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Women’s position, birth order and
child nutritional status in Ethiopia

Hilde Bras & Jornt Mandemakers

Paper presented at the LCIRAH Conference on Agri-Health Research, Addis Abeba, Ethiopia (June 24, 2016) and at the Dutch Demography Day in Utecht (November 23, 2016).

ABSTRACT: Women’s position is seen as key to improved child nutrition. However, in many cultures child nutritional status also varies by gender and birth order because of specific food distribution patterns, care giving practices, and access to formal health care. Whereas female empowerment may be expected to increase household resources for children, it is unclear whether it also compensates the nutrition security of the worst-off children in the household. Does having a more empowered mother straighten sibling inequalities in nutritional status? We base our analysis on a pooled sample of the 2011/12 and 2013/14 waves of the Ethiopian Rural Socioeconomic Survey (ERSS) using 5,966 observations from 4,200 children nested in 2,607 households. Children’s nutritional status was assessed by means of WHO reference population standardized measures for height-for age and weight-for-age. Women’s educational level, her age at childbirth, and spousal age gap were used as indicators for women’s position. A child’s sibling position was defined by gender and birth order. In general, girls do worse than boys both in terms of height-for-age and weight-for-age. Random-effect models show that children with better educated and older mothers had significantly better nutritional outcomes. In a second step household fixed-effect models were estimated to control for all observed and unobserved household characteristics. Results show that the higher the parity, the lower the height-for-age and weight-for-age z–scores of both boys and girls. Analyses including interactions with mother’s education and age show that there is indeed compensation within the sibling set when the mother is better educated; maternal education decreases the boy-advantage and the earlier-born advantage, particularly for girls. Our findings show that mother’s position not only improves children’s nutritional status, which has been found before, but that empowerment also straightens out long-lasting sibling inequalities, particularly ameliorating the health position of later-born girls in households.