Early childbearing can negatively impact women's labor market outcomes in Brazil. Using data from the 2013 Brazilian National Health Survey, the study examined the impact of bearing a child during adolescence on labor force participation, participation in formal jobs, and earnings later in life. Instrumental variable methods were used to control for the endogeneity of childbearing decisions. The results showed that early pregnancy increased labor force participation by 9-11 percentage points but decreased participation in formal jobs by 12 percentage points. It also decreased women's earnings by around 28% due to lower educational attainment from early pregnancy. The findings suggest early childbearing can force women in low-income families into the labor market through flexible informal jobs to support their children, while limiting their
Os cuidados de saúde prestados durante a gravidez salvaguardam o bem-estar da mãe e do feto e proporcionam um bom começo de vida aos bebês. Os custos financeiros de ter um bebê podem ser catastróficos, impedindo as mulheres grávidas de procurar serviços essenciais de saúde materna e colocando em risco a vida das mães e de seus filhos.
De acordo com a análise recentemente divulgada, estima-se que 5 milhões de famílias vivendo na África, Ásia, América Latina e Caribe incorrerão em grandes dificuldades financeiras a cada ano - ou gastos catastróficos em saúde - devido a ausência de cuidados pré-natal e parto. Os gastos com saúde são considerados grandes se excederem 40% dos gastos não essenciais, não alimentares, de um domicílio. Quase dois terços dessas famílias, ou cerca de 3 milhões de famílias, estão na Ásia.
O documento aborda ainda, a epidemia de cesáreas, o casamento infantil, a gravidez na adolescência...
Obrigado e parabéns ao Unicef!
Prof. Marcus Renato de Carvalho
“Family planning is a way of thinking and living that is adopted voluntarily upon the basis of knowledge, attitude and responsible decision by individuals and couples in order to promote the health and welfare of the family group and this contribute effectively to the social development of a country. “WHO (1971)
An Expert Committee (1971) of the WHO defined family planning as "a way of thinking and living that is adopted voluntarily, upon the basis of knowledge, attitudes and responsible decisions by individuals and couples, in order to promote the health and welfare of the family group and thus contribute effectively to the social development of a country“.
Basic Human Rights
Scope of family planning services
Health aspects of family planning:
1. Women's health: Unwanted pregnancies, Limiting the number of births and proper spacing, Timing of births
2. Foetal health
3. Child health: Child mortality, Child growth, development and nutrition, Infectious diseases
The welfare concept
Small-family norm
Eligible couples
Target couples
Couple protection rate (CPR)
Os cuidados de saúde prestados durante a gravidez salvaguardam o bem-estar da mãe e do feto e proporcionam um bom começo de vida aos bebês. Os custos financeiros de ter um bebê podem ser catastróficos, impedindo as mulheres grávidas de procurar serviços essenciais de saúde materna e colocando em risco a vida das mães e de seus filhos.
De acordo com a análise recentemente divulgada, estima-se que 5 milhões de famílias vivendo na África, Ásia, América Latina e Caribe incorrerão em grandes dificuldades financeiras a cada ano - ou gastos catastróficos em saúde - devido a ausência de cuidados pré-natal e parto. Os gastos com saúde são considerados grandes se excederem 40% dos gastos não essenciais, não alimentares, de um domicílio. Quase dois terços dessas famílias, ou cerca de 3 milhões de famílias, estão na Ásia.
O documento aborda ainda, a epidemia de cesáreas, o casamento infantil, a gravidez na adolescência...
Obrigado e parabéns ao Unicef!
Prof. Marcus Renato de Carvalho
“Family planning is a way of thinking and living that is adopted voluntarily upon the basis of knowledge, attitude and responsible decision by individuals and couples in order to promote the health and welfare of the family group and this contribute effectively to the social development of a country. “WHO (1971)
An Expert Committee (1971) of the WHO defined family planning as "a way of thinking and living that is adopted voluntarily, upon the basis of knowledge, attitudes and responsible decisions by individuals and couples, in order to promote the health and welfare of the family group and thus contribute effectively to the social development of a country“.
Basic Human Rights
Scope of family planning services
Health aspects of family planning:
1. Women's health: Unwanted pregnancies, Limiting the number of births and proper spacing, Timing of births
2. Foetal health
3. Child health: Child mortality, Child growth, development and nutrition, Infectious diseases
The welfare concept
Small-family norm
Eligible couples
Target couples
Couple protection rate (CPR)
Family planning methods and modern contraceptives by Dr. Sonam AggarwalDr. Sonam Aggarwal
Family planning is a way of thinking and living that is adopted voluntarily, upon the basis of knowledge, attitude and responsible decision by individuals and couples in order to promote the health and welfare of family group and thus contribute effectively to the social development of country.
For other topics: click on the link https://www.slideshare.net/SonamAggarwal7/cytokine-syndrome-in-covid-19
The Reproductive Health Bills, popularly known as the RH Bills, are legislative bills aiming to guarantee universal access to reproductive health care services, supplies and information in the Philippines. There are presently six bills with the same goals, the most prominent of which is House Bill 96 but they are all referred to in the country as "the RH Bill" as they have the common purpose of promoting reproductive health, responsible parenthood and informed choice in conformity with internationally recognized human rights standards. The contentious aspect of the bill which has spawned a national debate is its key proposal that the government funds and undertakes widespread distribution of family planning devices such as oral contraceptive pills (OCPs) and IUDs, dissemination of information on their use, and enforcement of their provision in all health care centers and private companies, as a way of controlling the population of the Philippines. The bill is based on the premise that present population growth impedes economic development and exacerbates poverty.
Identifying Factors Associated with Depressive Symptoms
in Japanese Fathers Who Try to be Actively Involved in
Childcare: A Web-based Cross-Sectional Study
Maternal, Newborn and Child Health: A Global PerspectiveMichelle Avelino
Presentation of Jacqueline F. Kitong, M.D., MPH, technical officer for Maternal and Child Health and Nutrition, World Health Organization at the PhilHealth Maternal, Newborn and Child Health Summit
meaning of small family norms: Small family norm connotes control over the number of children.
The rate of reproduction and the level of acceptance of family control methods are to a large extent influenced by what people consider as the ideal family size.
Adoption of small family norms is today not only desirable but It has become difficult to survive with a large family particularly because of rising cost of living, growing needs and necessities.
It is a fact that a small family is a happy family.
Lesser number of children is a boon not only to their parents but also to the country.
They have better chances of food, clothing and education.
almost a necessity
nature of small family norms
benefits of small family norms
barriers of small family norms
Shows a detailed look how family planning policies have worked in different countries ---- predominantly Catholic, Buddhist, Islamic, Democratic, Authoritatian or Communist.
In this presentation, myself and my group members Mary Lenon Bates, Lauryn Waters, and Rachel McPhaul explored the reasons behind why the United States has high infant mortality rates. We also took comparisons from other countries and paid close attention to how things like socioeconomic status affect the outcome of an infant.
Family planning methods and modern contraceptives by Dr. Sonam AggarwalDr. Sonam Aggarwal
Family planning is a way of thinking and living that is adopted voluntarily, upon the basis of knowledge, attitude and responsible decision by individuals and couples in order to promote the health and welfare of family group and thus contribute effectively to the social development of country.
For other topics: click on the link https://www.slideshare.net/SonamAggarwal7/cytokine-syndrome-in-covid-19
The Reproductive Health Bills, popularly known as the RH Bills, are legislative bills aiming to guarantee universal access to reproductive health care services, supplies and information in the Philippines. There are presently six bills with the same goals, the most prominent of which is House Bill 96 but they are all referred to in the country as "the RH Bill" as they have the common purpose of promoting reproductive health, responsible parenthood and informed choice in conformity with internationally recognized human rights standards. The contentious aspect of the bill which has spawned a national debate is its key proposal that the government funds and undertakes widespread distribution of family planning devices such as oral contraceptive pills (OCPs) and IUDs, dissemination of information on their use, and enforcement of their provision in all health care centers and private companies, as a way of controlling the population of the Philippines. The bill is based on the premise that present population growth impedes economic development and exacerbates poverty.
Identifying Factors Associated with Depressive Symptoms
in Japanese Fathers Who Try to be Actively Involved in
Childcare: A Web-based Cross-Sectional Study
Maternal, Newborn and Child Health: A Global PerspectiveMichelle Avelino
Presentation of Jacqueline F. Kitong, M.D., MPH, technical officer for Maternal and Child Health and Nutrition, World Health Organization at the PhilHealth Maternal, Newborn and Child Health Summit
meaning of small family norms: Small family norm connotes control over the number of children.
The rate of reproduction and the level of acceptance of family control methods are to a large extent influenced by what people consider as the ideal family size.
Adoption of small family norms is today not only desirable but It has become difficult to survive with a large family particularly because of rising cost of living, growing needs and necessities.
It is a fact that a small family is a happy family.
Lesser number of children is a boon not only to their parents but also to the country.
They have better chances of food, clothing and education.
almost a necessity
nature of small family norms
benefits of small family norms
barriers of small family norms
Shows a detailed look how family planning policies have worked in different countries ---- predominantly Catholic, Buddhist, Islamic, Democratic, Authoritatian or Communist.
In this presentation, myself and my group members Mary Lenon Bates, Lauryn Waters, and Rachel McPhaul explored the reasons behind why the United States has high infant mortality rates. We also took comparisons from other countries and paid close attention to how things like socioeconomic status affect the outcome of an infant.
Running head MATERNAL, INFANT AND CHILD HEALTH .docxcowinhelen
Running head: MATERNAL, INFANT AND CHILD HEALTH 1
MATERNAL, INFANT AND CHILD HEALTH 9
Maternal, infant and child health
Name
Institution
Abstract
Maternal, infant health is very essential for the progress of any country since they form the pillar of our future generations. United States has made significant strides towards securing the maternal and child health through various initiatives and programs within the country and around the globe. Despite the existence of health care initiatives to promote maternal, infant and child health, maternal and infant mortalities are still recorded on a daily basis in the U.S. Risk factors to maternal, infant and child mortalities include poor and a lack of a antenatal care attendance, unskilled birth attendants,ce and childhood illnesses. More than a quarter of every single maternal mortality is because of postpartum hemorrhaginge, for the most part after labor.
Infant mortality is another prevalent case that contributes to the worsening situation in child and maternal health, because of untimely births represent more than a quarter of infant mortalities, trailed by mortalities during births and neonatal sepsis. Maternal and child health (MCH) programs concentrate on medical problems concerning related to mothers, children, and families – such as , for example, access to suitable pre-natal and child welfare services, baby mortality mitigation initiatives, emergency medical services, prevention of injuries, infant screening, and administrations to kidschildren children with unique health care needs. The United States is working to prevent maternal deaths, infant mortalities, and child mortalities, and to reduce the prevalence of these incidences. It calls for a multidisciplinary approach in order to eliminate this issue affecting the mothers and children. Reinforcing referral systems and linkages between various levels of hospital-based patient care, and between healthcare organizations providers and the general population, must be a top needpriority.
1- (the things in red is the corrections, if its underline means this is the correct world and if its cross off means you have to delete it)
2- ( the things in yellow you have to delete it and write the topic and the purpose of the paper and I will write it for you at the end of the first paragraph).
3- Change anything about child health and just focus on mortality maternal unless there is something related to the child health so then you can mention that.
4- Scoop of the problem
5- Associated factors
6- solutions
Maternal child and infant health
Enhancing the prosperity of mothers, newborn children, and young children is a vital public health objective for the United States and the entire globe. Their prosperity dictates the strength of the people in the future and can anticipate future public wellbeing challenges for fam ...
Every family deserves to experience a happy and healthy pregnancy. However, approximately 700 pregnant women die each year in the U.S due to pregnancy and complications (CDC, 2018)1. Even more, it is reported that more than half of these deaths are due to preventable factors, such as having access to quality maternal health care (Building U.S. Capacity to Review and Prevent Maternal Deaths, 2018)2.
Severe disparities by race and socioeconomic status plague this public health problem. While maternal mortality can impact women of all backgrounds, women of color, mothers aged 30 years or older, immigrants, and women living in poverty, are populations that are disproportionately affected by this issue (Amnesty International, 2010)3. Why is the mortality rate increasing in various parts of the U.S., even as our advances in technology are rapidly improving? Solutions to this problem might exist both inside the birthing room in the form of safer precautions in hospitals, and may also be related to other factors, including financial barriers and limited knowledge on prenatal care.
Mothers are often the center point of the family. But mothers are also the most undervalued and overworked members of our society. It is high time that we start prioritizing the lives of those who give life to us. As my main project at the Illinois Department of Public Health, Office of Women's Health & Family Services, here is a portion of my state-by-state analysis of maternal mortality prevention recommendations.
1. Pregnancy-related health outcomes are influences by a variety of factors, including healthy weight and diet, risk of cardiovascular disease, previous injuries and complications, and substance abuse.
2. Nine Maternal Mortality Review Committees (MMRC) were tasked to collaboratively collect data from states that together represent 92% of the country’s maternal deaths. These include Colorado, Delaware, Georgia, Hawaii, Illinois, North Carolina, Ohio, South Carolina, and Utah.
3. Addressing the structural barriers to receiving care, also known as the social determinants of health, are important components to preventing maternal deaths.
Adolescent pregnancy continues to be a grave problem in India not only from the obstetrical point of view but from the social and economical perspectives also. Complications of pregnancy and childbirth are the leading cause of mortality among women between the ages of 15 and 19 in the developing world.
Maternal & Child Health Among Detroit Michigan’s Lower Socio.docxandreecapon
Maternal & Child Health Among Detroit Michigan’s Lower Socioeconomic Group
Delroy Barnett
Christina Bergman
Maria Victoria Blanton
Veverly Brooks
Jennifer Castro
Ashford University
HCA415- Public and Community Health
Instructor: Tynan Mara
April 6, 2015
1
Target Population
Detroit Michigan Population:688,701
Percent of White American: 10.6%
Percent of Black American: 82.7%
Percentage of Women: 52.7%
Pregnancy Related Deaths 36.6 per 100,000 births.
Pregnancy Associates Deaths 75 pre 100,000 births.
Pregnancy Related deaths - 50.8 per 100,000 births in African Americans.
-3rd highest in nation
As of 2010, Detroit Michigan has a total population of 688,701 people. Of the 688,701 people, 10.6 % are White American and 82.7% are Black American. The community of Detroit is dealing with a rising concern with maternal health and pregnancy related mortality rates. Of the total population, 52.7% (or 362,945) are women. The cause of mortality among maternal mothers is obstetric causes, medical, accidents, suicide, assaults, and other causes. Per year on average, 6 women die from pregnancy issues, this amount is three times higher than that of the national average. These high mortality rates are more common in African American women than other races. Pregnancy related deaths among African Americans is 50.8 per 100,000 live births. This makes Detroit Michigan the third highest city of pregnancy related mortality in the nation. The high mortality rates in Detroit are due to health conditions, poverty, and proper health care. These numbers show that it is dangerous for a pregnant women to live and give birth in Detroit.
2
Thesis Statement
Thesis
The health disparities among women and children in Detroit are some of the worst in the nation. “The maternal mortality rate for black mothers in 2002 was almost 25 deaths per 100,000 live births, compared to nearly 6 deaths per 100,000 live births among white mothers and more than 7 deaths…among Hispanic mothers” (National Institute of Health, 2006, p.x). That is nearly four times the national average. More focus needs to be placed on maternal and child health in low socio-economic areas of Detroit.
Factors & Causes
Over 40% of population is living in poverty
Chronic Diseases
Limited access/ quality of health care
Obstetric, Medical, Accidents leading cause
While normally a major health concern in less developed countries, maternal and child health in the United States has become a major concern. “Child mortality is highly preventable and can be reduced greatly through improvement of environmental conditions and hygiene levels, as well as increased parental compliance with immunizations for vaccine preventable diseases…Many of these deaths were caused by preventable or easily treatable condition or by malnutrition (WHO, 2012c; WHO, 2012a)” (Friis, Bell, & Philibert, 2013). Poverty is a detrimental impact on the maternal health of women in Detroit. With the me ...
CDade-GraduateIntern-IDPH-OWHFS-MaternalMortality-FinalReportChelsea Dade, MS
As a part of my contribution to Illinois’s Maternal Mortality review process, I was tasked to investigate the maternal mortality review committees, related literature, and other related reports of 26 states, plus Washington D.C. and Illinois. The goal of this project was to give my supervisors and IDPH staff an overview of what has worked, what isn’t working in terms of maternal mortality reduction recommendations in other states. In addition to including incidence rates, racial breakdowns, and other markers, I examined the methods that states used to present their maternal mortality data. The latter refers to graphics selections, terminology, and other creative considerations that might have been used to impact a reader’s connection and understanding of the issue in a state’s report.
It is important to acknowledge that not every state had an existing report. Furthermore, in my analysis I found that even for states with existing maternal mortality review committees, reports were not always readily accessible online. Moreover, every state with an existing review committee do not always have a list of recommendations. Therefore, the following summaries are a couple of examples from my complete 26 state analysis, featured on the states of Louisiana, North Carolina, New Jersey, and Ohio, as they were able to provide a direct list of official recommendations.
Choice for women: have your say on a new plan to tackle reproductive, materna...DFID
More than a third of a million women die every year from complications during pregnancy and childbirth. Improving reproductive, maternal and newborn health in the developing world is a major priority for the UK Government. DFID is therefore developing a new business plan.
To inform the plan we are holding a 12 week consultation, which will close on 20 October 2010. We want to hear what people in the UK and around the world have to say on the subject of reproductive, maternal and newborn health. This will help us to understand different viewpoints, how these issues might vary in different countries, and how DFID could work better with partners.
If you want to discuss the consultation with colleagues, partners or users of services, we have created this presentation document to help you stimulate discussion. Once you have gathered responses submit your feedback online or use our template response document and email your comments.
To find out more visit http://www.dfid.gov.uk/choiceforwomen
A case study about Teenage pregnancy which is a widespread problem all over the world. Teen pregnancy and childbearing bring substantial social and economic costs through immediate and long-term impacts on teen parents and their children.
Teen pregnancy in the United StatesTeen pregnancy in the Unite.docxmattinsonjanel
Teen pregnancy in the United States
Teen pregnancy in the United States
The National Campaign to Prevent Teen Pregnancy was founded in 1996 and has its headquarters in Washington D.C. and has nearly 200 organizations and media outlets which serve as partners. The National Campaign to Prevent Teen and Unplanned Pregnancy’s main agenda seeks to improve the lives and future prospects of children and families by ensuring that children are born into stable, two-parent families who have a commitment to and are ready for the demanding task of raising the next generation. Their strategy is aimed at the prevention of teen pregnancy and unplanned pregnancy among single, young adults by supporting a combination of responsible values and behavior by both men and women and responsible policies in both the public and private sectors. Their actions are aimed at improving child and family well-being therefore reducing the prevalence rate of poverty by providing more opportunities for the teenagers to complete their education or achieve other life goals while advocating for fewer abortions towards the creation of a stronger nation.
Teenage pregnancies have resulted to a total of 273,105 babies who were born to women aged 15–19 years, for a live birth rate of 26.5% per 1,000 women in this age group. There has been a decline in teen pregnancies with a drop of 10% in 2013. The birth rates declined at 13% for women aged 15–17 years, and 8% for women aged 18–19 years (Child Trends, 2014). Still, the U.S. teen pregnancy rate is substantially higher than in other western industrialized nations (Clay, et al, 2012). The national teen pregnancy rate has been declining steadily over the last two decades which has been attributed to the combination of an increased percentage of adolescents who are waiting to have sexual intercourse and the increased use of contraceptives by teens. The teen pregnancy rate includes the pregnancies that end in a live birth, as well as those that end in abortion or miscarriage resulting from fetal loss. In the United States 4 in 10 teens get pregnant at least once before they reach the age of 20 which leads to the teenagers dropping out of school with more than 50% of teen mothers never completing school. The trends show that less than 10% of the fathers marry the mother of their child and that almost a half of the teen mothers get their second child within the first 24 months since 80% of teens who do not use protective methods have higher chances of becoming pregnant.
Teen birth rates have been declining significantly in the recent years, however, despite these declines, there still exists a lot of disparities that need to be properly addressed (Dessen, 2005). There are substantial disparities that persist in teen birth rates, and teen pregnancy and childbearing which continue to carry significant social and economic costs. In 2013, the Hispanic teen birth rates were still more than two times higher than the rate for ...
Module IIIMaternal Health ______________________________________.docxmoirarandell
Module III
Maternal Health _______________________________________________
Introduction
In the Module we will explore maternal health paying particular attention to global disparities in the support and care mothers around the world get, the factors that promote such disparities, causes of maternal mortality and morbidity, the impact of reproductive patterns on the health of children, and mechanisms to reduce maternal morbidity and mortality, particularly in low-and –middle income countries.
At the end of this Module you should be able to articulate the following:
Critical Skills
1. Explain the global trends in maternal health.
2. Identify the key players and they play in promoting maternal health.
3. Be able to identify the causes of maternal mortality and morbidity in the U.S and other countries, particularly developing nations.
4. Explain mechanisms used to reduce maternal morbidity and mortality.
5. Be familiar with at least two development organizations/NGOs and their work around maternal health.
Maternal Health at a Glance
Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. While most women look forward to motherhood (and their spouses to fatherhood), for too many women, motherhood is a torturous experience associated with suffering, ill-health and even death. It is estimated that about 800 women die from pregnancy- or childbirth-related complications around the world every day. Consider the following few facts about maternal health (WHO):
· Every day, approximately 800 women die from preventable causes related to pregnancy and childbirth – about 287 000 women in 2010 alone. Most of them died due to preventable cause like not being able to access skilled routine and emergency care.
· The FOUR main maternal mortality causes are: severe bleeding, infections, unsafe abortion, and hypertensive disorders (pre-eclampsia and eclampsia). After delivery bleeding is very serious condition, if unattended, it can kill even a healthy woman within two hours.
· Of the more than 136 million women who give birth a year, about 20 million of them experience pregnancy-related illness after childbirth.
· About 16 million girls aged between 15 and 19 give birth each year, accounting for more than 10% of all births. Complications from pregnancy and childbirth are the leading cause of death among girls 15-19 in developing nations.
· The state of maternal health mirrors the gap between the rich and the poor. Less than 1% of maternal deaths occur in high-income countries. The lifetime risk of dying from complications in childbirth or pregnancy for a woman in the developing world is an average of one in 150 compared to one in 3800 in developed countries. Of the 800 women who die every day,440 live in sub-Saharan Africa, 230 in Southern Asia and five in high-income countries.
· Most maternal deaths can be prevented through skilled care at childbirth and access to emergency obstetric c ...
When it comes to maternal healthcare, a lot of factors need to be taken into consideration. Another report reveals that the past decades have displayed a tremendous decline in the maternal mortality ratio
Underweight and Pregnant: Designing Universal Maternal Entitlements to Improv...Srishti Katiyar
Poor maternal nutrition in India is a major cause for concern. The depth of India’s maternal nutrition
problems is evident in its high neonatal mortality, widespread underweight pre-pregnancy, low
weight gain during pregnancy and high rates of maternal anaemia. Poor maternal nutrition has negative
consequences for the health and economic productivity for the next generation.
This report sheds light on the significance of digital trade integration for Pakistan and selected
Central Asian countries including Afghanistan, Kazakhstan, Tajikistan, and Uzbekistan. Digital trade
integration involves regulatory structures/policy designs, digital technologies, and business
processes along the entire global/regional digital value chain. Digital trade
integration requires free cross-border movement of not only digital products, services, and
technologies but also other manufactured goods, data, capital, talent, and ideas along with the
availability of integrated physical and virtual infrastructure. Hence, digital trade integration requires
the removal of digital trade barriers as well as extensive technology, and legal and policy
coordination between member states.
Countries around the world have actively engaged in establishing new and progressive bilateral and
regional trade agreements to boost trade and economic growth. The significance of digital trade has
increased considerably after the COVID-19 pandemic. Improvement in digital connectivity, ease in
regulations, and skilled workers are key factors to facilitate trade integration and promote the
growth of the e-commerce sector. The report examines the regional trade agreements of Pakistan
and selected Central Asian countries and their relevance for digital trade integration. It also
scrutinizes the challenges faced by the public institutions of Pakistan in the implementation of digital
trade policy. Besides this, the report also observes the challenges faced by SMEs dealing with digital
trade-related products.
The findings show that Pakistan and selected Central Asian countries are at different levels of digital
adoption, including mobile connectivity index and download speed of mobile and broadband.
Kazakhstan and Pakistan have a higher export and import volume compared with other countries.
However, neither country has any major trading partner from the countries selected in this study,
which demonstrates the lack of regional cooperation and the need for regional trade agreements to
boost bilateral and regional trade.
The report discusses the e-commerce laws of Pakistan and selected Central Asian countries, whereas
domestic policies and measures to increase digital trade are also reviewed. The countries are at a
different level in terms of implementing digital trade facilitation measures. Lack of effective
enforcement of intellectual property rights, non-tariff measures, foreign investment restrictions in
digital space, data and information costs, cyber security, and tax policy and administration are all key
policy issues that influence digital trade integration.
The study offers a way forward in which action points are provided for governments, the nongovernmental
sector (notably, business associations and networks), academia and think tanks, and
development partners. #DigitalTradeIntegration
#RegionalTradeAgreements
#EconomicGrowth
#DigitalConnectivity
#EcommerceLaws
The policy brief by the Sustainable Development Policy Institute (SDPI) outlines the urgent need to address the high consumption of Industrially Produced Trans Fatty Acids (iTFA) in Pakistan, which poses significant health risks, particularly in contributing to cardiovascular diseases. Despite being the second-highest per capita consumer of iTFA in the WHO-Eastern Mediterranean Region, Pakistan lacks comprehensive regulations and enforcement mechanisms to mitigate iTFA consumption effectively. The brief recommends a multi-faceted approach involving uniform standards, transparent enforcement, public awareness campaigns, capacity building for regulatory authorities, and collaboration with the food industry to promote healthier alternatives. It highlights the importance of political commitment, intersectoral collaboration, and public-private dialogue to successfully eliminate iTFA from the food supply chain and improve public health outcomes in Pakistan.
In his comprehensive analysis, Vaqar Ahmed highlights the challenges and impediments faced by Pakistan's trade and industrial policies, particularly concerning macroeconomic stability, energy shortages, rising costs, and regulatory constraints. The recent decline in the value of the Pakistani Rupee has further intensified issues for the manufacturing sector. The adverse macroeconomic conditions, including high inflation and a policy rate exceeding 20 percent, have hampered the sector's ability to secure working capital. Large firms' reluctance to operate in special economic zones due to supply-side gaps, coupled with global economic uncertainties, has delayed the next phase of the China Pakistan Economic Corridor (CPEC). Ends with some policy recommendations.
Creating a conducive environment for sustainable economic development, improve living standards for all citizens, and secure a brighter future for the nation.
Highlights the country's large and young labor force, with a 1.94% population growth rate and 65.5 million individuals actively seeking work according to the 2017-18 Labor Force Survey. However, the unemployment rate currently stands at 5.8%, with the highest rate (11.56%) among youth aged 20-24. In response, the government launched the Prime Minister's Kamyab Jawan Programme, allocating Rs 100 billion to support entrepreneurship and create employment opportunities for youth. This program encompasses six key initiatives, including the Youth Entrepreneurship Scheme, Hunermand Pakistan Programme, Green Youth Movement, Startup Pakistan, National Internship, and Jawan Markaz. By focusing on skills development, entrepreneurship, and youth empowerment, the government aims to address unemployment challenges and foster a more vibrant economy.
The Khyber Pakhtunkhwa Urban Policy aims to transform KP's urban centers into engines of social, economic, and cultural growth by promoting vibrant communities, sustainable practices, and economic opportunities. It focuses on inclusive development, infrastructure improvement, efficient governance, environmental protection, and cultural preservation, aiming to make cities globally competitive and provide a high quality of life for all citizens. This policy, reviewed every five years, provides a roadmap for urban development in KP, seeking to create a brighter future for its residents.
This study aims to explain the macroeconomic and welfare impacts of changes in indirect taxes brought about in response to COVID-19. We study whether the tax relief provided for in the federal budget for fiscal year 2020-21 was effective in providing relief to private enterprises and the trade sector. We also study whether production subsidies granted during the first wave of COVID-19 were effectively able to support firms in the agricultural sector. This assessment allows us to draw lessons that may be useful for designing tax benefit policies amid future waves of the pandemic or during other emergency times.
The Government of Pakistan has offered export facilitation schemes
to exporters with the objectives to lower trade costs and expand
output. Currently, nearly one dozen export facilitation schemes are
active. They also include those which are run by the Federal Board
of Revenue (FBR). The question of ‘effectiveness’ of such schemes
in boosting Pakistan’s exports has remained a consistent theme of
interest among policymakers, international development partners
and private sector. This policy brief builds on a firm-level survey,
conducted by the Sustainable Development Policy Institute (SDPI),
and is an attempt to understand the effectiveness, overall gains,
and shortcomings of four major export facilitation schemes offered
by the FBR, including Duty and Tax Remission for Exports (DTRE),
Manufacturing Bond (MB), Export Oriented Unit (EOU) and Export
Facilitation Scheme (EFS). The study aims to provide insights on how
best to improve design of Export Facilitation Scheme 2021, which will
absorb all other schemes by the end of 2023.
The Ministry of Commerce in Pakistan unveiled the National Tariff Policy 2019-24 (NTP 2019-
24) in November 2019. The core aims of the policy were to: i) remove tariff-related
anomalies in the short-term to lower businesses’ cost of inputs and increase their
turnover, ii) increase employment generation in the medium-term, and iii) gain
competitiveness and exports in the long-term.
After its announcement, there remains a need to analyze the effectiveness and
impact of the policy. SDPI team conducted primary research to assess the impact
of tariff policy on Small and Medium Enterprises (SMEs) with the help of a firm-level
survey.
This specific survey aims to bridge the evidence gap by providing an in-depth
analysis on the NTP-2019-24 impact in terms of its three prime objectives. Besides,
the study also attempts to understand the business community’s challenges and
expectations vis-à-vis tariff-related matters.
Digital trade is increasing rapidly throughout the world whereas digital platforms and Coronavirus have further enhanced the importance of the digital economy and digital trade. Countries are focusing on promoting digital trade and integration through various measures including free trade agreements and bilateral negotiations. This study examined digital trade as defined by WTO E-commerce work and USITC. The study included the items that come under the definition of digital trade and examined the digital trade volume of Pakistan from 2010-2020 through three-step methodology. This includes the identification of digital trade items based on Harmonized System at a six-digit level, examining trade volume for digital goods, and identification of top ten export and import items along with top ten markets for digital trade. Favorable government policies and measures have helped Pakistan in promoting digital trade flows. However, there is a need to develop information and communication technology infrastructure in Pakistan to flourish trading activities. Furthermore, Pakistan has to reduce the fiscal and trade barriers such as rules and regulations for foreign investment in digital space, data and information costs, and ensure online security and data protection to promote digital trade integration.
by Asif Javed & Vaqar Ahmed
This study presents a pathway for fostering regional digital trade integration through
South-South and Triangular cooperation. Our main study goals include answering the
following questions:
» What are the challenges faced in the digital trade sector of Afghanistan, Pakistan
and Sri Lanka? How can these be overcome through various cooperative models?
» How can inclusive regional and free trade agreements help to overcome barriers
and enable digital trade integration?
» What can Small and Medium Enterprises (SMEs) dealing with digital trade-related
products learn from literature on South-South and Triangular cooperation?
Suggested citation:
Ahmed, V. and Javed, M. Digital Trade Integration: South-South and Triangular
Cooperation in South Asia (unpublished). South-South Idea Paper Series, United Nations
Office for South-South Cooperation (UNOSSC),Washington D.C.New York, 2022.
Pakistan is facing numerous socioeconomic impacts of the Covid-19 pandemic, including on food security. Food insecurity, which is a long-standing issue, has become more visible since the pandemic. Covid-19 Responses for Equity (CORE) partner the Sustainable Development Policy Institute (SDPI) – a leading policy research thinktank – has been supporting the Government of Pakistan to maintain essential economic activity and protect workers and small producers during the pandemic. One notable contribution has been the development of a Food Security Portal, which is being used by the government to better manage food security in the country. It is the first track and trace system from farm to fork for essential food items.
URI
https://opendocs.ids.ac.uk/opendocs/handle/20.500.12413/17619
Citation
Suleri, A.Q.; Ahmed, V.; Ahmad, S.M.; Shah, Q.; Zahid, J. and Gatellier, K. (2022) Strengthening Food Security in Pakistan During the Covid-19 Pandemic, Covid-19 Responses for Equity (CORE) Stories of Change, Brighton: Institute of Development Studies, DOI: 10.19088/CORE.2022.008
Political and socio-economic discussions in Pakistan’s popular discourse are often inward-looking and generally focus on the country itself, or on its relationships to its immediate neighbors (Afghanistan, India, and China). We suggest here that Pakistan is part of a global system, as well. It is influenced not just by its direct neighbors, but also by: international events (war in Ukraine is just one example); by global economic factors (e.g. oil prices, changing terms of trade, or the danger of a global recession); and by various other global governance arrangements (e.g. Financial Action Taskforce and its demands from Pakistan). At the same time, Pakistan is not insulated from the global systemic changes. The global pandemic has overwhelmed the policymakers with possibilities of future epidemics also not being ruled out. In the past migration of people, both incoming and outgoing, has impacted the social fabric.
Likewise, the country is suffering from global warming and the resulting patterns of weather and precipitation. Pakistan is also a player at the international arena and is expected to play a responsible and proactive role at various global governance forums. The speech of the former Prime Minister of Pakistan at the UN General Assembly on September 27, 2019 has indicated regarding this responsibility and highlighted Pakistan’s role in the Cold War, or the engagement of Pakistani soldiers abroad, either in the United Nations peace keeping framework, or bilaterally. While many Pakistanis are aware of some of Pakistan’s international roles and dependencies, and of Pakistan’s image abroad, there is limited discussion about the country’s global role – what it should be? Who are the internal and external actors that shape Pakistan’s role, engagement, influence, and perception abroad? What role does the state and citizens play in deciding Pakistan’s global role? These are some of the questions that our chapter authors aimed to touch upon in this book. A conscious effort has been made to reach out to Pakistanis living and working abroad. Chapters have been invited from such resource persons who are not only Pakistanis but also study Pakistan from abroad and often through various lens external to Pakistan.
Web: https://pakistan.fes.de/e/global-pakistan-pakistan%CA%BFs-role-in-the-international-system
The Covid-19 pandemic and related
restrictions have had profound
socioeconomic impacts worldwide.
Governments have been faced with
responding urgently to mitigate such
effects, especially for the most
vulnerable. Covid-19 Responses for
Equity (CORE) partner Partnership for
Economic Policy (PEP) – a Southernled
organisation which believes that
evidence produced from an in-country
perspective, by empowered and
engaged local researchers and
policymakers, results in better policy
choices – has been working closely
with policymakers in Pakistan to
assess the Covid-19 impacts and the
effectiveness of current and potential
policies. As a result, PEP has helped
introduce tax reforms for the hardest
hit, agricultural subsidies for farmers,
and the reduction of trade tariffs for
struggling businesses.
Marginalization of Researchers in the Global
South in Global, Regional, and National
Economic-Development Consulting
Authors Ramos E. Mabugu | Vaqar Ahmed | Margaret R Chitiga-Mabugu
| Kehinde O. Omotoso
Date February 2022
Working Paper 2022-05
PEP Working Paper Series
ISSN 2709-7331
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Examining the Impact of Early Childbearing on Labor Outcomes in Brazil
1. working paper
2020-19
Examining the Impact of Early Childbearing
on Labor Outcomes in Brazil
Ana Lucia Kassouf
Vaqar Ahmed
Agnès Zabsonré
Ronelle Burger
Mitzie Conchada
April 2020
2. Examining the Impact of Early Childbearing
on Labor Outcomes in Brazil
Abstract
We examined the labor-market participation, participation in formal jobs, and earnings
of women who bore a child during their adolescent years. A woman’s decision to bear
a child is influenced by such factors as her motivation and her own assessment of her
productivity and labor-market returns, factors that also affect her labor outcome. Aware
of the endogeneity of childbearing, we used Brazilian National Health Survey data (2013)
to examine such instruments as age at menarche and miscarriage. Our results showed
an increase of nine to eleven percentage points in labor participation as a result of early
pregnancy and a decrease of twelve percentage points in participation in formal jobs.
In low-income families, women enter the labor force to support their children and
maintain family income, though they tend to select into more flexible, low-skilled, informal
jobs. One of the mechanisms through which teenage pregnancy affects labor
participation and earnings was education. Early pregnancy decreased women’s
education by 1.3 years, and we observed a negative impact of early pregnancy on
earnings of close to 28%. We analyzed impacts for different racial groups, income, and
region of residence.
Keywords: childbearing, labor market, earnings, education.
JEL codes: J08, J13, O15, J46
Publication on Social Science Research Network: Economics Research Network -
Women's & Gender Studies; Economics
Authors
Ana Lucia Kassouf
Professor, Department of Economics
University of Sao Paulo, Brazil
anakassouf@usp.br
Ronelle Burger
Professor, Economics Department
Stellenbosch University, South Africa
rburger@sun.ac.za
Vaqar Ahmed
Joint Executive Director
Sustainable Development Policy Institute
Pakistan
vaqar@sdpi.org
Mitzie Conchada
Associate Professor, School of Economics
De La Salle University, Philippines
mitzie.conchada@dlsu.edu.ph
Agnès Zabsonré
Assistant Professor, Department of Economics
and Management
Université Nazi Boni, Burkina Faso
zabagnes@yahoo.fr
Acknowledgements
This research work was carried out with financial and scientific support from the
Partnership for Economic Policy (PEP) (www.pep-net.org) with funding from the
Department for International Development (DFID) of the United Kingdom (or UK Aid), and
the Government of Canada through the International Development Research Center
(IDRC).
3. Table of contents
I. Introduction 1
1.1 Background 1
1.2 Women’s Labor Outcomes and Fertility 2
1.3 Pathways of Impact Mechanisms 5
1.4 Endogeneity of Childbearing 7
II. The Brazilian National Health Survey Data 9
III. Methodology 9
IV. Data Analyses 11
4.1 Summary Statistics 11
4.2 Instrumental Variables 14
V. Main Results 16
5.1 The Effect of Childbearing on Women’s Labor-Force
Participation 17
5.2 The Effect of Childbearing on Women’s Participation in
Formal Jobs 18
5.3 The Effect of Childbearing on Women’s Earnings 19
5.4 Exploring Heterogeneity in Effects of Childbearing 21
VI. Policy Implications and Recommendations 22
6.1 Childbearing and Labor-Force Participation 22
6.2 Childbearing and Wages 23
6.3 Childbearing and Education 23
6.4 Childbearing and Poverty 24
6.5 Childbearing and Inequality 25
VII. Conclusions 25
References 33
4. List of figures
Figure 1: Percentage of Women from 20-49 Who Bore a Child Before Age 20, by Income
Level...................................................................................................................................................12
Figure 2: Percentage of Women from 20-49 Who Bore A Child before Age 20 by
Educational Level............................................................................................................................12
Figure 3: Percentage of Women from 20-49 Who Bore a Child before Age 20, by Age at
First Menstruation.............................................................................................................................13
Figure 4: Percentage of Women from 20-49 Working by the Age of First Occurrence of
Menstruation ....................................................................................................................................13
Figure 5: Percentage of Women from 20-49, by Age at First Menstruation.........................14
List of tables
Table 1. Descriptive Statistics for the Group of Women Who Bore a Child before Age 20
and at Age 20 or Older..................................................................................................................28
Table 2. Childbearing First-Stage Regressions............................................................................30
Table 3. Labor-Force Participation Equations for Women from 20 to 49, Estimated Using
Probit, OLS, Bivariate Probit, and Two-Stage Least Squares Models.....................................30
Table 4. Formal Labor Equations for Women from 20-49, Estimated Using Probit Model,
OLS Model, Bivariate Probit Model, and Two-Stage Least Squares Models........................31
Table 5. Log Wage Hour Equations for Women 20-49, Estimated Using OLS and Heckman
Two-Stage Models...........................................................................................................................31
Table 6. The Effect of Childbearing on Labor outcomes for Different Categories,
Estimated Using Bivariate Probit and Two-Stage Least Squares (2SLS) Models...................32
5. 1
I. Introduction
1.1 Background
One of the biggest challenges in many low- and middle-income countries is
adolescent pregnancy and motherhood. According to the World Health Organization (2020),
nearly twenty-one million girls aged 15-19 and about two million girls under 15 become
pregnant every year, most of them in low- and middle-income countries. The average global
birth rate among 15-19-year-olds is 46 per 1000 girls, with the highest rates in sub-Saharan
Africa and the second largest rates in Latin America. In West Africa, adolescent birth rates are
as high as 115 births per 1000 women while, in Latin America and the Caribbean, the rate is
66.5 births per 1000 women.
In South America, only Venezuela, Ecuador, and Bolivia have higher birth rates than
Brazil for women in the 15-19-year-old group; in Latin America, Brazil is in seventh place out
of sixteen countries that have been analyzed (Pan American Health Organization, 2017).
Because Brazil has the largest population in Latin America, however, the number of teenage
pregnancies is the largest in absolute values, and the United Nations Population Fund (2013)
reported that the fourth highest incidence of women aged 20-24 who gave birth by age 18
was in Brazil, after India, Bangladesh, and Nigeria.
Knowing that pregnancy and complications of childbirth are the leading causes of
death among girls from 15-19 in many low- and middle-income countries, that deaths in the
first week of life are 50% higher among babies born to adolescent mothers than among
babies born to mothers in their twenties, that adolescents mothers are more often exposed
to sexually-transmitted diseases, and that they have a higher probability of dropping out of
school and have fewer job opportunities and lower incomes, governments should be aware
that many of United Nations Millennium Development Goals are directly affected by the
incidence of early pregnancy. For example, Goal 1(end hunger and extreme poverty); Goal 2
(achieve universal primary education); Goal 3 (promote gender equality and empower
women); Goal 4 (reduce child mortality); Goal 5 (improve maternal health); and Goal 6
(combat HIV). In this way, governments must act to avoid pregnancy among adolescent
women and break their cycles of poverty.
6. 2
The objective of this study was to measure the impact of teenage childbearing on
labor outcomes, understanding the link between early pregnancy and labor-force
participation and earnings. We were interested in such questions as: Is there a selection
among early-age mothers towards low-skilled and low-paid jobs as a result of lack of
education and need for income? Is poverty aggravated as a result of girls and adolescents
bearing children early in life?
1.2 Women’s Labor Outcomes and Fertility
Although abortion is illegal, the Catholic Church opposes birth control, and
government family planning is rare, fertility rates have dropped across Latin America. In 1960,
women in Latin America had almost six children on average, which fell to 2.3 children by
2010. Brazil’s declining fertility rate has been particularly drastic, falling from 6.2 children per
woman in 1960, to 4.1 in 1980, to 1.7 according to the latest figures available (Brazilian
Geographical and Statistical Institute, 2015.)
Conversely, women’s labor-force participation in Brazil increased from 27% in 1980 to
44% in 2018. Although the fertility rate has been rapidly decreasing and women’s labor-force
participation is increasing, teenage pregnancy remains high. In 2015, a total of 68.4 babies
were born to a group of a thousand women aged 15-19 years (Pan American Health
Organization, 2017). The participation of those teenage mothers in the total fertility rate was
17.4% (Instituto Brasileiro de Geografia e Estatística, 2015b). Unlike other regions in the
world, and particularly unlike developed countries, Latin America’s conservative and
traditional culture, coupled with religious beliefs, limits any success in the fight against teen
pregnancy. In fact, such barriers actually encourage teen pregnancy and early marriage by
shaping individual behaviors. Taylor et al. (2019), for instance, emphasized the role of social
norms and cultural traditions in contributing to child marriage in Latin America. In particular,
they reported that, in Brazil, girls and young women got married in order to leave their
parents as a sign of social status and freedom.1
Moreover, parents prefer their daughters to
marry during adolescence in order to avoid stigmatization as a result of pregnancies outside
1
Similar arguments were mentioned by Heilborn and Cabral (2011).
7. 3
marriage. Undoubtedly early marriage contributes to the persistence of teen pregnancy
which, in turn, leads to early childbearing.
Wodon et al. (2017), studying 25 countries in Africa, Asia, and Latin America, reported
that one in five women had children before they were 18 because of child marriage.
Consequently, in Latin America, as in poor countries in general, early childbearing and early
marriage intertwine, leading to more complicated links with socioeconomic outcomes.
Recent studies that have focused on early marriage and socioeconomic outcomes in
developing countries include Jensen and Thornton (2003), Field and Ambrus (2008), Parsons
et al. (2015), Marchetta and Sahn (2016), Wodon et al. (2017), Sunder (2019), and Asadullah
and Wahhaj (2019).
Like most recent studies that have analyzed early childbearing and socioeconomic
outcomes, the contributions of these authors have dealt with endogeneity problems and have
improved the methodologies and engaged in considerations of ways to control observed and
unobserved factors in order to isolate the true effect of the correlation and avoid bias in the
childbearing coefficient.
Studies with better controls and more sophisticated econometric approaches have
shown less impact than researchers and policy makers claimed in the 1980s and 1990s, which
concluded that a woman who gave birth as teenager was socially and economically
disadvantaged throughout her life. Moreover, given that most teenage mothers are born into
poor families, have lower levels of education, and live in threatening neighborhoods,
difficulties in isolating the effects of early pregnancy are obvious (Hoffman, 2011)).
The impact of childbearing on mothers’ labor outcomes is, therefore, difficult to
isolate as a result of the endogeneity of this decision. The literature has proposed a number
of exogenous sources of variation in family size to try to solve the problem. Rosenzweig and
Wolpin (1980), for example, used the occurrence of twins in the first pregnancy, and Angrist
and Evans (1998) used gender composition of the first two children, as instruments of family
size. However, these instruments may be less relevant for the issue of becoming a teen
mother. More relevant for this research may be instrumentation via infertility, miscarriage,
and age at menarche (Hotz, McElroy & Sanders, 2005; Fletcher & Wolfe, 2008; Aguero &
Marks, 2011).
8. 4
Our use of miscarriage and age at menarche as an instrumental variable relied on the
fact that these variables were likely to capture early childbearing more credibly than other
instruments. Based on the argument that an earlier age at menarche may increase the years
during which a young woman is at risk of becoming pregnant, Ribar (1994) and Klepinger,
Lundberg, and Plotnick (1995) analyzed the effects of early childbearing on educational
attainment. While Ribar did not find significant effects on high school completion, the
Klepinger authors found large adverse effects. Field and Ambrus (2008) used age at
menarche as an instrument for age of first marriage in Bangladesh. They found negative
effects on schooling. Delaying marriage was, in fact, associated with positive educational
outcomes.
Most of the studies over the past decades that have looked at the socioeconomic
consequences of early childbearing have focused on education and on developed countries,
especially the United States and Great Britain (see, e.g., Geronimus & Korenman, 1992;
Chevalier & Viitanen, 2003; Lang & Weinstein, 2015; and Huang et al., 2019). Such
socioeconomic consequences are less discussed with respect to labor outcomes and in the
context of low- and middle-income countries. A few exceptions include Aguero and Marks
(2011), Marchetta and Sahn (2016), Berthelon and Kruger (2017) and Branson and Byker
(2018).
Trussell and Pebley (1984) and Geronimus (1987) also emphasized the fact that teen
motherhood exposed both child and mother to greater risks of mortality. Thus, as a result of
its negative impact on women’s education and long term socioeconomic outcomes,
adolescent pregnancy and motherhood has become a major policy concern for the global
community.
At the same time, although teenage childbearing is a major problem in Brazil, only
two studies have investigated those relationships. Narita, Dolores, and Diaz (2016) used
household survey from 1992 to 2004 and health ministry data from 1981 to 1992 to create a
pseudo-panel by state of birth and cohort. Using a fixed-effect model, they found that
teenage pregnancy negatively affected educational level and labor-market outcomes. The
study had many drawbacks because the Brazilian household survey did not contain questions
9. 5
regarding age at first birth and because the authors worked with averages of cohort groups
instead of individual data.
Marteleto and Villanueva (2018), using the International Labor Organization’s 2013
School-to-Work Transitions Survey, found that early childbearing was detrimental to the
educational outcomes of Brazilian women. The authors pointed out that the sample size was
comparatively small, as a result of which they were unable to explore differences across
subgroups. Lack of such relevant variables as women’s family structure, age at sexual debut,
test scores, may also have affected the results.
Given the importance of understanding how early pregnancy affects labor outcomes,
the main objective of this study was to use data from the 2013 National Brazilian Health
Survey (Instituto Brasileiro de Geografia e Estatística, 2013) to measure the impact of early
childbearing on women’s participation in the labor market and the formal market and on their
earnings later in life. To control for the endogeneity problem in the teenage-childbearing
variable, we used age at menarche and miscarriage as instruments. Therefore, we took
advantage of a natural experiment to compare the outcomes of women who became
pregnant and gave birth in adolescence to the outcomes of women who became pregnant
in adolescence and miscarried.
1.3 Pathways of Impact Mechanisms
The direction of the expected impact of childbearing on labor-force participation is
unclear. A woman with a small child may have a smaller probability of working outside her
house because her reservation wage is higher and the time she spends at work means less
time with her child. Bearing a child early in life would also require long hours of intensive
baby care that could prevent women from entering the labor market. For example, Bloom et
al. (2009) and Schultz (2008) found a negative effect of childbearing on labor-market
outcomes.
On the other hand, teenage mothers may have a higher probability of working. In low-
income families, where teenage pregnancy is more prevalent, the lack of income and the
increase in expenses related to the new child may force women to drop out of school and
10. 6
enter the labor force as a way to support their children and maintain family income. The
entrance into the labor market, however, does not mean high-quality employment. Usually,
as a result of lack of human capital, low-paid and low-skilled jobs are prevalent.
Hotz, McElroy, and Sanders (2005) found that teenage childbearing raised the labor
supply in the United States. Similarly, Azevedo, Lopez-Calva, and Perova (2012) found in
Mexico that women who gave birth early in life had a higher probability of being employed,
and Herrera, Sahn and Villa (2019) found that motherhood had a positive impact on labor-
force participation in Madagascar.
Klepinger, Lundberg, and Plotnick (1995) observed that bearing a child early in life
had large deleterious effects on education outcomes. On the other hand, Ribar (1994)
analyzed the effects of early childbearing on educational attainment and found no significant
effects on high school completion. Hotz, McElroy, and Sanders (2005), moreover, found that
teenage childbearing had negligible consequences on the socioeconomic outcomes of
teenage mothers in the United States. The reason the authors did not obtain significant
effects is related to a discussion in the literature about the difficulties of isolating the true
effect of teenage childbearing: most teenage mothers are born into deprived families and
are not well educated. Low socioeconomic conditions that young mothers face confound the
pure effect of a bearing a child (Hoffman, 2011).
According to Becker’s human-capital theory (1994), early childbearing decreases or
prevents educational attainment and consequently affects young women’s labor-market
participation and earnings. Many girls who become pregnant have to drop out of school,
decreasing their skills and opportunities to earn income. If a teenage mother spends a large
number of hours taking care of a baby or spends time working in the labor market, she will
not have time to study and will probably drop out of school. Lower human-capital formation
results in fewer labor opportunities, more low-level jobs, and lower wage rates. Negative
impacts of early pregnancy on wage rates could then be expected.
11. 7
1.4 Endogeneity of Childbearing
The difficulties involved in interpreting the impact of childbearing on mothers’ work
(as a result of the endogeneity of the decision) have been made clear in the literature (see
Angrist & Evans, 1998; Lee, 2010; and Aguero & Marks, 2011, for example). A woman’s
decision to bear a child is influenced by such factors as her motivation and her own
assessment of her productivity and labor-market returns, factors that also affect her labor-
force participation.
To control for the endogeneity of childbearing, we used age at menarche and
miscarriage as an instrumental variable. Menarche reflects the woman’s first menstrual cycle
and, in our data, occurred from 8-23 years of age. Miscarriage equaled 1 if a woman had a
spontaneous or unwanted abortion and 0 otherwise.
The medical literature has provided evidence that age at menarche and miscarriage
are influenced by such factors as genotype, nutritional conditions, stress, use of tobacco and
alcohol, and life environment, among others (Yermachenko & Dvornyk, 2014; Szwed, Czapla
& Kosinska, 2013; and Fletcher & Wolfe, 2009, e.g.). This could make these two instruments
endogenous with respect to labor-market outcomes. Szwed, Czapla, and Kosinska (2013)
distinguished such factors as either internal (affecting the human organism) or external
(geography and socioeconomic status).
The first study to use miscarriage as an instrument for childbearing was developed by
Hotz, McElroy, and Sanders (2005). They claimed that, after they had controlled for drinking,
smoking, and early contraception, miscarriage could be used as a natural experiment to
measure the effects of teenage pregnancy on mothers’ outcomes.
Fletcher and Wolfe (2009) also used miscarriage as an instrument, but they raised the
point that it could be a non-random event predicted by the occurrence of abortion in the
individual’s environment. To deal with this possible bias, they used community fixed-effects
to control for unobserved community-level characteristics. Likewise, Ashcraft, Fernandez-Val,
and Lang (2013) and Lang and Weinstein (2015) claimed that miscarriage was non-random
when abortion was a choice. Miscarriage was not random, that is, because adolescents who
aborted usually came from wealthy families while those who miscarried were from more
12. 8
deprived families. In consequence, samples could become non-random, biasing the
estimates.
Although most variables in our analysis were based on information that women
provided during the 2013 survey, important genetic and environmental controls were also
available, such as age, race, anthropometric measures, consumption of tobacco and alcohol
during adolescence, and the occurrence of chronic diseases. We also included a variety of
socioeconomic and location variables in the models as controls to avoid possible bias (e.g.,
participation in religious activities, abortion, wealth and income indicators, household
infrastructure, women’s educational levels, state of residence, urban versus rural residence,
etc.). We believed that including all these control variables together with the instrumental
variables would solve or minimize estimation problems discussed in the literature and allow
us to obtain consistent estimates.
Taking advantage of both a rich data set from a 2013 Brazilian National Health Survey,
in which menarche and miscarriage were used as instrumental variables, and of all the controls
on socioeconomic and health aspects, we concluded that early pregnancy increased labor-
force participation as a result of young mothers’ need to generate additional income.
Because we observed a decline in the probability of working in formal jobs and a decrease in
earnings, however, a selection into “bad jobs” also occurred. Heterogeneous effects showed
larger effects in such less privileged groups as black and mulatto women, women living in
poor regions, or women in the 50% lowest income group. These results indicate that, for
women from low-income families and poor socioeconomic environments, early-age
childbearing may perpetuate the cycle of poverty.
13. 9
II. The Brazilian National Health Survey Data
The Brazilian National Health Survey was a national household survey undertaken by
the Brazilian Geographical and Statistical Institute in 2013 (Instituto Brasileiro de Geografia e
Estatística, 2013) in partnership with the Brazilian Ministry of Health. It was composed of three
separate questionnaires: (i) household, with information on household characteristics; (ii) all
members of the household, with an adult member of the household as respondent; and (iii)
individual, with an emphasis on chronic diseases, life style, and access to healthcare; one
member of the household aged 17 or older was the respondent. There were measures of
height and weight for each adult member of the household. The sample included 81,767
households in 1,600 municipalities, and the data were representative of all twenty-six states
and the Federal District in Brazil, and of rural, urban, and metropolitan areas.
Women from 18-49 were asked about fertility, abortion, miscarriage, age at menarche,
healthcare, labor-market participation, wages, income, education, etc.
III. Methodology
Consider the following equation:
!" = $"% + '"( + )" (1)
where Yi represents labor outcomes (labor-force participation, formal labor
participation, and earnings), Xi is a vector of control variables, and Ci is the childbearing
variable, which is 1 if a woman from 20-49 bore a child before age 20 and is 0 otherwise.
In an attempt to account for the endogeneity of childbearing, we used instrumental
variables that were uncorrelated with the error term εi but which were correlated with the
endogenous variable Ci. The instrumental variables were menarche (Mei ) and miscarriage (Mii
). Menarche reflects the woman’s age at her first menstrual cycle and ranged from 8-23 years
of age, while miscarriage was equal to 1 if a woman had a spontaneous or unwanted abortion
and 0 otherwise.
14. 10
Because Ci was endogenous, we estimated the equation
'" = *+"%, + *-"%. + $"% + /"
to obtain '1" that was be used in Equation 1 to consistently obtain the parameter
estimate of interest (1.
The outcome variables (labor-force participation and formal labor participation) as well
as the right-hand-side variable, childbearing, were treated as binary or continuous and
depending on that, a bivariate-probit or instrumental-variable model was applied,
respectively.
According to Wooldridge (2010), as a result of the fact that both the outcome variable
and the endogenous right-hand-side variable (childbearing) were dichotomous, the correct
model to account for the presence of endogeneity was the bivariate probit. This model was
appropriate if there were at least one variable that was correlated with whether or not a
woman bore a child early in life and was uncorrelated with women’s participation in the labor
force. We used menarche and miscarriage as instrumental variables. After controlling for
other observed factors, we noted that menarche and miscarriage did not determine labor-
force participation.
Besides Wooldridge (2010), who showed that the appropriate model to use when the
probit contains an endogenous binary explanatory variable is the bivariate probit model,
Angrist (1991) pointed out that the standard two-stage least squares model was an alternative
to the bivariate probit model. Using a Monte Carlo simulation, Angrist (1991) showed that
estimating the model using an instrumental variable approach and ignoring the fact that the
dependent variable was dichotomous, gave similar results as did estimates in a bivariate
probit model.
Moreover, we estimated the effect of childbearing on earnings using Heckman
selection correction model with an endogenous explanatory variable because only 62% of
women worked. In this case, earnings per hour were calculated as the women’s monthly
earnings from all jobs divided by the number of hours worked.
15. 11
IV. Data Analyses
4.1 Summary Statistics
A teenage pregnancy, as defined by the World Health Organization (2004), is a
pregnancy that occurs for a woman under the age of 20. This definition is also used by
American Pregnancy Association and by UNICEF.
Table 1 shows a description of the variables used in the estimations as well as the
mean and standard-deviation for women from 20-49 who bore a child before the age of 20
(childbearing = 1) or at 20 or older (childbearing = 0). The averages of the variables used in
the regression models and presented in Table 1 show worse socioeconomic and health
conditions for women who bore a child earlier in life. For example, family income, educational
level, and whether they had piped water and sewage systems were worse in the case of
women who bore a child before the age of 20. More than 65% of women worked when they
bore a child at 20 or older, while near 56% worked when they bore a child before they were
20. A large percentage of women worked in formal jobs when they had children later in life.
We observed that the value of the wage was almost half when women were mothers at a
young age. Although ours was a very simple descriptive analysis, there was an indication that
bearing a child at a young age probably prevented women from studying and from acquiring
skills that would have allowed them to find better jobs and higher salaries.
Figures 1 and 2 show the percentage of women aged 20-49 who bore a child before
age 20, separated by family income (quartile of the distribution) and educational level,
respectively. As expected, the largest percentage of teenage childbearing occurred in the
lower-income group, where 48% of women gave birth to a child before they were 20. On the
other hand, the percentage of childbearing in the wealthiest families was 22%. Figure 2 shows
that close to 60% of women with a low level of education bore a child before age 20, but this
happened among only 13% of women with college degree.
16. 12
Figure 1: Percentage of Women from 20-49 Who Bore a Child Before Age 20, by Income Level
Figure 2: Percentage of Women from 20-49 Who Bore A Child before Age 20 (Childbearing=1)
or at 20 or Older (Childbearing=0), by Educational Level
Figure 3 shows the percentage of women from 20-49 who bore a child before the age
of 20 by the first occurrence of menstruation. Menarche was an instrumental variable, and
identification of the IV model therefore required correlation between childbearing and
menarche. There was a negative correlation between age at menarche and teenage
pregnancy. Girls who had their first menstrual cycle early in life had a higher probability of
bearing a child before the age 20. To put it another way, young women with early menarche
tended to become pregnant at a younger age than did later-maturing women.
17. 13
Figure 3: Percentage of Women from 20-49 Who Bore a Child before Age 20,
by Age at First Menstruation
Also, if the instrument was strong, the labor-market participation of women should
have decreased with the age at menarche via a lower rate of early pregnancy among women
with late menarche, as shown in Figure 4.
Figure 4: Percentage of Women from 20-49 Working
by the Age of First Occurrence of Menstruation
Figure 5 shows age at menarche by percentile groups. Some women had their first
menstruation at 8 years old and others as late as 23. The largest percentage occurred at 12
and 13, but large numbers of women also experienced menarche at 11, 14, or 15.
.25.3.35.4.45.5
childbearing
8 10 12 14 16 18
menarche
95% CI Fitted values
.58.6.62.64.66
work
8 10 12 14 16 18
menarche
95% CI Fitted values
18. 14
Figure 5: Percentage of Women from 20-49, by Age at First Menstruation
4.2 Instrumental Variables
To check the validity of the two instrumental variables, menarche and miscarriage, we
ran a simple OLS model of childbearing as a function of menarche and miscarriage. In order
to be valid instruments, those variables should have had a large impact on childbearing. As
expected, the t-test equaled 9.2 for menarche and 23.1 for miscarriage, both highly
significant. On the other hand, menarche and miscarriage should not have had an effect on
a woman’s participation in the labor force. We ran a probit model of women’s decisions to
work as a function of menarche and miscarriage and observed that the z-tests were very low
(1.1 for menarche and 1.2 for miscarriage) and not statistically significant at the 10% level or
lower. These results suggest that a spontaneous abortion or age at first menstruation did not
affect the woman’s decision to work, but they did affect women’s decisions to have a baby
earlier in life. Although these were not formal tests, knowing that a single equation model
was wrongly specified gave us an idea of the validity of the instrumental variables.
Table 2 shows the first-stage equations for labor-force participation (Columns 1 and
2) and participation in formal jobs (Columns 3 and 4) for the bivariate probit model and the
two-stage least squares model. Column 5 shows first-stage results for the earnings equation,
which includes, besides menarche and miscarriage, the inverse of the Mills ratio to correct for
selectivity bias as a result of the fact that only 62% of women in the sample participated in
19. 15
the labor force. The instrumental variables age at menarche and miscarriage were highly
significant in all childbearing equations. Menarche had a negative effect and miscarriage a
positive effect on childbearing. The negative sign of the coefficient for menarche indicated
that, the later the occurrence of first menstruation, the older a woman would be when she
got pregnant. The positive sign of the coefficient for miscarriage showed higher risks involved
in teen pregnancy. The literature has indicated that a large percentage of teen pregnancies
result in miscarriage because many teenagers lack the nutrition, development, and growth
necessary for a healthy pregnancy.
Estimating a two-stage least squares model allowed us to test the strength of the
instrumental variables more rigorously. Instrumental variables had to be correlated with
endogenous right-hand-side variable and orthogonal to the error term in the structural
equation. The former condition could be tested by observing the fit of the first-stage
regression.
For the labor-force participation equation, the Sanderson-Windmeijer multivariate F
test of excluded instruments was highly significant and equaled 180.2. The under-
identification test showed the explanatory power of the instruments. According to Baum
(2006), if no explanatory power exists, the model is unidentified with respect to the
endogenous variable, and if the “bias of the IV estimator is the same as that of the OLS
estimator, [the] IV becomes inconsistent, and nothing is gained from instrumenting” (211).
The Kleibergen-Paap rk Lagrange Multiplier test resulted in a chi-squared distribution and
was equal to 333.6, showing that the instruments did have explanatory power. Besides the
under-identification test, the Cragg-Donald Wald F statistic (192.0) was highly significant.
For the second condition (the strength of the instrumental variable), given that we had
over-identified instrumental-variable estimations (2 IV and 1 endogenous variable), we tested
the orthogonality of the error term with the over-identifying instrumental variable using the
Hansen J test. The result of this chi-squared test was 0.63, and we did not reject the
hypothesis of no correlation between the error term and the over-identifying instrumental
variable. This type of test is conditional on one of the two instruments being valid.
Similarly, for the formal-labor participation and earnings equations, the Sanderson-
Windmeijer multivariate F test of excluded instruments was highly significant (113.6 and 90,
20. 16
respectively). The Kleibergen-Paap rk Lagrange Multiplier test showed a chi-squared
distribution and was equal to 210.9 and 324.4, showing that the instruments had explanatory
power. The weak identification test, the Cragg-Donald Wald F statistic, was highly significant
at 124 and 97.3. The Hansen J chi-squared test was 25.6 and 28.5, and we did reject the
hypothesis of no correlation between the error term and the over-identifying instrumental
variables.
Although these tests are widely used in the literature, some authors have criticized the
importance given to them in choosing valid instrumental variables. Parente and Silva (2012)
pointed out that “whether or not the overidentifying restrictions are valid gives little
information on whether the instruments are correlated with the errors of the underlying
economic model and on whether parameters of interest can be successfully identified” (315).
Deaton (2010) discussed similar issues and stated that “when random control trials are not
possible, the proponents of these methods advocate quasi-randomization through
instrumental variable (IV) techniques or natural experiments…. I argue that many of these
applications are unlikely to recover quantities that are useful for policy or understanding: two
key issues are the misunderstanding of exogeneity and the handling of heterogeneity” (424).
Angrist and Pishche, in their Mostly Harmless Econometrics, wrote that “overidentification
testing … whether multiple instruments are validated according to whether or not they
estimate the same thing, is out the window in a fully heterogeneous world” (2009, 166).
V. Main Results
Tables 3, 4, and 5 present the results of the impact of teenage childbearing on work
participation, formal market participation, and earnings, respectively. In each of these results,
we included these control variables: age, level of education, race, number of children, marital
status, household infrastructure, income, presence of chronic diseases, weight and height,
consumption of alcohol during adolescence, smoking habits during adolescence, religious
activities, occurrence of abortion, and location, which included twenty-six Brazilian states and
21. 17
the Federal District as well as urban/rural areas. Menarche and miscarriage were used as
instruments.
5.1 The Effect of Childbearing on Women’s Labor-Force Participation
As a result of the endogeneity of childbearing or the unobserved effects present in
the error term, more independent women with higher economic autonomy and who are more
career-oriented probably postpone pregnancy or even choose not to have children, deciding
at the same time to participate more actively in the labor market. If omitted variables (e.g.,
being an autonomous women) led to both higher employment and reduced childbearing, we
should have observed a downward bias on the childbearing coefficient in the uncorrected
labor-market participation model. Similarly, the coefficient should have been larger in the
corrected model (IV) if the instruments were performing adequately. This is, indeed, what we
observed.
Ignoring the endogeneity of childbearing, Column 1 of Table 3 presents the marginal
effects of the probit model with the binary dependent variable (1 if a woman participated in
the labor force and 0 otherwise). For comparison reasons, we also estimated an ordinary least
square model (OLS), whose result is displayed in Column 2. In both cases, the coefficient of
childbearing was positive and not statistically significant at the 10% level or less. However, in
a more appropriate model, such as the bivariate probit, the coefficient of childbearing was
significant at the 5% level, as shown in Columns 3 and 4 for the coefficient and the marginal
effect, respectively.
The last column of Table 3 presents the second-stage estimations of the two-stage
least squares model. In this case, the effect of childbearing was also positive and statistically
significant. The coefficient of childbearing was 0.09, very similar to the marginal effect of
childbearing in the bivariate probit model (0.11).
Based on these results, we concluded that bearing a child before age 20 increased
the probability that a woman would enter the labor force by nine to eleven percentage points.
The positive coefficient may be explained by the fact that early-age pregnancy would require
more income to deal with the extra expense of a child, including medical care, schooling,
22. 18
food, etc. Consequently, women would probably drop out of school and enter the labor
market.
Although most papers have found a negative relation between childbearing and
employment, Hotz, McElroy, and Sanders (2005), using data from United States, showed that
teen mothers were more likely to work during their early adulthood than those who delayed
childbearing. Similarly, Azevedo, Lopez-Calva, and Perova (2012), using Mexican data from
the National Survey of Demographic Dynamics, found that the probability of being employed
for women who gave birth during their adolescence was, on average, twenty-one percentage
points higher, compared to their counterparts who miscarried.
We also ran the same models using only menarche and only miscarriage as
instrumental variables. The significance of both menarche and miscarriage alone was very
high, and the effect of each IV on teenage pregnancy was the same as before: negative for
menarche and positive for miscarriage. The impact of childbearing on labor-force
participation in both cases was positive. The childbearing coefficient was significant at the
10% level for menarche and at the 1% level for miscarriage.
5.2 The Effect of Childbearing on Women’s Participation in Formal
Jobs
The impact of teenage childbearing on labor-force participation showed that early
pregnancy drove women to work, but that work probably involved low-skilled jobs, given
women’s income needs and lack of skills. To test this hypothesis, we estimated the impact of
early pregnancy on formal labor participation. The idea was that low-skilled jobs with more
time flexibility and which did not require a high level of education were more informal and
that young mothers would be more likely to be involved in this type of work.
We considered women working as employees in private or public sectors to be
engaged in formal jobs, while domestic servants, self-employed, or unpaid employees were
considered informal workers.
The results in Table 4 confirm that the probability of working in formal jobs for women
pregnant at an early age was twelve percentage points lower (probability of working meaning
23. 19
that more of these women were engaged in low-skilled work). Estimating the bivariate probit
model or instrumental variable model again gave very similar childbearing coefficients (-0.12
and -0.11). The childbearing coefficient in the IV model (0.11), although not statistically
significant at the 10% level, was significant at the 11% level.
Aguero and Marks (2011) observed a similar decline in the probability of paid work
for women who were adolescent mothers, concluding that being a mother at an early age
affected the type of work a woman sought.
5.3 The Effect of Childbearing on Women’s Earnings
To obtain the impact of teenage childbearing on women’s earnings, we estimated a
sample-selection model (Heckman two stage type model) with an endogenous explanatory
variable. The results are presented in Table 5. Here, menarche and miscarriage were
instrumental variables, and childbearing was an endogenous right-hand-side variable in the
earnings equation. All variables were treated as controls except childbearing. For
identification of the structural equation, we needed some variables that affected labor-force
participation but not the wage offer. In this case, we excluded from the wage equation and
included in the labor-force participation equation these variables: number of children below
the age of 6 and number of children between 6 and 14 years old. Those variables were
essential to explaining women’s decisions to work but, at the same time, should not have
affected hourly wage rates.
Comparing the childbearing estimate using OLS (Column 1) with the IV estimate
(Column 2) shows a smaller coefficient for OLS in absolute terms. Therefore, other,
unmeasured effects might exist, such as girls living in poorer socioeconomic conditions who
wished to be free of their parents because of family conflicts and who chose to get pregnant
as a way to get married and escape from their families. Such a choice, however, could drive
an adolescent out of school and into a low-wage job.
We should also point out that the instrumental variable estimate reflected the effect
of childbearing only for the population whose choice of the treatment was affected by the
instruments, which was the local average treatment effect (LATE). LATE is the average
24. 20
treatment effect for the sub-population of compliers and is not informative about effects on
always-takers and never-takers. In our case, because we used miscarriage and age at
menarche as instruments to identify the endogenous childbearing variable, distinguishing
compliers from noncompliers was not straightforward.
The results show that the coefficient of childbearing was highly significant and
negative. Bearing children at a young age had the effect of decreasing women’s hourly wages
by 0.25 percentage points, measured in logarithm, which was equivalent to a 28% decrease
in the average wage rate. This very large decrease in wages reflected the fact that early-age
mothers may work in low-skilled and low-paid jobs compared to women who bear a child
later in life.
Fletcher and Wolfe (2009) found a decline in income and wages of $2,200 to $2,400
per year and a drop in the probability of finishing high school for women who gave birth as
teens.
One of the mechanisms driving young mothers to work in unskilled jobs and to receive
lower wages was low education. We expected teenage mothers to drop out of school and
therefore reduce their number of years of education. As a result of their lower human-capital
skills and fewer opportunities to find high-quality jobs, mothers’ wages would decrease. To
check the veracity of this argument, we estimated the effect of early childbearing on years of
education using two-stage least squares.
The coefficient of childbearing was highly significant and negative, indicating that
bearing a child before the age of 20 decreased women’s education by approximately 1.3
years.
Children start school in Brazil at the age of 6 and are supposed to finish primary level
at the age of 14. These nine years in primary school are mandatory. After that, they should
spend three years in high school and then start college. Data from the 2015 Brazilian National
Household survey showed that 52% of the adult population (i.e., over 25) had only primary
school education (nine years). Only 26% had finished high school, and 13.5% had a college
degree (Instituto Brasileiro de Geografia e Estatística, 2015a).
25. 21
The average number of years of education in the Brazilian National Health Survey
sample was 9.2 (Instituto Brasileiro de Geografia e Estatística, 2013). Therefore, a decrease
of one year of education as a result of adolescent pregnancy is equivalent to a 14% reduction
in the average number of years of education.
5.4 Exploring Heterogeneity in Effects of Childbearing
Table 6 shows the heterogeneous effects of childbearing on labor-force participation,
formal labor market participation, and earnings per hour. The full sample of women was
divided into two color/racial groups (black/mulatto and white/Asian), two income level groups
(lowest 50% and highest 50%), and two regional groups (North/Northeast and
South/Southeast/Central).
Brazil’s ethnic groups differ in many ways, including the rates of teenage childbearing.
Black and mulatto Brazilian women are poorer than Asians and whites and so are more likely
to have children earlier in life. In the 2013 Brazilian National Health Survey, the percentage
of white adolescents (<20 years old) who bore a child was 28.9% (Instituto Brasileiro de
Geografia e Estatística, 2013). Rates for blacks and mulattos’ adolescents were higher: 38.1%
and 43.2%, respectively. Dividing the sample by race, we observed that blacks and mulattos
had larger positive probabilities than whites or Asians of working after early-age childbearing.
Adolescent black and mulatto mothers also had a highly significant coefficient with a drop in
wages of 30%. On the other hand, the white and Asian group presented the largest decrease
in formal labor participation. Probably, the wealthiest women who were already working in
formal jobs, once they were pregnant or had a small child, had to find more time-flexible
positions whose skill requirements were lower.
Using family income without considering a woman’s wages, we constructed an income
variable and divided the sample between women in the bottom 50% lowest family income
and the upper 50% highest family income. Childbearing was not statistically significant when
considering the probability of entering the labor force. However, the probability of working
in formal jobs when pregnant among women in the upper-income group, who probably had
better jobs, ended up decreasing. In addition, the per-hour wages of women who bore a
26. 22
child early in life were reduced by almost 47% in lower-income families, while a smaller effect
was observed for the upper-income group.
Brazil is divided into five large regions with major cultural and socioeconomic contrasts
among them. In the poorest North and Northeast regions, 42.5% of women bear a child early
in life while, in the South, Southeast, and Central regions, the percentage is lower and near
31%. Women in the poorest regions had a greater probability of working and of receiving
lower wages (a 34% drop) when they bore a child before the age of 20. Those in wealthier
families, however, were less likely to work in formal jobs when they were pregnant at an early
age.
Looking at the impact of childbearing on education for each category, we observed
that, in all groups, childbearing decreased the educational level by one year or more.
Independent of race, income level, or region, bearing a child early in life decreased women’s
learning and skills.
VI. Policy Implications and Recommendations
6.1 Childbearing and Labor-Force Participation
As our results showed, childbearing had a positive impact on labor-force participation.
Joining the labor force for most teenage mothers may be a necessity rather than a choice
but, in most cases, it is likely that entering the labor force may be difficult. Women may end
up accepting jobs that are harder to perform and which pay low wages because of the
additional financial demands that come with a child. Herrera, Sahn, and Villa (2019) discussed
this issue, noting that women who bore their first child during adolescence ended up in low-
quality, informal jobs, a sector that usually does not provide medical coverage or other social-
welfare benefits. This ultimately reduced their welfare and the time they could devote to their
children. In line with the social safety nets that have been attempted in several countries, we
recommend a guarantee of a public-sector job for a time-bound period, which could also
27. 23
result in consumption-smoothing. It would also significantly reduce the job search time of
teenage mothers.
6.2 Childbearing and Wages
Our results indicated a negative impact of childbearing on wages. This was intuitive,
given the demands on teenage mothers’ time and energy. In cases of blue-collar work, wages
may decline sharply in light of mothers’ health restrictions during pregnancy and after
childbirth. Manual labor can also have an impact on newborn children because mothers may
be at their jobs and the result may be a reduction in time and energy available for children.
In this respect, it is important for local governments to implement consumption-smoothing
schemes that would work essentially in the same way as unemployment insurance (see
Gruber, 1994 and Ahmed, 2017).
While past experience indicates that government support to teenage workers has
been the key to consumption-smoothing, appropriate legislative efforts can also bind
employers to do more for teenage mothers (see examples in Ahmed, Zeshan & Wahab, 2013
and Ahmed & Zeshan, 2013).
Governments can also allow tax credits to employers who allow leave with pay (of
some proportion) and who contribute toward health care coverage. In the event that such
mechanisms are not possible, which may be the case in a developing country, the solution
could be a universal basic allowance during pregnancy and for some part of the time after
birth (see Ostner & Schmitt, 2008).
6.3 Childbearing and Education
Our results indicated a negative effect of teenage childbearing on women’s
education. A two-pronged policy effort will be required if girls’ rights to education are to be
safeguarded from the impact of childbearing. First, during the period leading up to childbirth,
young women need access to an extensive network of women’s education and counseling
units in schools and colleges that can inform the expecting teenager how best to deal with
the evolving situation. This support is necessary as is the option of taking a deferment from
28. 24
school, which school administrations should make easier. This would, however, require
appropriate legislative reforms at the national level.
Second, the post-birth period is crucial for teenage mothers given the increased
demands on their time. It is at this stage that schools as well as district-level administration
should subsidize or provide free services that should include daycare services for the baby
and counseling for the mother. Having a child also results in additional financial demands.
These need to be covered through dedicated social-safety-net-programs as explained below.
The literature can provide some guidance for designing such programs. Narita, Dolores, and
Diaz, 2016), for example, suggested that girls who gave birth as teenagers usually tended to
catch up (with appropriate help) with higher-level education while they were still young,
though doing so became difficult as they grew older.
6.4 Childbearing and Poverty
Our analyses clearly show that low-income women were most affected by early-age
pregnancy. Women in low-income families have a larger reduction in the number of years in
school when they have a baby early in life, and they receive lower wages, probably as a result
of a reduction in education. Therefore, poverty seems to be exacerbated as a result of
teenage childbearing.
An ample literature has suggested that early-age mothers are not well represented in
national or sub-national welfare programs, though no consensus exists regarding what kinds
of welfare programs can break the linkages between early-age childbearing and poverty. A
response would, of course, also depend upon country setting and, perhaps, sub-national
political economies if the program is designed for a specific place. As the competition for
public resources increases, both preventive and remedial approaches to teenage pregnancy
should be considered, both of which have been successful under certain conditions. Moore
and Wertheimer (1984), for example, suggested conditions under which strategies to prevent
early childbearing might be successful and might, over time, ultimately reduce demands on
scarce public resources. Several other studies have also pointed out that the costs associated
with preventive strategies are lower than those associated with remedial programs (public
investment to keep teenage mothers in school, e.g.).
29. 25
School- and community-based education and programs that show girls both how to
avoid early pregnancy and its consequences have gained traction in several countries. In
Brazil, for example, it has been widely suggested that many girls get pregnant to be free of
their parents, thinking that life may offer better outcomes. Their lack of information results in
worse situations. Recent experience also indicates the usefulness of social enterprises that
can help teenage mothers at a local level, particularly where pure-market and pure-public
models of assistance fail (see Richardson et al., 2017).
6.5 Childbearing and Inequality
Our results provide some evidence of how childbearing may aggravate inequality in the
Brazilian context. For example, we separately analyzed the impact of teenage childbearing
on labor-force participation to see whether early pregnancy drove women to work and
whether, given their income needs during pregnancy and after childbirth and their low job
skills, work opportunities were limited to low-skilled jobs.
In our country-specific context, “formal” means work in the private sector, in the
public sector with a contract, or as an employer. Informal jobs are domestic service, self-
employment, or unpaid work. The results in Table 4 confirm that the probability of working
in a formal job was twelve percentage points lower for women with early-age pregnancies,
meaning that they were employed in low-skilled jobs. These results have implications for the
widening of overall and inter-gender income inequalities (see also Ahmed & O’Donoghue,
2010; and Khan et al., 2016).
VII. Conclusions
As women’s labor-force participation increases and adolescent pregnancy remains a
significant challenge in many developing countries, measuring the impact of teenage
childbearing on labor participation, participation in formal jobs, and earnings becomes
30. 26
important, as is analyzing the mechanisms through which childbearing affects labor
outcomes. To this end, we analyzed data from the 2013 National Brazilian Health Survey.
To control for the endogeneity problem in the teenage childbearing variable, we used
age at menarche and miscarriage as an instrumental variable. Depending on the outcome
variable, we estimated specific econometric models, such as a bivariate probit model, a two-
stage least squares model, and a Heckman two-stage procedure.
The results showed that bearing a child before the age of 20 increased the probability
that a woman would enter the labor force by nine to eleven percentage points. This positive
coefficient or the increase in labor-market participation can be explained by the fact that
being pregnant at an early age requires more household resources to deal with the extra
expenditures for a new child (medical treatment and schooling, e.g.). However, this increase
in labor-force participation was related to a decrease in formal jobs by twelve percentage
points, meaning that teenage mothers were more involved in informal jobs that require fewer
skills and are more flexible in time. However, informal jobs give women fewer welfare
benefits.
With respect to earnings, we observed that having babies at a young age decreased
women’s hourly wages by 0.25 percentage points, measured in logarithm, which was
equivalent to a 28% decrease in the average hourly wage rate.
It is clear that early pregnancy affects labor participation and earnings through
education. We found that adolescent pregnancy reduces women’s education by 1.3 years,
which was equivalent to 14% reduction in the average number of years of education in the
sample.
We have also investigated heterogeneous effects by diving the full sample of women
into two color/racial groups (black/mulatto and white/Asian), two income level groups (lowest
50% and highest 50%), and two regions groups (North/Northeast and
South/Southeast/Central).
31. 27
Black and mulatto teenage mothers as well as those living in the poorest regions of
Brazil have a higher probability of working and significantly lower wages.2
Independent of
race, income level, or region, it is clear that bearing a child early in life decreases women’s
learning and skills by more than a year of education.
Policies to reduce teenage pregnancy include education programs in sexuality,
relationships, sexual behavior, sexual health, family planning, etc. Adolescents and families
in more vulnerable groups should be aware of pregnancy prevention and should have
information and access to anticonception methods. Day care centers would assist teenagers
in restarting their schooling and consequently in finding better quality jobs that would
provide higher earnings and improve women’s quality of life.
2
Our results focused mainly on the economic side of the problem. The health side, however, is extremely
important and well documented. For example, besides being associated with health problems and a higher risk
of maternal mortality, teenage pregnancy generates barriers to the psychological and social development of
young women. Moreover, the children of adolescents have a higher probability of being unhealthy and of ending
up in poverty.
32. 28
Table 1. Descriptive Statistics for the Group of Women
Who Bore a Child before Age 20 (Childbearing=1) and at Age 20 or Older (Childbearing=0)
Childbearing = 0 Childbearing = 1
Variables Description of the variables number mean s.d. number mean s.d.
wage_hour wage per hour (reais) 8573 11.0 15.37 4301 6.47 8.06
lnwage_hour log wage per hour 8573 1.96 0.88 4301 1.55 0.77
Work 1 if works and 0 otherwise 13406 0.65 0.48 7956 0.56 0.50
Formal 1 if works as employee or employer 8,695 0.70 0.46 4,412 0.52 0.50
years education Number of years of education 13406 10.25 4.12 7956 7.46 4.39
Miscarriage 1 if had miscarriage 13406 0.14 0.35 7956 0.26 0.44
Menarche age at first menstruation 13271 12.93 1.65 7908 12.73 1.50
Age woman’s age from 20 to 49 13406 34.31 8.26 7956 33.99 8.03
primary_sch if had primary school or not 13406 0.21 0.40 7956 0.42 0.49
high_sch if had completed high school or not 13406 0.43 0.50 7956 0.34 0.47
graduate_sch if had completed graduate school or not 13406 0.30 0.46 7956 0.10 0.30
other_races black, mulatto, or indigenous race 13405 0.57 0.50 7956 0.70 0.46
chless6 number of children younger than 6 13406 0.34 0.59 7956 0.51 0.72
child6_14 number of children between 6 and 14 13406 0.54 0.78 7956 0.96 1.04
with_husband 1 if husband was in the household 13406 0.59 0.49 7956 0.68 0.46
Plumb 1 if household had plumbing water 13406 0.83 0.38 7956 0.73 0.44
Sewerage 1 if household had sewage system 13406 0.76 0.43 7956 0.62 0.48
faminc_ownearn family labor income - own earnings (÷1000) 13406 1.86 4.04 7956 1.14 1.69
Nonlaborinc family non-labor income (divided by 1000) 13406 0.50 1.32 7956 0.36 0.80
Chronic_disease 1 if diagnosed with a chronic disease 13406 0.13 0.34 7956 0.13 0.34
religious 1 if often participated in religious activities 13406 0.55 0.50 7956 0.52 0.50
33. 29
Childbearing = 0 Childbearing = 1
Variables Description of the variables number mean s.d. number mean s.d.
Urban 1 if household was in urban area 13406 0.87 0.34 7956 0.78 0.41
Weight Weight in kilograms 12599 66.71 14.38 7516 67.66 14.6
Height Height in centimeters 12611 159.75 7.00 7522 157.77 6.76
Drink_adolesc 1 if consumed alcohol during adolescence 13406 0.11 0.30 7956 0.11 0.30
Smoke_adolesc 1 if smoked during adolescence 13406 0.10 0.29 7956 0.18 0.38
Abortion 1 if had non-spontaneous abortion 13406 0.02 0.13 7956 0.04 0.21
Source: The 2013 Brazilian National Health Survey (Instituto Brasileiro de Geografia e Estatística, 2013).
34. 30
Table 2. Childbearing First-Stage Regressions
Labor-force participation Formal Log wage
hour
Bivariate
probit
(1)
IV Model
(2)
Bivariate
probit
(3)
IV Model
(4)
IV Model
(5)
menarche -0.0662*** -0.0212***
-0.064
***
-0.0208***
-0.0196***
(0.0063) (0.0019) (0.0083) (0.0024) (0.0024)
miscarriage 0.386*** 0.132*** 0.403*** 0.134*** 0.132***
(0.025) (0.0087) (0.032) (0.011) (0.011)
Mills Ratio - - - - 0.583***
(0.106)
Sanderson-Windmeijer F
(excl. instruments) 176.8 *** 110.7 *** 91.7 ***
Kleibergen-Paap rk LM (under-
identification test) 327.7 *** 205.9 *** 331.0 ***
Cragg-Donald Wald F (weak
identification) 188.7 *** 121.3 ***
91.7 ***
Hansen J statistic (over-identification
test) 0.48 26.0 ***
34.8 ***
N observ 19,873 19,873 12,323 12,323 12,104
Note: Standard errors in parentheses. *Significance at 10%; **significance at 5%; ***significance at 1%.
Control variables included age, race, education, number of children, whether respondent drank or
smoked during adolescence, whether respondent ever had an abortion, whether religious, weight,
height, chronic diseases, household infrastructure, family income, and location (twenty-six states+
Federal District).
Source: The 2013 Brazilian National Health Survey (Instituto Brasileiro de Geografia e Estatística, 2013).
Table 3. Labor-Force Participation Equations for Women from 20 to 49, Estimated Using Probit,
OLS, Bivariate Probit, and Two-Stage Least Squares Models
Bivariate Probit IV Model
Variables
Probit dy/dx
(1)
OLS
(2)
Work
(3)
dy/dx
(4)
Work
(5)
childbearing 0.0024 0.0013 0.346** 0.114** 0.091
(0.0079) (0.0073) (0.136) (0.043) (0.054)
ρ = -0.21 *
F-statistics 57.1 *** 70.0 ***
N. observations 20,036 20,036 19,873 19,873 19,873
Note: Standard errors in parentheses. *Significance at 10%; **significance at 5%; ***significance at 1%.
Control variables included age, race, education, number of children, whether drank during
adolescence, smoked during adolescence, whether respondent ever had an abortion, whether
35. 31
religious, weight, height, chronic diseases, household infrastructure, family income, and location (twenty-
six states+ Federal District).
Source: The 2013 Brazilian National Health Survey (Instituto Brasileiro de Geografia e Estatística, 2013).
Table 4. Formal Labor Equations for Women from 20-49, Estimated Using Probit Model, OLS
Model, Bivariate Probit Model, and Two-Stage Least Squares Models
Variables
Probit OLS
(2)
Bivariate probit IV Model
dy/dx
(1)
Formal
(3)
dy/dx
(4)
Work
(5)
childbearing -0.040 *** -0.036 *** -0.377** -0.122** -0.106
(0.0103) (0.0090) (0.170) (0.0575) (0.067)
ρ = 0.16 *
F-stat 63.5 *** 77.2 ***
N. observations 12,412 12,412 12,323 12,323 12,323
Note: Standard errors in parentheses. *Significance at 10%; **significance at 5%; ***significance at 1%.
Control variables included age, race, education, number of children, whether respondent drank or
smoked during adolescence, whether respondent ever had an abortion, whether religious, weight,
height, chronic diseases, household infrastructure, family income, location (twenty-six states+ Federal
District).
Source: The 2013 Brazilian National Health Survey (Instituto Brasileiro de Geografia e Estatística, 2013).
Table 5. Log Wage Hour Equations for Women 20-49, Estimated Using OLS and Heckman Two-
Stage Models.
Variables OLS
Heckman
Procedure
Log wage hour
childbearing -0.090*** -0.252***
(0.014) (0.084)
F-stat 159.06*** 123.8***
N. observations 12,191 12,104
Note: Standard errors in parentheses. *Significance at 10%; **significance at 5%; ***significance at 1%.
Control variables included age, race, education, number of children, whether respondent drank or
smoked during adolescence, whether respondent ever had an abortion, whether religious, weight,
height, chronic diseases, household infrastructure, family income, location (twenty-six states+ Federal
District).
Source: The 2013 Brazilian National Health Survey (Instituto Brasileiro de Geografia e Estatística, 2013).
36. 32
Table 6. The Effect of Childbearing on Labor outcomes for Different Categories, Estimated
Using Bivariate Probit and Two-Stage Least Squares (2SLS) Models.
Work Formal Job Log wage
hour
Bivariate
Probit
2SLS - IV Bivariate Probit 2SLS - IV 2SLS - IV
dy/dx dy/dx
Black and mulatto .126 * .114 * -0.005 -0.042 -0.263 ***
s.e. (0.057) (0.067) (0.072) (0.081) (0.103)
Observations 12,270 12,270 7,236 7,236 7,084
White and Asian .122 * 0.073 -0.143 * -0.192 * -0.230 *
s.e. (0.065) (0.09) (0.085) (0.116) (0.138)
observations 7,603 7,603 5,087 5,087 5,020
50% lowest income 0.059 0.023 0.004 -0.032 -0.383 ***
s.e. (0.052) (0.061) (0.071) (0.080) (0.096)
observations 10,302 10,302 6,451 6,451 6,331
50% highest income 0.121 * 0.103 -0.295 *** -0.244 ** -0.260 *
s.e. (0.073) (0.087) (0.066) (0.125) (0.143)
observations 9,571 9,571 5,872 5,872 5,773
Poorest regions (N,NE) 0.159 *** 0.163 ** -0.0063 -0.015 -0.296 **
s.e. (0.057) (0.071) (0.079) (0.087) (0.12)
Observations 10,800 10,800 6,032 6,032 5,878
Wealthiest regions
(S,SE,C)
0.062 -0.011 -0.144 * -0.202 * -0.145
s.e. (0.067) (0.081) (0.075) (0,106) (0.112)
observations 9,073 9,073 6,291 6,291 6,226
Note: Standard errors in parentheses. *Significance at 10%; **significance at 5%; ***significance at 1%.
Control variables included age, race, education, number of children, whether respondent drank or
smoked during adolescence, whether respondent ever had an abortion, whether religious, weight,
height, chronic diseases, household infrastructure, family income, location (twenty-six states+ Federal
District).
Source: The 2013 Brazilian National Health Survey (Instituto Brasileiro de Geografia e Estatística, 2013).
37. 33
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