Essays on Schooling and Health in Sub-Saharan Africa

Abstract

This dissertation includes three papers in the field of education and health. This first paper provides estimates of the effects of secondary schooling on HIV infection and childbearing. A 1996 policy reform in Botswana changed the grade structure of secondary school and led to sharp increases in educational attainment among affected birth cohorts. Exploiting cohort-specific exposure and differential impact by birth village as ‘natural experiments’, I find that the reform decreased HIV infection and childbearing. Turning to mechanisms, I find that schooling had no effect on HIV knowledge; however it influenced sexual debut, norms and behaviors, labor force participation, and literacy. In HIV endemic settings, estimates of the returns to secondary schooling may be underestimated due to the exclusion of health benefits. The second paper uses data from the Tanzania Censuses to investigate whether additional schooling in children affects their parent’s old-age survival. To do so, I exploit quasi-random variation resulting from a policy reform that initiated a drive towards Universal Primary Education in the mid-1970s. I show that the reform caused a large increase in school enrollment. Additional primary schooling in children as a result of the reform induced large reductions in the probability of parental death by the time exposed child cohorts had reached age 40. These survival gains highlight the large societal benefits of human capital investment, particularly in low-resource settings. In the third paper, I exploit the 1980 Zimbabwe education reform, which rapidly expanded access to secondary schools. Exploiting cohort-specific exposure, I assess whether additional schooling among parents affected the risk of undernutrition in their children under five. I find no evidence of a causal effect of parental schooling on undernutrition in their children at the national level. Among urban and wealthier households, additional maternal schooling had a protective effect against the risk of wasting in their children. Parental schooling may play a more muted role in child investment decisions than previously suggested. This essay emphasizes the need for directed health investments to improve child development in low-resource settings.