DCP Chapter 28: Postponing Adolescent Parity in Developing Countries through Education: An Extended Cost-Effectiveness Analysis

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The World Bank Group

This chapter examines the potential impact on maternal mortality and impoverishment of the increase in the level of female education by one school year for a cohort of adolescent women, ages 15–19 years, in Niger and India. The use of the extended cost-effectiveness analysis (ECEA) methodology (1) enables the assessment of the impact of public policies on distributional consequences and their benefits in protecting against impoverishment, in addition to the traditional dimension of health benefits; and (2) provides critical additional metrics to policy makers inside and outside the health sector when allocating financial resources. Increased educational attainment for adolescent girls could bring large poverty reduction benefits in addition to significant health benefits by avoiding early pregnancies and maternal deaths. The extent of these gains varies significantly across socioeconomic groups, with more lives saved in the poorer groups—because they face higher rates of early pregnancy—and more out of pocket (OOP) expenditures averted in the richer groups—because they use more health care.

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