The effect of partners' education on women's reproductive and maternal health in developing countries

• Published in: Social science & medicine (1982) 2018-01, Vol.197, p.104-115
• Main Authors: Adjiwanou, Vissého, Bougma, Moussa, LeGrand, Thomas
• Format: Article
• Language: English
• Subjects: Antenatal care visits; Attendance; Birth control; Childbirth & labor; Children; Childrens health; Contraception - utilization; Contraceptives; Delivery, Obstetric - utilization; Developing Countries; Educational attainment; Educational Status; Female; Health behavior; Health services; Health services utilization; Health status; Health surveys; Humans; Infants; LDCs; Male; Maternal and infant welfare; Maternal characteristics; Maternal Health - statistics & numerical data; Medical personnel; Midwifery; Modern contraceptive use; Mothers; Partners' education; Pregnancy; Prenatal Care; Reproduction; Reproductive Health - statistics & numerical data; Secondary education; Sexual Partners; Skilled birth attendance; Spouses; Visits; Women and child health; Women's education; Working women
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2017.11.054

The effect of partners' education on women's and children's health in developing countries has received relatively little attention to date. This study uses couple data from 37 recent Demographic and Health Surveys fielded in sub-Saharan African and Asian countries to assess the effect of partners' schooling on women's modern contraceptive use, frequency of antenatal care visits, and skilled birth attendance. Using multilevel logistic regressions, the study shows that partners' schooling has strong effects on their spouses' maternal healthcare utilization; especially when partners had secondary or higher levels of schooling. Overall, women whose partners had an above secondary level of education were 32% more likely to use modern contraceptives, 43% more likely to attend at least four antenatal care visits, and 55% more likely to deliver their most recent baby with a health professional, compared to women whose partner had no education, after controlling for individual and community-level covariates. Finally, interacting the partners' years of schooling, we found that an additional year of partners' schooling was 1) positively associated with modern contraceptive use when the women had low educational attainment (substitution effect), but negatively associated when women were better educated, 2) positively and increasingly associated with the frequency of antenatal care visits as women's education increased (multiplicative effect), and 3) positively and significantly associated with skilled birth attendance for less educated women (substitution effect). This study highlights the importance of male education in shaping their wife's health behaviours in developing countries and provides strong impetus for male education beyond primary level (as well as for women), something that has been neglected in past policy discourse. •Partners' education positively affects their wives' health care-seeking behaviour.•Effects are stronger for skilled birth attendance and antenatal care behaviours.•The effects of partners' and wives' schooling interact in varied ways.•Women's education remains the most important factor for use of their health care.