1. Among survey participants from low and middle income countries (LMICs), gender disparities in adolescent secondary school attendance were noted to increase in the context of recent illness among younger siblings.
2. Gender-based schooling gaps when siblings were sick were also found to increase in association with in households with mothers working outside of the home.
Evidence rating level: 2 (Good)
Study Rundown: While gender gaps in primary education in LMICs have decreased in the last 20 years, disparities in secondary school completion remain largely unchanged. Previous survey data suggests this may be tied to a heavier reliance on adolescent females to contribute to household chores, such as child care, that interfere with their ability to attend school. In this study, researchers investigated the relationship between school attendance and illness episodes among younger siblings within the same household. They also looked to characterize this further, by examining the influence of mothers who work outside the home on the gender gap in the context of sibling illness. In addition, researchers analyzed the effect of national vaccination rates on gender disparities in education, with the hypothesis that better vaccination coverage leads to decreased childhood illness which may be tied to decreased gender schooling gaps. Results showed that female adolescents were significantly less likely than males to go to school at baseline and their attendance worsened when a younger sibling was ill. The effect of sibling illness episodes on female education was worse in households where the mother was reported to work outside the home. Results indicated that the gender gap in education decreased with increased childhood vaccination rates. While this was a large, comprehensive study, results from this piece may be confounded by other variables that affect both frequency of child illness and female education, as households with frequent child illnesses may be different from other households in ways not accounted for in this analysis. This study suggests developing policies to improve child health and support families with mothers who work outside the home will improve female secondary school attendance in LMICs.
In-depth [retrospective cohort study]: This study used data from 47 DHS in 38 LMICs conducted between 1999 and 2013 to analyze the relationship between gender based education disparities and sibling illness episodes within the last two 2 weeks. The analysis included information from 41 821 households with at least one adolescent female, one adolescent male and one child <5 years of age (“adolescent” was defined as 11 to 17 years old). Researchers also looked at the effect of maternal work outside the home on this relationship, as well as the link between national vaccination rates and schooling gender gaps. Study results indicated that adolescent females were 5.08% less likely to attend school than adolescent males (95%CI 5.50%-4.65%) without recent sick children at home. This difference in attendance increased to 7.77% with a single illness episode (95%CI 7.30%-8.24%) and 8.53% with ≥2 illnesses episodes among younger siblings (95%CI 9.32%-7.74%). This trend is similar but greater in magnitude in households with mothers who worked outside the home. In this context, adolescent females are 6.1% less likely to attend school in the absence of illness episodes among siblings, 8.7% less likely to attend with one illness episode, and 10.06% less likely with ≥2 recent illnesses episodes (95%CI 6.69%-5.60%, 9.27%-8.08%, and 11.06%-9.05% respectively). Results showed significant negative correlation between national vaccination rates of children <5 years old and gender disparities in education (correlation coefficient = 0.34, p=.02). In countries with greater than 70% vaccination coverage, the adolescent education gap was nearly zero.
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