EFFECTS OF FERTILITY AND MORTALITY ON CHILD HEALTH

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The principal objective of the proposed project is to assess how changes in the socioeconomic characteristics of parents and how a variety of program interventions alter the average health and human capital of children by influencing both the fertility of adult women and the survival rates of children. Estimates based on household data from four countries-- Bangladesh, the Ivory Coast, Malaysia, and the United States--exhibiting very different levels of birth and child death rates will provide information on how particular interventions affect the number and composition of children who are born, the number and composition of the survivors of the birth cohort and the average health and human capital of the survivors. The degree to which the relationships between socioeconomic characteristic of household and child mortality reflect the selectivity of fertility in behavior will be assessed as well as the selectivity of child survival in influencing the average healthiness of the population of survivors. Models incorporating selectivity in conception rates, fetal survival, and child survival will be estimated that will provide for the first time comprehensive estimates of program effects on child health and human capital that trace out their effects through fertility and mortality change. The estimates will be compared to those obtained from prior studies which look at one or another outcome in isolation and do not consider issues of sample selection induced by fertility and/or mortality. Econometric procedures will be developed and applied that provide estimates that take into account the selective influences of fertility and mortality on child health under a wide variety of assumptions about the heterogeneity of populations. Applications of models treating fertility and mortality as selective processes will provide improved estimates of program interventions on child health and a better understanding of how changes in the socioeconomic status of parents and changes in health infrastructure influence the average health status of surviving children in populations characterized by different levels of fertility and mortality.