Abstract:

The success of large-scale family planning programs depends on potential long-term benefits for women's health and economic empowerment. They are presumed to reduce total pregnancies and family size, which may free up women's time and resources. However, few studies have established long-term effects on health. We investigate the highly influential Matlab Maternal Child Health / Family Planning quasi-experiment effects on lifetime fertility and multiple dimensions of health 35 years after introduction of services. For cohorts of women defined by age at program initiation, using baseline and follow-up survey data, we find the program led to fewer children but few significant effects on health or economic production with one exception: women born 1950-1961, who experienced the largest MCH/FP effects on contraception and childbearing, have significantly poorer metabolic and functional health. Despite strong arguments in favor of long-term benefits, we observe no positive effects of this family planning program on long-term health.

Abstract:

We demonstrate that improving the early childhood health environment has long-term and intergenerational effects on human capital with important distributional effects in Bangladesh. Adults who were eligible as children for health promoting interventions exhibit increased height, reduced short stature, and achieved higher levels of educational attainment. Findings are largest for individuals with the lowest pre-program health endowment, reducing inequality in human capital. Intergenerational effects reveal daughters experienced increased height, reduced stunting, and improved cognitive functioning. These effects are correlated with mother's income generation activities. Failing to consider these distributional and intergenerational effects leads to underinvestment in children.