
影响因子：
5.4
通讯作者：
Heymann, Jody
中科院分区：
文献类型：
--
作者：
Bose, Bijetri;Heymann, Jody
2017年，至少有十分之一的已婚或同居育龄妇女的计划生育需求未得到满足。在教育、工作和家庭决策等多种社会环境中的性别不平等影响到获得计划生育服务的机会。在本文中，我们将研究在教育中增加性别平等的法律和政策是否可以改善计划生育的结果。特别是，我们把重点放在免学费的初级教育政策上，以此作为变革的手段。我们估计的影响，女孩被暴露在免学费的小学教育政策对他们的健康决策和计划生育的需要作为妇女。使用17个低收入和中等收入国家的差异中的差异方法，我们发现，与没有类似接触的妇女相比，在儿童时期接受小学免费教育政策的妇女更有可能满足其计划生育需求，并从传统避孕药具转向现代避孕药具。这些妇女也更有可能在夫妻的健康相关决定中拥有一定的发言权。事实表明，更多的两性平等决策可在一定程度上促进教育政策对生殖健康的积极影响。这项研究的结果表明，需要增加对教育的投资，卫生政策制定者需要优先考虑跨部门的参与。
At least one in ten married or in-union women of reproductive ages had an unmet need for family planning in 2017. Gender inequalities in multiple social settings, including education, work and household decision-making, influence access to family planning. In this paper, we examine whether laws and policies that increase gender equality in education can lead to improved family planning outcomes. In particular, we focus on tuition-free primary education policies as a means of change. We estimate the impact of girls being exposed to tuition-free primary education policies on their health decision-making and on their family planning needs as women. Using a difference-in-difference methodology on 17 low- and middle-income countries, we find that women who were exposed as children to tuition-free education policy throughout primary school have a greater likelihood of meeting their family planning needs and of shifting from traditional to modern contraceptives, relative to women without similar exposures. These women also have a greater likelihood of having some say in health-related decisions of the couple. More gender-equal decision-making is shown to mediate a portion of the positive impact of the education policy on reproductive health. The results of this study indicate the need for increased investments in education and for health policy makers to prioritize cross-sectoral engagements.