The Interaction of Public Assets, Private Assets and Community Characteristics and its Effect on Early Childhood Height-for-Age in Peru

Abstract: Child health, particularly long-term nutritional status, is closely related to the characteristics of families, communities and children, including level of education and access to public services,. Public policy has a crucial role in increasing the likelihood that a child can access high quality health-care and other services that affect health status. Access to these public services, however, may have different effects depending on community and family characteristics, particularly the education level of the mother or caregiver. In Peru, despite a dramatic increase in investment in health during the last decade, there is still a large degree of inequality of access.

This paper uses Young Lives data to explore the interaction of private assets, such as education, with public services, provided at the community and household level. The authors explore the ways in which maternal education levels interact with access to clean water and sewage, availability and quality of health facilities, proximity to paved or engineered roads, and access to electricity. The authors also focus on the direct and indirect impact of maternal education levels on height-for-age measurements. Their results clearly establish that the level of maternal education is an important determining factor of child nutritional status. Only in the case of those mothers who are more educated does access to services not make a significant difference to nutritional status. These findings thus endorse the argument investment in public services is even more necessary in areas of low maternal education levels.

Keywords: Peru, child health, asset ownership, education, Hazard ratios