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Length of maternal schooling and children’s risk of malaria infection: evidence from a natural experiment in Uganda
INTRODUCTION: An estimated 216 million cases of malaria occurred worldwide every year. Cross-sectional studies have reported negative association between maternal education and child malaria risks; however, no randomised trial or quasi-experimental study using a natural experiment has confirmed a ca...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7042595/ https://www.ncbi.nlm.nih.gov/pubmed/32133186 http://dx.doi.org/10.1136/bmjgh-2019-001729 |
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author | Masuda, Kazuya |
author_facet | Masuda, Kazuya |
author_sort | Masuda, Kazuya |
collection | PubMed |
description | INTRODUCTION: An estimated 216 million cases of malaria occurred worldwide every year. Cross-sectional studies have reported negative association between maternal education and child malaria risks; however, no randomised trial or quasi-experimental study using a natural experiment has confirmed a causal relationship between these two factors. I used the free primary education reform in Uganda to assess the causal effects of maternal schooling on children’s risk of malaria infection. METHODS: Malaria biomarkers of children aged <5 years were collected from the 2009 and 2014 Uganda Malaria Indicator Surveys (n=5316). In 1997, the government eliminated tuition requirements in primary schools, which increased the educational attainment of the affected cohorts. Using exposure to the reform as an instrumental variable, I used a two-stage least squares approach to estimate the causal effects of maternal year of education on the probability that a child would contract malaria at the time of the survey. I also evaluated the cost-effectiveness of primary schooling as a malaria control intervention. RESULTS: One extra year of maternal education reduced children’s risk of malaria infection by 7.5 percentage points (p=0.057) from baseline (34.9%). The length of maternal education was also positively associated with insecticide-treated bednet usage by their children. The results were robust to a variety of sensitivity tests. Primary schooling for women was a cost-effective intervention to reduce children’s malaria infection. CONCLUSION: Improving access to primary education could be a cost-effective measure to reduce malaria prevalence among children of educated mothers aged <5 years in malaria-endemic countries. |
format | Online Article Text |
id | pubmed-7042595 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-70425952020-03-04 Length of maternal schooling and children’s risk of malaria infection: evidence from a natural experiment in Uganda Masuda, Kazuya BMJ Glob Health Original Research INTRODUCTION: An estimated 216 million cases of malaria occurred worldwide every year. Cross-sectional studies have reported negative association between maternal education and child malaria risks; however, no randomised trial or quasi-experimental study using a natural experiment has confirmed a causal relationship between these two factors. I used the free primary education reform in Uganda to assess the causal effects of maternal schooling on children’s risk of malaria infection. METHODS: Malaria biomarkers of children aged <5 years were collected from the 2009 and 2014 Uganda Malaria Indicator Surveys (n=5316). In 1997, the government eliminated tuition requirements in primary schools, which increased the educational attainment of the affected cohorts. Using exposure to the reform as an instrumental variable, I used a two-stage least squares approach to estimate the causal effects of maternal year of education on the probability that a child would contract malaria at the time of the survey. I also evaluated the cost-effectiveness of primary schooling as a malaria control intervention. RESULTS: One extra year of maternal education reduced children’s risk of malaria infection by 7.5 percentage points (p=0.057) from baseline (34.9%). The length of maternal education was also positively associated with insecticide-treated bednet usage by their children. The results were robust to a variety of sensitivity tests. Primary schooling for women was a cost-effective intervention to reduce children’s malaria infection. CONCLUSION: Improving access to primary education could be a cost-effective measure to reduce malaria prevalence among children of educated mothers aged <5 years in malaria-endemic countries. BMJ Publishing Group 2020-02-23 /pmc/articles/PMC7042595/ /pubmed/32133186 http://dx.doi.org/10.1136/bmjgh-2019-001729 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Original Research Masuda, Kazuya Length of maternal schooling and children’s risk of malaria infection: evidence from a natural experiment in Uganda |
title | Length of maternal schooling and children’s risk of malaria infection: evidence from a natural experiment in Uganda |
title_full | Length of maternal schooling and children’s risk of malaria infection: evidence from a natural experiment in Uganda |
title_fullStr | Length of maternal schooling and children’s risk of malaria infection: evidence from a natural experiment in Uganda |
title_full_unstemmed | Length of maternal schooling and children’s risk of malaria infection: evidence from a natural experiment in Uganda |
title_short | Length of maternal schooling and children’s risk of malaria infection: evidence from a natural experiment in Uganda |
title_sort | length of maternal schooling and children’s risk of malaria infection: evidence from a natural experiment in uganda |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7042595/ https://www.ncbi.nlm.nih.gov/pubmed/32133186 http://dx.doi.org/10.1136/bmjgh-2019-001729 |
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