Son‐biased fertility stopping, birth spacing, and child nutritional status in Pakistan

Abstract

In this article, we append information from four cross-sectional household surveys (Multiple Indictors Cluster Survey of the United Nations International Children's Emergency Fund) in Punjab, Pakistan, collected between 2007 and2018 to create a data set of 140,000-150,000 child-level observations. Using linear regression, we document a strongly negative birth-order gradient in the nutritional status (measured as height-for-age z-scores) of children below age 5, indicating a pattern of disinvestment in later-born children that is even greater than that documented for poorer countries in sub-Saharan Africa in an earlier study. Consistent with other empirical work in developing-country contexts, girls have on average higher z-scores than boys, but their advantage is lower in Pakistan than other countries outside of the South Asian region, and worryingly, the negative birth-order gradient is steeper for girls than boys. Son-biased fertility stopping rules and close-birth spacing appear to play key roles in Pakistan; following the birth of daughters, parents reduce contraceptive use and breastfeeding (a natural birth control). Using an IV strategy based on the genders of the previously born children, we find that shortened intervals between births harm children's nutritional status, especially that of boys. | 713CHAUDHRY et Al. | INTRODUCTION AND LITERATURE REVIEWPakistan's population growth rate remains high compared to the rest of South Asia at 2.2% per annum, and it is now the world's fifth most populous country. Because of its population growth, the country has struggled to develop its human capital, in terms of both nutrition and educational achievement. 1 Continued high fertility (currently at 3.8 children per woman) will not only exacerbate these problems but will also make it difficult for the country to further progress in reducing child and maternal health undernutrition, key Millennium Development Goals that Pakistan failed to meet by the target date, 2015 (Rizvi et al., 2015). In this study, we aim at demonstrating how son-biased fertility stopping and short birth intervals are important to understanding both child malnutrition and excess fertility in Pakistan.While the disadvantages women and girls encounter have been a persistent concern for researchers, aid agencies, and policymakers, another less-discussed but important type of disinvestment in children and affecting both genders occurs with higher birth order. Therefore, earlier-born children tend to have better health outcomes than their younger siblings. Although a few studies suggest that later-born children are advantaged compared to earlier-born children when parents gain experience with additional pregnancies (Girma & Genebo, 2002), the majority of research demonstrates that first-born children are favored in terms of parental investment because they benefit from lack of sibling competition (Hatton & Martin, 2008), are born to younger mothers, or are expected to care for parents in their old age (Bhalotra & Attfield, 1998). Time is an endowment ...

Does Dowry Drive Labor Export? Evidence from Pakistan

“…Reflecting earlier studies, they concluded that families strive for the desired mix of boys to girls through differential stopping behavior—that is, by continuing to bear children until the desired number of boys and girls is reached. This important conclusion from birth data is supported by other studies showing a steep birth‐order gradient in child nutritional status (Chaudhry, Khan, and Mir 2021), a phenomenon also observed in other South Asian populations with strong son preference (Jayachandran and Pande 2017).…”

Do unconditional cash transfers increase fertility? Lessons from a large‐scale program

“…For Pakistan, persistent annual growth in population, which has been accompanied by many development issues, is often linked to high levels of fertility. Despite sustained efforts to reduce fertility, including the introduction of a national family planning initiative that dates back to the 1960s, the average fertility rate remained above six children per woman for several decades (Robey, 1991) until more recently, when this declined to an average of 3.8 births per woman (Chaudhry et al, 2021;Hardee & Leahy, 2008). We examined if Pakistan's nation-wide social security program, the BISP, has contributed to increasing fertility.…”

“…First, our evidence is for the BISP, which is the largest social protection program in South Asia, and the flagship program of Pakistan. Besides the scale of the BISP of being different from the Zambian Child Grant Programme, the focus on Pakistan is unique and likely to yield different results given the dynamics around fertility which includes sociocultural preference for male offspring (Chaudhry et al., 2021), and religious opposition to family planning (Ataullahjan et al., 2019). Second, we also contribute to the theoretical literature on the relationship between cash transfers and fertility.…”

“…An established body of literature suggests that high fertility rates in Pakistan are linked with low status of women, and that the economic empowerment of women should aid in reducing fertility (Abadian, 1996). Other studies also associate high fertility with the sociocultural preference for male offspring in Pakistan (Chaudhry et al, 2021), as well as religious opposition to family planning (Ataullahjan et al, 2019). Undeniably, while there is evidence to suggest that these factors are important determinants of fertility, the design of UCTs, which makes families with children the target of transfers, raises concerns about UCTs providing an incentive for greater fertility (Wilcox et al, 1996).…”

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“…Relatedly, sons (especially eldest sons) in traditional societies are perceived as the source of old-age support for parents and play keys roles in inheritance and religious practices, contributing further to gender gaps in schooling (Hannum et al, 2009; Kaul, 2018). 3 Son bias in Pakistan increases fertility in families, since many couples continue having children until the desired number of sons is reached (Chaudhry et al, 2021; Hafeez & Quintana-Domeque, 2018). In this way, consanguineous marriage matches may be easier to find for women from families with a high degree of son preference.…”