Effects of Family Planning and Child Health Interventions on Adolescent Cognitive Functioning: Evidence from Matlab in Bangladesh

Early childhood health interventions, such as vaccinations, improve the health status of young children in developing countries. It is believed that improvements in health and nutrition early on may lead to improved cognitive development, health, educational achievements, and labor market opportunities in the future. It is unclear, however, whether the benefits of these interventions are long-term, continuing into adolescence and adulthood, especially in environments where there are many competing health risks. This paper exploits a quasi-random placement and the phasing in of the Matlab Maternal and Child Health Project in Bangladesh to determine if typical family planning and early childhood health interventions received in childhood have lasting effects on cognitive functioning in late childhood and adolescence. Single and double difference with propensity score weighting as well as mother fixed-effects models are used to determine the intent-to-treat effects of the program. We estimate the intent-to-treat effects for those children whose mother was eligible for the family planning program when they were born, but born before most of the child health interventions were available, and for those children who were born when both components of the program were available. Eligibility for both aspects of the program in childhood leads to 0.3 standard deviation increase in cognitive functioning as measured by the Mini Mental State Exam when these children are 8-14 years of age. We find no program effect on the 15-19 year olds who may have benefited from the family planning program but not the child health interventions. 1 We would like to thank Jane Menken, Randall Kuhn, and Nizam Kahn for their useful comments and help with understanding the data and the study site.