Research Problem
Early childhood development (ECD) is crucial for overall human development, as it establishes the foundation for lifelong growth through epigenetic, immunological, physiological, and psychological adaptations to the environment (Young, 2002) Research indicates that children in low- and middle-income countries who participated in early educational programs experienced a 25% greater cognitive development over the past 25 years compared to those who did not (Glewwe, 2005).
Early Childhood Development (ECD) is recognized as a crucial element for sustainable development in developing countries The significance of child development was underscored by The Lancet's landmark series published in 2007, which highlighted the challenges and opportunities for enhancing child development in these regions.
Since 2011, there has been a significant rise in scientific publications focused on Early Childhood Development, alongside an increase in funding programs dedicated to this area Recent research highlights the impact of early human development on overall growth and development throughout an individual's life (Britto et al., 2017).
Over the past few decades, early childhood development has seen significant improvements, largely due to the support of various development agencies These efforts align with the United Nations Development Programme's initiatives aimed at achieving the Millennium Development Goals.
1990, so that there has been a great improvement in child survival while mortality of child under five is dramatically dropped
Numerous studies have established a strong link between a mother's education and various aspects of child development For instance, Barrera (1990b) discovered that higher maternal education levels positively correlate with improved health and nutritional status in children Similarly, Hill and King (1995) highlighted that as mothers attain higher education, families tend to have fewer children, enabling them to invest more resources in each child's well-being.
Some fact on Lao social, economic Status
Government policy on gender
The Lao Constitution, adopted in 1991, guarantees gender equality in politics, economics, culture, and society, with specific provisions in family law In 2003, the National Assembly revised the family law to emphasize the state's commitment to promoting women's advancement and protecting the rights of women and children, highlighting their importance to the Lao government The law further ensures that all Lao citizens, regardless of ethnicity, enjoy equal legal rights and opportunities in economic and social spheres, affirming the country's dedication to gender equality and the empowerment of women.
In addition to constitutional provisions, various laws and legal documents uphold the principle of gender equality, such as the Labor Law of 1994, which mandates non-discrimination in employment and ensures equal pay for both men and women, considering both quantity and quality of work Female employees are entitled to a maternity leave of at least ninety days with full pay from their employers or the social security fund, with an additional thirty days available for any illness related to pregnancy.
In October 2004, the National Assembly of the Lao PDR enacted the Law on Development and Protection of Women, which was officially announced by the President through a decree This law aims to enhance the role of women by establishing fundamental provisions and measures to protect their legitimate interests, while also outlining the responsibilities of the state, society, and family towards women Key objectives include promoting women's knowledge and competencies, advancing gender equality, eliminating discrimination, combating trafficking and domestic violence, and creating conditions for women's active participation in national development The law emphasizes the collective responsibility to foster knowledge, capacity, and gender equality among women.
Laos is committed to implementing various international conventions, including the Convention on the Political Rights of Women, in addition to adhering to national laws and regulations.
1969, and ratifies the convention on the elimination of all forms of discrimination against women (CEDAW) and the convention on the Right of Child (CRC) in 1981 and
In 1990, the CEDAW and CRC established crucial frameworks for protecting the rights of women and children, respectively CEDAW specifically prohibits discrimination against women, while the CRC mandates that governments safeguard the rights of all children, ensuring their basic needs are met, including safe motherhood Additionally, the government's dedication to gender equality is reflected in various policy documents related to population, health, and human resources.
Lao PDR has integrated key concepts from international conventions into its constitution, yet there is a pressing need to enhance its legal framework due to limited experience, human capacity, and public awareness The Ministry of Justice is actively working to improve awareness of women's rights and plans to incorporate gender training into the legal education curriculum at the Faculty of Law and Political Science at the National University of Laos Additionally, gender training will be extended to crime investigators and Supreme Court judges to promote understanding of human rights, particularly for women, ethnic minorities, children, and other marginalized groups.
Mechanism
The Lao government has designated the Lao Women’s Union and the Lao National Commission for Advancement of Women (NCAW) as key organizations to enhance women's status and promote gender equality in the country.
The Lao Women’s Union, established in 1995 as the Lao Patriotic Women’s Association, serves as a mass organization recognized by the 1991 constitution to advocate for the rights and benefits of Lao women and children Its primary mission is to unite women from diverse ethnic backgrounds and social classes in their collective efforts toward national liberation and empowerment.
Following the liberation and establishment of the Lao PDR on December 2, 1975, the organization was renamed the Lao Women’s Union (LWU), broadening its role to align with the socioeconomic development of the new era Operating at a ministerial level, the LWU features a structured organization from central to grassroots levels The IV National Lao Women’s Congress endorsed the Lao Women’s Slogan: “Three goods,” which emphasizes the importance of being a good citizen, excelling in development, and fostering a good cultural family.
The LWU plays a crucial role in educating women from all ethnic backgrounds about their rights and benefits as outlined in the constitution, laws, and international conventions It is dedicated to safeguarding the rights of Lao women and children, while also encouraging their active participation in socio-economic development Additionally, the LWU is committed to preserving the rich cultural traditions of Lao women across diverse ethnic groups.
The Lao Women’s Union serves as the national body dedicated to promoting equal rights and advancing women's status It is responsible for monitoring the implementation of government policies and programs that focus on women's development and gender-related issues.
Over the last three decades, the Lao Women’s Union (LWU) has significantly enhanced its efforts to empower ethnic minority and rural women through skill training, income generation, and financial support The organization promotes good health practices, family planning, and awareness of women's rights, particularly in the workplace and regarding land registration Additionally, the LWU has established women's professional associations and supports women's advancement in civil service and the National Assembly Recently, the LWU has begun to tackle pressing issues such as domestic violence, HIV/AIDS, and human trafficking, while maintaining its core mission of politically mobilizing Lao women.
Since 1997, the LWU has been a key advocate for gender equality and women's empowerment through the Gender Resource Information and Development Center (GRID) This initiative focuses on raising gender awareness and providing gender analysis to government officials at all levels, facilitating effective gender mainstreaming GRID's achievements include collaborating with the National Statistic Center to promote the use of sex-disaggregated statistics, partnering with the CPI to develop guidelines and conduct training on gender-sensitive planning, and offering training for government staff and media on gender awareness Additionally, GRID has conducted comprehensive research on various aspects of Lao women's lives, consulted with ministries to integrate gender into the NGPES, and produced a range of informational materials, including a country gender analysis, newsletters, and multimedia resources.
In 2002, the Lao government initiated the establishment of the Lao National Commission for the Advancement of Women (NCAW) to enhance gender equality and women's advancement, drawing inspiration from the experiences of Vietnam and the Philippines Officially established by Decree No 37 in April 2003, the Lao NCAW operates as a state organization, distinct from the Lao Women's Union (LWU), yet both share a commitment to safeguarding the rights of Lao women and promoting gender equality across diverse ethnic groups The Lao NCAW serves as a key coordinating body, collaborating with local authorities and international organizations to implement government policies aimed at gender equality and combating discrimination against women To bolster these efforts, the Prime Minister of Lao PDR mandated that all organizations, line ministries, and local authorities establish sub-Commissions on the Advancement of Women, tasked with coordinating the execution of national laws, policies, and plans for women's advancement.
The National Strategy for the Advancement of Women (2005-2010) aligns with the Beijing Platform for Action and focuses on five key goals: enhancing women's participation in the National Growth and Poverty Eradication Strategy (NGPES); promoting women's education; improving access to healthcare services for women; increasing the representation of women in decision-making positions; and strengthening organizations dedicated to protecting and advancing women's rights.
Despite the achievements of Lao women through various initiatives, they continue to encounter significant challenges that hinder their progress These include insufficient human capacity for effective gender mainstreaming in programs and training for ministry staff, a lack of accurate sex-disaggregated and relevant gender data for informed policy-making, limited budgets and resources to support gender mainstreaming efforts, and inadequate coordination among government ministries, international donors, and INGOs in gender-related activities.
Education policy toward women empowerment
Lao PDR has achieved notable advancements in education over the past few decades; however, it still faces some of the lowest education indicators in East Asia Disparities persist between urban and rural areas, as well as between genders and socioeconomic groups While the gender gap in urban education has nearly closed, rural regions experience alarming educational deficits, particularly affecting girls and ethnic minority groups Consequently, a significant number of children, especially girls, remain out of school, contributing to a higher illiteracy rate among women compared to men.
Illiteracy and low attendance rates among girls and women are influenced by various factors, including poverty, traditional beliefs, language preferences, and geographic remoteness Additionally, many girls drop out of school due to household responsibilities, early marriage, or pregnancy Poor families often fail to recognize the value of formal education in enhancing their livelihoods, and parental disinterest further discourages children from pursuing their education.
Government policy on education
The Lao Constitution and Education Law guarantee the right to education for all citizens, emphasizing compulsory primary education and focusing on the needs of ethnic minority groups, impoverished women, and both disabled and gifted children Key documents such as the Strategic Plan 20 years to 2020 and the five-year development plan for education guide these efforts Additionally, government policies, including the Prime Minister's Decree on Decentralization of the Education Sector, the five-year social-economic plan, and the National Poverty Reduction Plan, significantly influence the educational landscape in Laos.
The Lao Government has ratified international agreements related to education, including CEDAW and CRC, and has committed to the eight Millennium Development Goals (MDGs), specifically aiming for "Education for All" (EFA) The goal is to achieve a net enrollment rate (NER) of 95% for primary education and 74% for lower secondary education by 2015 In 2004, education expenditure accounted for 11.8% of GDP The Ministry of Education (MOE) is implementing a $55 million project focused on basic education for girls and school feeding programs in remote areas, aimed at improving access to education for poor children, particularly ethnic minority groups.
Literacy status of Lao people
Approximately 40% of the population in Lao PDR lives below the poverty line, significantly influencing access to primary education, duration of schooling, and educational outcomes The adult illiteracy rate stands at about 34%, with women facing a higher rate of 45% compared to 23% for men (Bank, 2002).
The gender gap remains significant, especially in rural and impoverished households, as well as among ethnic minorities However, urban areas have seen considerable improvements over the past few decades, with the literacy gap between men and women narrowing rapidly Notably, poor urban females have made remarkable progress recently, surpassing their male counterparts in educational achievements (King and Van de Walle 2005).
Gender disparities in literacy are pronounced in highland areas with significant ethnic minority populations The literacy rate for poor rural non Lao-Tai women stands at a mere 29%, starkly contrasting with the 66% literacy rate among poor rural Lao-Tai women (World Bank 2006) Furthermore, this issue varies among different ethno-linguistic groups, as only 20% of Chine-Tibet women report being able to read and write, which is even lower than the overall rate for rural poor non Lao-Tai females.
Significant gender disparities in education persist, particularly at the university level, where the gap between boys' and girls' participation continues to widen as educational attainment increases Despite the Ministry of Education's ongoing efforts to address these inequalities, challenges remain that must be addressed to achieve gender parity in educational opportunities.
Table1.1: Attendance of students by Education Level in 2014-2015
Primary enrollment rates in Laos are among the lowest in East Asia, particularly affecting ethnic minority girls in rural areas (UNESCO 2003) While 80% of villages have access to a primary school, only 36% of these schools offer a complete education with all five grades (National Census 2015) This highlights the significant educational challenges faced in the region.
North region is of particular concern nationwide, 90 percent of schools in the poorest districts are incomplete, and more than 40% of students attend an incomplete school
Over the past five years, the net intake of students in the 46 poorest districts has doubled Despite this progress, in areas with high concentrations of ethnic minorities, only three out of five children enroll in school at any point, and just half of these students complete a basic education Alarmingly, most ethnic minority children do not advance beyond the second grade.
In rural regions, over 40% of girls and 30% of boys fail to complete their education by the end of the fifth year, with non Lao-Tai students facing even higher dropout rates, nearing 50% by the end of primary school (King and Van de Walle, 2005).
Primary school enrollment rates reveal significant disparities among different ethnic groups in Laos Non-Lao-Tai girls in rural areas face the lowest enrollment rates, while Lao-Tai men from urban settings enjoy the highest For example, 48% of rural Hmong-Lu Mien girls are enrolled, compared to 66% of boys In the Mong-Khmer group, enrollment stands at 57% for girls and 61% for boys The gender gap is narrower among the Chinese-Tibet ethnic group, with only 33% of girls and 39% of boys in rural areas enrolled Notably, the gender gap in primary school enrollment is less pronounced in urban areas compared to rural ones for all three non-Lao-Tai groups.
Table 1.2: Mean primary school enrollment rates (in %) for children aged 6-12 (2012-
Source: King and Van de Walle 2015 based on LECS3
Transitioning from primary to secondary education poses significant challenges, with only 35% of students enrolling in secondary schools Of those, merely 5% manage to complete the full six-year program, and less than 5% advance to university level.
Nationally, female enrollment in lower secondary education remains low, with a secondary net enrollment rate of 38% for males and only 32% for females, reflecting significant declines of 48% and 42%, respectively Furthermore, urban students have a net enrollment rate of 48%, whereas rural children face a stark contrast with only 25% enrolled.
To address the issue of illiteracy and the existing gender disparities in education sector, government of Lao has the strategic plan as follows:
The goal is to universalize the quality of basic education at the primary level while expanding access to lower secondary education This ensures that everyone has the opportunity to leverage their education in support of socio-economic programs.
Eradication of illiteracy, thus providing poor people with a means of helping to improve their quality of life;
Expansion of vocational, technical and higher education to meet the demands of the new labor market and to improve economic rates of return on human capital investment;
The training of skilled workers, technicians, professionals, and intellectual to have the capacity to apply modern science and technology to serve development needs; and
Gradually upgrade the quality of national education to the international standard
In Laos, there is a notable disconnect between public policy and its implementation, with public investments primarily directed towards urban infrastructure and business subsidies aimed at stimulating economic growth However, expenditures on healthcare significantly declined between 2014 and 2016, raising concerns about the sustainability of such investment strategies.
In Laos, the fluctuation in maternal and child health status may be attributed to the fact that health care for children primarily falls under the responsibility of the Ministry of Health, with health expenditures ranging from 3% to 2.4% of GDP.
According to the LSIS reports from 2012 and 2017, the Early Childhood Development (ECD) index in Laos improved from 81.3% to 89.1% However, ECD in Northern Laos remains significantly lower than in the central and southern regions A World Bank survey of 7,520 children from five Northern provinces found that only 25% of children participated in early childhood education, 22% received health services, and 50% experienced stunting.
Due to the limited number of scientific studies on early childhood development (ECD) in Laos, public awareness of its significance remains confined to certain sectors This study aims to investigate and scientifically establish the relationship between maternal education levels and ECD, highlighting the need for policymakers to invest in human capital for long-term socio-economic development The anticipated findings will contribute to existing literature and promote sustainable development in Laos by emphasizing the critical roles of education, health, and information sectors.
Research objective and Research question
This study investigates the impact of maternal education on early childhood development and overall child health in Laos from 2000 to 2016 It aims to provide a comprehensive understanding by controlling for factors such as family wealth quintiles and other maternal characteristics The primary focus is to assess how maternal education influences child health outcomes during this period.
First, does maternal education influence the early childhood development in Lao PDR?
Second, how does the access to information of women affect the development of children in Laos?
And finally, are there any big differences in terms of ECD among different regions of Laos?
Scope of the Study
This thesis analyses and calculates the interaction among level of education of mothers and early childhood development.
Contribution
To achieve the Millennium Development Goals and sustainable development in Laos, it is crucial to prioritize early childhood development Identifying the key determinants of development allows for targeted and scientifically informed policymaking This research aims to provide evidence for policymakers to understand the significance of child development, maternal education, and women's access to information.
Thesis structure
This thesis is organized into 5 chapters, above section is first chapter, and sections hereafter are:
Literature review
Theoretical background
Early childhood development is a complex, multi-dimensional concept influenced by various theoretical frameworks, including psycho-analytical, behavioral, social learning, biological, cognitive development, and systems theory These diverse theories enable researchers to identify key determinants and comprehend the relationships among socio-economic factors that impact a child's development.
Early childhood development is significantly shaped by psychoanalytical theories, particularly those of Sigmund Freud and Erik Erikson Freud emphasized that a child's personality is formed through parental management of sexual and aggressive drives In contrast, Erikson expanded on Freud's ideas by incorporating societal influences, highlighting their role in personality development Additionally, Behavioral and Social Learning theories focus on the interplay between environmental factors and nurturing, further contributing to a child's growth and development.
Child development and health are influenced by various factors, which can be assessed through different indicators and measurement methods According to Glewwe (1999), key determinants of a child's health include parental education, household resources, the local health environment, and the child's inherent health characteristics.
Ecological systems theory, now known as Bioecological systems theory, emphasizes that a child's development occurs within a complex system of relationships in their environment, where each layer influences growth This theory highlights the importance of a child's biology as a key factor in development, alongside their immediate family and community The interplay between these elements, along with broader societal influences, shapes a child's growth, indicating that changes or conflicts in one layer can affect others Therefore, a comprehensive study of a child's development requires examining not only the child and their immediate surroundings but also the interactions with the larger environment.
The microsystem is the closest structure to a child's health and development, encompassing the immediate relationships and interactions within their surroundings, such as family, school, and neighborhood (Berk, 2000) This level features bi-directional influences, where a child's beliefs and behaviors are shaped by their parents, while simultaneously, the child's actions can impact their parents' beliefs and behaviors Bronfenbrenner's theory highlights the significance of these interactions both within the microsystem and between different environmental layers Although the strongest bi-directional influences occur at the microsystem level, interactions from outer layers can still affect the inner structures, underscoring the complexity of child development.
The mesosystem serves as the crucial link connecting various elements within a child's microsystem, such as the relationship between a child's teacher and their parents, as well as interactions between the child's church and neighborhood.
The exosystem represents the broader social context that indirectly influences a child's development Structures within this layer, such as parental work schedules and community resources, interact with elements of the child's microsystem Although the child may not engage directly with these external factors, they still experience the effects—positive or negative—stemming from these interactions.
The macrosystem represents the outermost layer of a child's environment, encompassing cultural values, customs, and laws that shape their upbringing (Berk, 2000) This layer exerts a significant influence on the interactions within all other environmental layers For instance, in cultures where the belief prevails that parents are solely responsible for child-rearing, there tends to be a lack of resources available to support parents in their roles.
The dynamics of parental responsibility significantly influence the structures within which parents operate, impacting their ability to nurture and support their child effectively within the child's microsystem.
The chronosystem encompasses the dimension of time in relation to a child's environments, including both external factors, like the timing of a parent's death, and internal factors, such as physiological changes associated with aging As children mature, their responses to environmental changes evolve, enabling them to better understand and assess the impact of these changes on their lives.
According to Bronfenbrenner’s ecological theory (1986), several key factors influence child development, including maternal education at the microsystem level, family involvement in home activities at the macrosystem level, participation in school activities at the mesosystem level, and social support at the exosystem level.
The ecological theory posits that child outcomes are influenced by various factors, including the child, family, school, community, and broader society, along with their interactions However, critics argue that this traditional framework falls short by not adequately addressing key variables like social position—encompassing social class, ethnicity, race, and gender—and social stratification, including racism and discrimination To overcome these limitations, Coll et al (1996) introduced an integrative model that emphasizes the importance of social position and stratification in understanding the development of competence in children of color This model highlights crucial aspects often overlooked in mainstream ecological approaches, such as the impacts of racism, the diversity within minority families, and the roles of social stratification and acculturation on the developmental outcomes of minority children.
Children exist within interconnected family and childcare microsystems, where parents choose childcare options based on various factors such as family structure, parental characteristics, and geographic location These choices can differ in quality and are influenced by the child's age Singer et al (1998) emphasized the importance of considering these selection effects in childcare research to accurately assess the long-term impact of childcare on children's development The study highlights the significance of both family-level and community-level factors in shaping childcare experiences.
This study investigates the hypothesis that maternal education significantly impacts children's health through two primary mechanisms Firstly, women with higher educational attainment demonstrate greater production and allocation efficiencies in health production, leading to improved health outcomes for their children (Grossman, 2006) Production efficiency refers to achieving better health with the same resources, while allocation efficiency involves optimizing the use of various health inputs within a budget Secondly, increased maternal education correlates with enhanced financial resources, as educated women tend to earn higher incomes and often partner with similarly educated spouses (assortative mating effect) This increased family income and improved environment facilitate the accumulation of children's health human capital (McCrary and Royer, 2011).
Recent studies predominantly assess children's health through metrics such as weight, body mass index, and height, which primarily reflect physical well-being Research by Shanks (2007), Desai and Alva (1998), Thomas et al (1991b), and Barrera (1990a, 1990b) highlights that the independent variable of maternal education is typically measured by years of schooling Additionally, studies by Britto et al (2017), Duncan and Dunifon (2012), Aslam and Kingdon (2012), Cutler and Lleras-Muney (2006), Frost et al (2005), Glewwe (1999), Desai and Alva (1998), Barrera (1990b), and Ware (1984) utilize the Early Childhood Development (ECD) index established by UNDP as a standardized measure for evaluating early childhood development.
Empirical review
Many recent studies have examined the impact of the mother’s (and father) education on child health For comprehensive reviews of the literature, (Strauss and Thomas,
This thesis provides an overview of recent studies that examine the influence of maternal education on early childhood development, emphasizing the overall health status of children.
Research across various countries indicates that a mother's education positively influences child height and weight While many studies provide reduced form estimates, some delve deeper into the mechanisms through which maternal education enhances child health For instance, a study in the Philippines by Barrera (1990b) revealed that more educated mothers weaned their children earlier but mitigated the effects of shorter breastfeeding by providing superior care, resulting in healthier children as evidenced by higher height-for-age z-scores.
Thomas et al (1991a) explored the "information processing" attributes of schooling using Braillian data, which examined variables such as women's newspaper reading, radio listening, and television watching habits Their findings indicated that a mother's education level was not significant when accounting for these "information processing" activities Specifically, in rural areas, both newspaper and radio usage were significant, while in urban areas, only television viewing emerged as a significant factor.
The Cebu Longitudinal Health and Nutrition Survey has provided valuable insights into the factors influencing child nutritional status and morbidity Research by the Cebu Study Team (1991, 1992) indicates that maternal education significantly improves waste disposal practices and increases non-breastmilk calorie intake, both of which contribute to a lower incidence of diarrhea in children Although maternal education can lead to earlier weaning, which may increase diarrhea episodes, the overall impact of maternal education is a reduction in diarrhea incidence.
A significant critique of the relationship between maternal education and child health is the hypothesis that education may merely reflect unobserved maternal characteristics Behrman and Wolfe (1987) analyzed Nicaraguan data on mothers' siblings to control for unobserved family fixed effects, concluding that there was no significant impact of maternal education on child anthropometric status In contrast, Strauss and Mundial (1988) conducted a study in rural Côte d'Ivoire and found that maternal education positively influences child health, evidenced by improvements in height-for-age and weight-for-height, even after accounting for family fixed effects.
A study by Thu (2014) in Vietnam revealed that a mother's education significantly influences a child's health, while toilet usage does not have a notable impact Additionally, Cam (2018) highlighted that maternal education, along with household wealth, gender, and living area, plays a crucial role in determining children's health This research is pioneering in its use of quantile regression to assess the effects of maternal education on child health, contrasting with previous studies that utilized OLS or fixed effects methods By applying quantile regression, the study effectively analyzes how maternal education impacts child health across different quantiles of the child's body index variable.
Dr Vo's (2018) study highlights the significant impact of women's empowerment on child development in rural Vietnam Similarly, research by Thomas et al (1991b) indicates a positive correlation between a mother's education and her child's height, demonstrating a highly statistically significant effect Schultz (1984) further explores the influence of maternal education on child health, suggesting five key ways it impacts child mortality: educated mothers are better at utilizing health resources effectively, they can produce better health outcomes with the same resources, their schooling shapes their health preferences, increased education correlates with higher income and productivity, and it raises the opportunity cost of time, allowing mothers to dedicate more time to their children's care.
Maitra et al (2006) investigate how parental, household, and community characteristics influence children's health in China, emphasizing the importance of parental education and unobserved maternal heterogeneity Their findings indicate that parental education has a significant impact on child health, with maternal education playing a more crucial role than paternal education This suggests that higher maternal educational levels lead to better health outcomes for children, as it enhances the mother's access to information and resources Additionally, the study highlights the positive effect of addressing discrimination against girls on improving child health status.
A study conducted by Yusuke Kamiya and colleagues investigated the relationship between women's autonomy and childhood stunting in Laos, a country with the highest prevalence of stunting in the Indochina region The research involved cross-sectional questionnaires and body measurements from 100 mothers and their 115 children under five in semi-urban communities Key dimensions of women's autonomy measured included self-esteem, self-efficacy, decision-making power, freedom of mobility, and control of money The findings revealed that higher self-efficacy in healthcare, self-esteem, and control of finances were associated with a significantly lower likelihood of childhood stunting However, decision-making power and freedom of mobility did not show a significant correlation with stunting levels.
Research indicates that a mother's education significantly enhances child health, with some insights into the mechanisms behind this improvement However, there is a lack of comprehensive studies examining how various maternal characteristics influence child health, particularly in relation to early childhood development metrics.
1.2.1 The impact of maternal education on early childhood development
Numerous studies have established a strong connection between a mother's education and her child's health Research by Barrera (1990a) highlights that maternal education significantly influences child health, particularly as measured by height-for-age scores The findings indicate that higher levels of maternal education lead to improved nutritional outcomes and greater height-for-age measurements in children.
A study conducted in 22 developing countries examines the impact of maternal education on child health, focusing on three key indicators: infant mortality, children's height for age, and immunization status (Desai and Alva, 1998) The analysis categorizes mothers into two educational levels: those without formal education and those with secondary education The findings reveal a causal relationship between maternal education and infant mortality rates, while a positive and significant correlation exists between maternal education and children's height for age Although the correlation between maternal education and immunization status is relatively small, it remains statistically significant across the sampled countries.
Research indicates that a mother's education significantly influences child health in Morocco, highlighting a positive correlation between educational attainment and the well-being of children However, the findings also emphasize that household wealth plays a crucial role alongside education in determining child health outcomes.
Maternal education significantly influences child health outcomes, as more educated mothers tend to adopt better childcare practices and higher hygiene standards, leading to improved health results This relationship may also stem from their ability to select health inputs that yield greater health benefits compared to those chosen by less educated mothers (Thu, 2014).
Recent studies have explored the relationship between parental education and child health through natural experiments In Indonesia, Breierova and Duflo (2004) demonstrated that increased parental education positively impacts fertility rates and significantly reduces child mortality Both maternal and paternal education were found to contribute to lower child mortality rates In contrast, a study conducted in Taiwan by Chou et al (2010) highlighted a stronger causal effect of maternal education on child health compared to paternal education However, none of these studies have outlined the specific pathways for this relationship.
Research Methodology and Data Resources
Model
According to (Glewwe, 1999) it is not necessary to estimate straightforward the pathways by which mother’s schooling affects child health The production function for early childhood development:
ECDi is the early childhood development score level, which has two values, 1 for properly developed and 0 for poorly developed
Hi is a vector of social, economic factor effects on children of each household
Ei is a vector summarizing the environmental condition surrounding child i
The model outlined in equation (1) requires extensive data; however, the availability of such data is limited Consequently, the simplified version of the model illustrates the connection between a mother's education and child development.
Ms: Parental Characteristics: Mother’s age, Mother’s school year, Access information, age of mother, ethnicity of mother
A: Child’s endowment variables: Age and sex
E: Social, Economic environment variables: Wealth quintile, own land plot
H: Household characteristics: use clean water, number of family members, number of children under 5
Table 2.1 The detail of variables:
ECD Early Childhood Development 0=poorly developed 1=Properly Developed DM1
MEDU Maternal Education Number of
School year attended ACINFOR Access to Information 0=not access
MAGE Age of mother Years-old
CLEANWT Used Clean water for drinking 0 = Not Clean
Water 1= Used clean water for drink HHMEM Number of Household
Ordinal number UNDER5 Number of Children Under5 Ordinal
Number ETNGROUP Ethnicity of the Household head
WINDEX Wealth Quintile Index 1 Poorest
OWNLPLOT Owned Land Plot 0=not own any land plot 1=own at least
Public health facility environment (Social support)*
REGION Region of the Household 1: Northern
Regional disparities in health facilities across Laos may significantly impact children's development outcomes, as varying access to resources and services can influence overall health and growth in different areas.
Estimation method
Logit regression with a maximum likelihood approach and robust options is utilized due to the categorical nature of the dependent variable in our model The results of this regression will illustrate the trend of the impacts, while the coefficients can be estimated by examining the marginal effects of each individual variable.
Variable definitions
Early childhood development (ECD) is crucial for assessing a child's health outcomes and overall well-being, categorized into two statuses: properly developed and poorly developed This assessment can serve various purposes, including population monitoring, program evaluation, and exploratory research According to UNICEF, the early childhood period, specifically for children aged 2 to 5 years, is vital for the development of four key domains that lay the foundation for healthy growth in the future.
Figure 2.2: Development stages of life, (Sources: WD-ECD-measurement toolkit )
2.3.4 The construction of the domain for measuring child development
The MICS survey utilizes the Parent’s Evaluation of Developmental Status (PEDS) framework, which assesses children's development across four key domains: (1) Literacy and Numeracy, (2) Physical Development, (3) Social-Emotional Development, and (4) Approaches to Learning Each domain is evaluated through a standardized set of 10 questions designed to provide a comprehensive overview of a child's developmental status.
Unlike developed countries, survey methodologies in the US and EU focus on 9-12 domains, encompassing 18 key questions that assess various aspects of child development These domains include cognitive development, social-emotional development, motor development, language and emergent literacy, as well as health, hygiene, safety, cultural knowledge, participation, and approaches to learning.
UNICEF's research on early childhood development employs a standardized assessment framework encompassing four domains and ten key questions to evaluate the developmental progress of children aged 2 to 5 years.
1 Can (he/she) identify or name at least ten letters of the alphabet?
2 Can (he/she) read at least four simple, popular words?
3 Does (he/she) know the name and recognize the symbol at all numbers from 1 to 10?
4 Can (he/she) pick up a small object with two fingers, like a stick or a rock from ground?
5 Is (he/she) sometimes too sick to play?
6 Does (he/she) be able to follow a simple direction on how to do something correctly?
7 When giving something to do, is (he/she) able to do it independently?
8 Does (he/she) get along well with other children?
9 Does (he/she) kick, bite, or hit other children?
10 Does (he/she) get distracted easily?
The key indicators for ECD, however, in this paper adopts the UNICEF’s early childhood development’s indication which can be represented through 4 domains:
+ Literacy-numeracy: can be assessed from question number 1-2-3
+ Physical: can be assessed through question number 4 and 5
+ Aproach to learning: can be assessed through question number 6-7
+ Social-emotional can be assessed through question number 8-9-10
To ensure developmental progress in literacy and numeracy, children should meet at least two of the following criteria: in Early Childhood 1 (EC1), they can identify or name at least ten letters of the alphabet; in Early Childhood 2 (EC2), they can read at least four simple, commonly used words; and in Early Childhood 3 (EC3), they know the names and can recognize the symbols for all numbers from 1 to 10.
A child is considered to be on track in their physical development if they can pick up small objects, such as a stick or a rock, using two fingers, and if they are not frequently too sick to engage in play.
Effective learning approaches are crucial for development, particularly when children demonstrate the ability to follow simple directions (EC6=1) and can complete tasks independently (EC7) These indicators highlight a child's readiness to engage with new challenges and enhance their learning experience.
For a child’s social-emotional development to be considered on track, at least two of the following criteria must be met: the child gets along well with peers, does not engage in aggressive behaviors such as kicking, biting, or hitting, and shows the ability to maintain focus without getting easily distracted.
To calculate the ECD for each individual child we test the score for each domain if at least 1 one domain is missing, the child is considered poorly developed
Children's language development begins well before they speak their first words, with early signs including babbling, pointing, and gesturing during infancy In the first two years, children typically say their first words and form simple sentences, leading to a significant increase in vocabulary between ages two and three As they enter preschool, language development is marked by their ability to produce and comprehend words, tell stories, recognize letters, and engage comfortably with books.
Children's vocabulary under the age of three is a strong indicator of language development, particularly in literate cultures where this trend continues into older ages In contrast, cultures with less emphasis on literacy may utilize different criteria for assessing linguistic advancement For instance, in certain African cultures, the ability to use alliteration and metaphor creatively and grammatically correctly serves as a more relevant measure of an older child's linguistic skills.
Language development, much like cognitive and social-emotional growth, is significantly influenced by the quality of home environments and relationships Research indicates that children from lower-income families in the United States tend to develop their vocabularies at a slower pace compared to their higher-income peers, often using far fewer words by kindergarten (Hart and Risley, 1995) This disparity is partly due to lower exposure to infant-directed speech, as well as the reduced lexical richness and complexity of the language they encounter (Hoff, 2003; Hart and Risley, 1992) Furthermore, in low-income households, adult communication is often less responsive to children's cues, less focused on infants, and less frequent during shared interactions (Tamis-LeMonda, Bornstein, and Baumwell, 2001) Early reading experiences also play a crucial role in language development; children with less literate parents may face challenges in speech and vocabulary acquisition due to limited exposure to words and books at home (Fernald et al., 2006).
Large motor development involves the acquisition of movements that enhance mobility, such as scooting and walking While the timing and order of motor milestones can differ among children, nearly all healthy children will ultimately learn to walk and develop more advanced skills like running and jumping Initially, it was believed that motor skill advancement was solely influenced by brain and neuromuscular maturation However, recent studies reveal that additional factors, including physical growth, caregiving practices like swaddling or carrying, and opportunities for practice, play a significant role in motor skill progression.
Large motor skills in infants and young children encompass essential movements such as walking and running, while preschoolers develop skills like walking on a line, controlling movements in games, and jumping Although the timing of these skills typically does not predict future cognitive development, a lack of these abilities may signal a developmental delay, necessitating assessment for potential disorders Fine motor skills, which involve hand-eye coordination and muscle control, are crucial for tasks like drawing and writing For preschoolers, these skills include holding a pencil and engaging in creative activities, allowing children to explore their environment and achieve developmental milestones Difficulties in either large or fine motor skills may indicate underlying neurological or perceptual issues.
Social and emotional development plays a crucial role in various aspects of children's growth, particularly during the first two years of life when relationships with caregivers are foundational During this period, children learn about trust and responsiveness, which fosters their confidence to explore their environment Additionally, they begin to develop early strategies for managing negative emotions Warm and responsive caregiver relationships are vital in teaching children trust and helping them effectively navigate feelings of frustration and fear Healthy infants and toddlers typically form strong attachments to caregivers, show enthusiasm for exploring new objects and spaces, and actively engage in social interactions.
During preschool years, children's social and emotional development encompasses several key areas: social competence, behavior management, social perception, and self-regulatory abilities Social competence refers to how effectively children interact with peers and teachers, while behavior management involves their ability to follow directions and cooperate Social perception is the skill of recognizing thoughts and feelings in themselves and others, and self-regulatory abilities pertain to their emotional and behavioral control, particularly in stressful situations These social-emotional skills are closely linked to self-regulatory aspects of executive function, highlighting their importance in early childhood development.
Empirical result
Data description
This study utilizes a dataset derived from the Multiple Indicator Cluster Surveys (MICS), specifically combining data from MICS 5 and MICS 6 MICS 5 was conducted between 2011 and 2012, while MICS 6 was completed during the period of 2016 to 2017.
Total number of children age ranges from 2-5 years, in the collection of two times of surveys is 8.269 children, 4.080 are female child
Table 3.1: Descriptive statistic for variables used in the regression model
Early childhood development data reveals that out of 8,269 observations, 7,082 children, or approximately 85.65%, are properly developed This indicates that the majority of children in Laos are achieving healthy developmental milestones.
Domain 1: Literacy and Numeracy: out of 8.268 children, there are only 1.823 children are properly developed, while another 77,95% are poorly developed
Domain 2: Physical: almost all children have proper physical development, only 1% found to be poorly developed
Domain 3: approaches to learning: there are over 7000 children are properly developed, only 5% are found to be poorly developed
Domain 4: Social-Emotional Development: children who are not properly developed account for only 15% out of the whole samples
The study on maternal education reveals that among 5,693 mothers surveyed, the highest education level achieved is 22 years, while the lowest is no formal education On average, Lao mothers have 1.45 children, with the majority being primary school graduates, totaling 1,491 individuals.
Conclusion
Conclusions
This study analyzes data from the 2012 and 2017 MICS Surveys to explore the impact of maternal education on child health, specifically in Lao children, using Early Childhood Development (ECD) scores as a comprehensive measure The findings reveal that maternal education significantly influences child health outcomes, while household wealth quintiles and regional differences show no substantial impact The results underscore that higher maternal education enhances caregiving knowledge, leading to improved child development Ultimately, the research concludes that increased maternal education correlates with higher rates of hospital births, better living conditions, and increased household income, all contributing to healthier child development.
This study conducts an objective analysis of ECD status, minimizing the risk of misclassification, while addressing the relationship between maternal education and child health in Lao PDR Although previous research has primarily focused on children's weight and height as indicators of health, this study highlights the need for a deeper understanding of how maternal education influences child development It fills a gap in the literature by examining the interplay between maternal education, women's access to information, and child health outcomes in Lao PDR, thereby contributing valuable empirical evidence to the field.
This study, despite its limited sample size, offers valuable insights into the intricate interplay between microsystem factors, socioeconomic influences, and physical characteristics, highlighting their collective impact on children's health.
Recent research highlights the importance of an ecological and integrative approach to understanding the predictors of maternal education and socioeconomic status among Lao children Aligning with Bronfenbrenner's ecological theoretical framework, findings indicate that maternal education, a key microsystem factor, significantly influences child health outcomes Specifically, higher levels of maternal education are associated with improved developmental prospects for children Therefore, it is evident that maternal factors at the microsystem level play a crucial role in shaping children's health and development.
Policy implications
Increasing women's educational levels significantly enhances their participation in the labor market, leading to better employment opportunities and higher incomes This shift not only elevates the status of women in society and within families but also demonstrates that educated women contribute more substantial economic returns compared to their male counterparts (Schultz, 2002) However, many women in Laos still face limited decision-making rights compared to their husbands Education plays a crucial role in empowering women to assert their preferences more effectively To further support this progress, the government should consider revising the one-child family planning policy and implementing programs that promote gender equality and challenge parental biases favoring sons over daughters.
Integrating health and nutrition information into school curricula and mass media is essential for enhancing child health and early childhood development This approach will provide women with easier access to vital information, equipping them with the fundamental knowledge needed to care for their children effectively.
Limitation of the study 53 REFERENCES I APPENDIX
Further research is essential to explore how different levels of maternal education impact child health in developing countries, potentially leading to significant improvements These findings align with previous studies, such as Glewwe's 1999 research on Morocco, highlighting the need for additional studies across various contexts to determine the broader applicability of these results.
This study focuses on the educational level of mothers in Lao PDR, specifically measured by years of schooling, and its impact on child development indices To enhance the applicability of the findings for broader policy-making across ASEAN nations, future research should encompass a wider range of developing countries Additionally, the reliance on secondary data analysis in this study restricts the available concepts for examination, which may limit the generalizability of the results.
One limitation of this research is that the variable representing women's access to information does not accurately reflect access to specific health knowledge, such as childcare practices for different life stages To improve the study, the measurement and variables related to information access require more detailed design and refinement.
The dissertation presents significant predictors linking maternal education to early childhood development; however, it is limited in its ability to establish causal relationships Future research should delve deeper into the reasons behind these influences and examine the connection between maternal education and child development through longitudinal data analysis.
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