Do parents in Ethiopia invest more in the early health of sons? : a study of breastfeeding, vaccination and the role of unintended births

A recent World Bank (2011) study has documented a rise in the mortality risk of girls relative to boys in Sub-Saharan Africa. This paper investigates whether this disadvantage for girls in child mortality is a result of son bias in parents’ health investments in child nutrition (breastfeeding) and preventive medicine (vaccination) in a Sub-Saharan African country, Ethiopia. We also examine potential heterogeneity in son bias by distinguishing intended from unintended births. The latter implies that the mother had more children than she wanted, which may be a result of a lack of effective contraception or her husband’s desire for more sons. Using data from the Ethiopian Demographic and Health Survey, we find no gender bias in breastfeeding and vaccination of sons and daughters. A further examination of the results reveals that the treatment of boys and girls depends on whether the birth was intended. We find that intended boys and girls receive similar treatment in breastfeeding and vaccination. However, among unintended children, we find that girls receive significantly less breastfeeding and vaccinations than boys. Our finding implies that government policies designed to improve access to effective contraception and women’s bargaining power in the household are important to reducing unintended births and its consequences for girls’ well-being