The Impact of Macroeconomic Performance- Foreign Finance and Poverty on Child...

8/7/2019 The Impact of Macroeconomic Performance- Foreign Finance and Poverty on Child Well-being-Dissertation for Mast

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University of Antwerp

Institute of Development Policy and Management

Dissertation:

The Impact of Macroeconomic Performance, Foreign Finance and

Poverty on Child Well-being in Developing Countries: Lessons from theWorld Summit for Children

Dereje DEJENE ENGDASHET

Masters Degree in Development Evaluation and Management

Promoter: Dr. Nathalie Holvoet

Academic Year 2002 - 2003


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Determinants of Child Wellbeing in Developing Countries- Lessons from World Summit for children

Dereje Dejene Engdashet: MA Dissertation. UA-IDPM. Sptember, 2003

TABLE OF CONTENTS

List of Figures ................................ ................................ ................................ ................................ ... 1List of Tables ................................ ................................ ................................ ................................ ..... 2List of Acronyms ................................ ................................ ................................ ............................... 3Preface................................ ................................ ................................ ................................ ............... 4

I. INTRODUCTION ................................ ................................ ................................ ................................ ..... 5II. HYPOTHESIS AND METHODOLOGICAL APPROACHES ................................ ............................ 7

2.1HYPOTHESIS................................ ................................ ................................ ................................ ....... 72.2METHODICAL APPROACHES ................................ ................................ ................................ ................... 7

III. THE STATUS OF CHILDREN IN GLOBAL CONTEXT ................................ ................................ . 10

3.1CHILDREN IN GLOBAL DEMOGRAPHIC CONTEXT ................................ ................................ ....................... 103.2CHILD MORTALITY IN DEVELOPING COUNTRIES DURING THE DECADE ................................ ........... 123.3CHILD NUTRITION STATUS IN DEVELOPING COUNTRIES DURING THE DECADE : ............................... 133.4 CHILD EDUCATION (PRIMARY SCHOOL ENROLMENT) IN DEVELOPING COUNTRIES DURING THEDECADE: ................................ ................................ ................................ ................................ .............. 15

IV. WHAT HAMPERED THE WORLD SUMMIT FOR CHILDREN? ................................ ................. 20

4.1REVIEW OF END-DECADE REPORT OF THE UNITED NATIONS SECRETARY-GENERAL AND OTHER UNAGENCIES. ................................ ................................ ................................ ................................ ........... 204.2THE THEORETICAL FRAMEWORK ................................ ................................ ................................ .......... 224.3MACROECONOMICPERFORMANCE AND CHILD WELLBEING ................................ ................................ ....... 24

4.3.1 The link between macroeconomic performance and child wellbeing........................... 244.3.2 Economic growth and child wellbeing................................. ................................ ............. 264.3.3 Inflation and its effects on child wellbeing................................ ................................ ..... 35

4.4GOVERNMENT BUDGET ALLOCATION AND CHILD WELLBEING ................................ ................................ ..... 394.4.1 The link between government budget and child wellbeing................................ ........... 394.4.2 Effect of government budget allocation on child wellbeing ................................ ......... 41

4.5FOREIGN AID/ FINANCE AND CHILD WELLBEING ................................ ................................ ........... 454.5.1 Overview of the need and status of foreign aid during the decade............................. 454.5.2 The philosophy and interests behind aid................................ ................................ ......... 474.5.3 Foreign aid and private capital flows to developing countries................................ ..... 494.5.4 Effectiveness of aid in developing countries-review of literatures .............................. 504.5.5 How to measure aid/ foreign financial flows................................ ................................ .. 544.5.6 Effect of foreign aid/finance on child wellbeing during the decade............................ 56

4.6THE CHALLENGE OF POVERTY AND INEQUALITY ON CHILD WELLBEING ................................ ......... 674.6.1 Understanding Poverty................................ ................................ ................................ ....... 674.6.2 Measuring Poverty................................ ................................ ................................ .............. 694.6.3 The effects of income poverty and inequality on child wellbeing-a review................ 754.6.4 Poverty and inequality Vs. progress in child wellbeing indicators during the decade76

V. DETERMINING THE DETERMINANTS OF PROGRESS IN CHILD WELLBEING .................. 83

5.1OVERVIEW OF THE OTHER CONTRIBUTING FACTORS AFFECTING CHILD WELLBEING ....................... 835.2ANALYSIS OF DETERMINANTS ................................ ................................ ................................ ........ 85

5.2.1 Basic assumptions for building the models................................ ................................ ...... 855.2.2 Determinants of under 5 child mortality rate reduction................................ ............... 86

5.2.3 Determinants of under 5 child malnutrition rate reduction ................................ ......... 905.2.4 Determinants of improvement in primary education enrolment................................ .. 92

VI. SUMMARY CONCLUSION ................................ ................................ ................................ ............... 97

Annex 1: The details of variables by type by sources. ................................ ................................ ..... 101Annex 2. List of Countries included in the study by Region ................................ ........................... 103

BIBLIOGRAPHY ................................ ................................ ................................ ................................ ...... 104


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Dereje Dejene Engdashet: MA Dissertation. UA-IDPM. October 2003 Page 1

List of FiguresFig.- 1. Relative population (percent) of children of different age category in the glob and

different groups of countries (by the year 2000) 10Fig.- 2. Relative population (percent) of children of different age category in different regions

of Developing countries (by the year 2000) 11Fig.-3 Prevalence of Under 5 Child Malnutrition in Developing Regions of the World (1990

and 2000) 14Fig.- 4. Net Enrollment Ratio in Primary School in Different Regions of the World: 1990/91

and 2000/01 comparison 16Fig. -5 Variation in Net Enrollment Ratio-Primary School in Different Regions of

Developing World in the Year 2000/01 17Fig.-6 Net Enrollment RatioPrimary Education in the Year 2000/1 in Developing Regions

of the World by Sex. 18Fig.-7 Schematic framework (Theoretical Construct) of Factors Affecting Child wellbeing in

Developing Countries 21Fi.-8 Children at the Center: Successive Economic Environments that Affect Child Wellbeing 25Fig.-9 Scatter plot of Under 5 Mortality rate -Decade reduction (%), 1990-2000 vs. GDP per

capita average annual growth rate (%): (a)1990-2000 and (b) 1960-1990. 28

Fig. -10a Scatter plot of percent of Under 5 Under Weight (1995-2000) vs. GDP per capitaaverage annual growth rate (%): 1990-2000 30

Fig. -10b Scatter plot of percent of Under 5 Under Weight (1995-2000) vs. GDP per capitaaverage annual growth rate 1960-90 31

Fig.-11 Scatter plot of Net Enrolment Ratio-Primary-Total (2000) vs. GDP per capitaaverage annual growth rate (%): (a) 1990-2000 and (b) 1960-90 34

Fig.-12. The Total Net Flow of Long-Term Financial Resources from DAC Countries toDeveloping Countries and Multilateral Organizations by Type of Flow in Millions ofUS$ (2000 price) 49

Fig.-13. Scatter plot of under -5 child mortality rate by 1990 vs. Aid allocation (as % ofGDP) during the decade 1990-2000 (before after log transformation) 57

Fig.-14. Scatter plot of under -5 child mortality rate by 1990 vs. Per capita Aid allocation

during the decade (1990-2000 ) 59Fig.-15. Scatter plot of under -5 child mortality rate reduction over the decade -vs. aid (%GNP) transferred to developing countries during the decade (1990-2000). 64

Fig.-16. Example of Lorenz curve 71Fig.-17. Scatter plot of decade reduction of under -5 child mortality rate vs. poverty index

and poverty gap during the decade (1990-2000) 78Fig.-18. Scatter plot of decade reduction of under -5 malnutrition rate vs. poverty index and

poverty gap during the decade (1990-2000) 79Fig.-19. Scatter plot of progress in total NER primary education vs. poverty index and

poverty gap during the decade (1990-2000) 80Fig.-20. Scatter plot of progress in female NER primary education vs. poverty index and

poverty gap during the decade (1990-2000) 81Fig.-21 Scatter plot of total NER at the beginning of the decade (1990/1) Vs. Progress in total

NER-in primary education during the decade. (1990-2000) 95Fig.-22 Scatter plot of progress in female children NER- in primary education Vs. Private capitalflows into developing countries during the decade. (1990-2000) 96


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List of TablesTable-1 Under 5 child mortality rate and its rate of reduction in developing regions of the

World (1960-2000) 12Table-2 Female-Male Gap in NER in the Developing Regions of World (1990 & 2000) 18Table-3 Prevalence of Under 5 underweight (1995-2000) among countries with different rate

of GDP per capita growth during the decade(1990-2000) 32

Table-4. Level of Net Enrolment Ratio-Primary-Total (2000) among countries with differentrate of GDP per capita growth rate during the decade (1990-2000) 35

Table-5. Comparison of progress in child wellbeing indicators among countries with differentrates of inflation during the decade (1990-2000) 38

Table-6 Descriptive Statistics of central government expenditures allocation of developingcountries for Health, Education and Defense during the decade (1990-2000) 41

Table-7 Correlation matrix of Child wellbeing indicators vs. central government expendituresallocation for Health, Education and Defense during the decade (1990-2000) indeveloping countries 43

Table-8. Test for equality of Means in child wellbeing indicators among countries withdifferent level of central government expenditure allocated for Health during the decade(1990-2000) 44

Table-9. Correlation matrix of under 5 mortality rate (1990 and 2000) vs. total populationand under 5 population in 2000. 60

Table-10 Correlation matrix of progress in child wellbeing indicators vs. aid allocationduring the decade (1990-2000) 63

Table-11 Correlation matrix of progress in child wellbeing Indicators vs. private capital flowsand debt service during the decade (1990-2000.) 66

Table 12 Correlation matrix of status of child wellbeing indicators by the end of 2000 Vs.poverty and inequality measures during the decade (1990-2000.) 76

Table-13 Ordinary Least Square (OLS) estimators of explanatory variables alongsideU5CMR reduction during the decade (1990-2000.) 88

Table-14 OLS estimators of explanatory variables alongside Reduction ofPrevalence ofUnder 5 Child Malnutrition during the decade (1990-2000.) 91

Table-15 OLS estimators of explanatory variables alongsideP

ercent of Change in NER-Primary Education over the decade (1990-2000) 93Table- 16 Summary matrix: effect of different intervening variable on the progress of child

wellbeing indicators during the decade (1990-2000) 100


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List of AcronymsAAI Aid Allocation IndexACC/SNC United Nations Administrative Committee on Coordination

the Sub-Committee on NutritionCEE/CIS Central and Ester Europe and Country of newly Independent StateCNTS Cross National Time Series- a data base

CPI Consumer Price IndexCRC the Convention on the Rights of the ChildCRIN Child Right Information NetworkDAC Development Assistance CommitteeEDA Effective Development AssistanceEFA Education for AllGDP Gross Domestic ProductGNP Gross National ProductGQ Grant equivalents of loansHDI Human Development IndexHPI Human Poverty IndexIEC Information Education and CommunicationILO International Labour Office

IMF International Monetary FundLB Live BirthsMDGs Millennium Development GoalsNCHS National Center for Health StatisticsNER Net Enrollment RatioNGOs Non Governmental OrganizationsNPA National Plans of ActionODA Official Development AssistanceOECD Organization for Economic Cooperation and DevelopmentOED Operation Evaluation Department- of the World BankOLS Ordinary Least SquarePPP Purchasing Power partySSA Sun-Saharan Africa

U5CMR Under 5 Child Mortality RateUNAIDS The Joint United Nations Programme on HIV/AIDSUNDP United Nations Development ProgramUNESCO United Nations Educational, Scientific and Cultural OrganizationUN-HCHR United Nation High Commissioner for Human RightUNICEF United Nations Childrens FundUNICEF/ICDC United Nations Children's Fund/ Innocenti Research CentreUSAID United State Agency for International DevelopmentWDI World Development IndicatorsWDR World Development ReportWHO World Health OrganizationWHO World Health Organization


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PrefaceThere were two options offered by the Institute: to do internship with known agencies andwrite internship report or to write Dissertation based on field and/ or desk study as a partialfulfillment of Masters Degree in Development Evaluation and Management. As I initiallyproposed to the institute during my application for admission, I preferred to writedissertation. My initial proposition to the institute and to my employer, Christina Childrens

Fund Inc. (CCF), was to work on the impact of Poverty and Poverty Reduction Strategies on'Holistic Child Development. This proposition stemmed from my academic background andexperience (an Agricultural Economist who have been engaged in socioeconomic research andcommunity development work for 14 years and have a real sense of the damage of poverty)on one hand, and the recent mission and program strategies of CCF an agency which haveworking for wellbeing of disadvantaged children since 1938, to work for child development inholistic manner-under the strategic framework of Holistic Child Development. However, thisinitial proposition get wider as I read more literatures related to the subject and attended theinteresting courses of the Institute. After a series of informal discussions with my professorson my proposition, the proposition become fully developed research proposal by April-2003,which I presented it to my professors-Prof. Roberchet Renard and Dr. Nathalie Holvoet.Although it was too ambitious, my professors accepted my proposal due to my insistence andDr. Nathalie Holvoet became my promoter.

With the close advice, guidance, corrections and encouragement I abundantly obtained fromDr. Nathalie, and insight I got from her well organized course- Quantitative EvaluationTechniques in addition to my research and data analysis skills and experiences, I believe thisDissertation was written to the highest possible professional standards. And thus my veryspecial thanks go to Dr. Nathalie Holvoet. I thank also Prof. Renard for his initial inputswhich help me to think different ways of modeling determinants of child wellbeing. Inaddition to Prof. Renard, the extraordinary professor of the Institute, I am very grateful for Dr.Johan Bastiaensen, and Dr. Danny Cassimon for broadening my view of developmentthinking through their interesting and interactive courses, otherwise this paper wont havesuch scope.

My study at the Institute was made possible by the special support of CCF. Although thispaper, which is much wider, deeper and analytical than the initial proposition, is to the benefitof CCF, I want to express my genuine gratitude to the Managment of CCF Ethiopia NationalOffice, CCF Regional office in Nairobi, Kenya; and CCF HQ in Richmond, Virginia, USA;specifically to Mr. Fikru Abebe, Mrs. Margery Kabuya, and Mr. Daniel Wordsworth. I am alsodeeply indebted to Dr. Azene Bekele -Tessema, for his special encouragement and support.

Although I couldnt find special words to express my feeling, the grand overarching thanksand appreciation is for my wife, Mrs. Tilashwork Etsub. Had it not been due to her specialfollow-up to submit my application for admission to the Institute before the deadline,encouragement, love and compassion, good will and commitment to raise our four sons alone

for a year, it would have been impossible for me to come to Belgium and study at the Institute.Last but not least my mother have special place in my academic life. It is due to her specialeffort I managed to complete my high school education, and obtained my first degree fromAlemya University, Ethiopia.

My sons deserve special apology not a vote of thanks. Thus I apologize for my elder sonAmanuel-6, the twins Fikereselam and Hibret- 3.9/12 and the new comer Emnet 1.

7/12, whodeprived, for the reason unclear to them, the care and compassion a father should have toproved to his sons.


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I. Introduction

As today's children are the citizens of tomorrow's world, their survival,protection and development is the prerequisite for the future development ofhumanity. Empowerment of the younger generation with knowledge and

resources to meet their basic human needs and to grow to their full potentialshould be a primary goal of national development. As their individualdevelopment and social contribution will shape the future of the world,investment in children's health, nutrition and education is the foundation fornational development.United Nations DeclarationWorld Summit for children 1990.

Following the Convention on the Right of the Child (CRC), which wasunanimously adopted by the General Assembly of the United Nations in 1989, theWorld Summit for Children held at the United Nations in September 1990. Onthe 30th of September 1990, the World Declaration on the Survival, Protection andDevelopment of Children and the Plan of Action for Implementing the World

Declaration were signed by 71 heads of state and governments, and was laterendorsed by 181 countries. The Plan of Action lay down seven major goals thatwere considered achievable by the year 2000. Most of the goals of course laterbecome Millennium Development Goals (MDGs). The seven major goals are thefollowing:

(1)Reduction of 1990 under-5 child mortality rates by one third or to alevel of 70 per 1,000 live births, whichever is the greater reduction;

(2)Reduction of maternal mortality rates by half of 1990 levels;(3)Reduction of severe and moderate malnutrition among under-5

children by one half of 1990 levels;

(4)Universal access to safe drinking water and to sanitary means of excretadisposal;(5)Universal access to basic education and completion of primary

education by at least 80 per cent of primary school age children;(6)Reduction of the adult illiteracy rate to at least half its 1990 level (the

appropriate age group to be determined in each country), withemphasis on female literacy;

(7)Protection of children in especially difficult circumstances, particularlyin situations of armed conflicts.

The Plan of Action called for national action and international co-operation to

meet the goals set in the Plan. Governments were urged to prepare national plansof action (NPAs) for the implementation of these goals. At the international level,international agencies were asked to assist underdeveloped and highly indebtedpoor countries in the achievement of their plans of action (World summit forchildren, 1990).

End-decade review report of the United Nations, presented by the Secretary-General Kofi Annan, on the Special Session of the United Nations in June 2001indicated that many of the seven major goals of the 1990 Plan of Action


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achievements were less than impressive. For example: under-five mortality rateonly declined by 11 percent (rather than the goal of 33 percent), malnutritiondeclined by 15 percent (rather than 50 percent), there was no real progress in thereduction of maternal mortality (the goal was a 50 percent reduction) anduniversal access to safe drinking water and hygienic facilities is far from a reality

(UN, 2001).

It is often said that in many United Nations conferences, goals are ever set butnever met, and that commitments on paper are rarely translated into action on theground. But what hampered the achievement? The report of the secretary generalemphasized that beside lack of commitment and insufficient investment bygovernment and donors, chronic poverty remains the single biggest obstacle tomeeting the needs and fulfilling the rights of children. On the other hand,UNICEF report on The State of the World's Children 2002 depicted that there is nofixed relationship between the annual reduction rate of the U5CMR and theannual rate of growth in per capita GDP. But, if growth is good for poor as David

Dollar & Aart Kraay (2001) are arguing, and if poverty is the biggest obstacle,there should have been a robust relationship between growth and the rate ofreduction of U5CMR.

Overall, although there are a number of hypothesis, suggestions, debates and insome cases findings as to what intervening factors affecting child wellbeing,particularly in the case of child mortality, child nutrition and child education;there are inadequate empirical research and findings as to the circumstances or

factors that hindered the achievement of the Summit goals and/or contributed tothe variations among the regions and among the countries within and across theregions.

This paper will explore the extent of variability among developing countries andlook into the broad forces that account for the cross -country variation in the(under) achievement of three major goals that directly measure child wellbeing.These include: (1) reduction of under-5 child mortality rate; (2) reduction of severeand moderate malnutrition among under-5 children, (3) universal access to basiceducation (primary school enrollment)

The paper will uncover some of the causes for (under) achievement of the goalsby dissecting the major socio-economic environment of the developing countriessuch as macroeconomic performance, government budget allocation, foreign aid

and private financial flows, the level and depth of poverty, and other endogenousand exogenous factors affecting child wellbeing in developing countries with theaid of simple statistics as well as rigorous econometric methods.

As a concluding remark this paper will priorities the determinants of child wellbeingamong the broad forces, and major actions to be taken by the donors and governments ofdeveloping countries to meet and sustain the Millennium Development Goals related tolong term child survival, protection and development.


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II. Hypothesis and Methodological Approaches

2.1 Hypothesis

The starting hypothesis of this paper is that there could be considerable variation

in rates of change of child wellbeing indicators between developing countries.And this variation is most probably affected by macroeconomic performance andgovernment budget allocation of the developing countries; foreign aid and privatefinancial flows into developing countries; the level of poverty and inequalities indeveloping countries; as well as due to other endogenous and exogenous factorssuch as HIV prevalence, domestic conflict, adult literacy and access to informationand communication services.

This hypothesis just served as starting point or guiding star. The full theoreticalframework and elaborated hypothesis is presented in section 4 and the functionalrelation is given in the last section of this paper.

2.2 Methodical approaches

2.2.1 Review of similar studies and relevant literatures

Extensive review of similar studies/journal articles and relevant literatures,produced by UN systems, NGOs and private publishers as well as nationalgovernments has been done as the primary task of this paper. Emphasis was,specifically, given to publications from professional journals, the World Bank,different UN organizations (UN-HCHR/CRC, UNICEF-ICDC, UNDP, UNESCO,WHO), Child Right Information Network (CRIN), Save the Children Sweden,

Save the Children Alliance, The Future of Children.

The result of the reviews served as initial steps, on one hand to narrow down thetype of information I had to focus at, and on the other hand, to compare andcontrast previous findings with that of mine.

2.2.2 Data coverage and sources

The data required for this study were based on the three most important childwellbeing indicators of developing countries, which include (1) Under-5 ChildMortality Rate (U5CMR) , (2) prevalence of Under-5 malnutrition and (3) access to

basic education (primary school enrolment), as outcome variable. Where possiblethese data were disaggregated by gender, specifically for primary education.

The explanatory variables which are assumed to have most probable influenceson the achievement of the above three major goals of the Summit the focus ofthis paper are as followsa) Macroeconomic performance [as measured by: the long term GDP per

capita growth rate (1960-1990), GDP per capita growth rate during the


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decade (1990-2000), level of inflation during the decade (1990-2000) ], aswell as central government expenditure allocation for the Health Sector,the Education Sector, and for Defense.

b) The level and intensities of foreign aid & financial flows that includes:-Aid per GNI, Aid per Capita, Foreign Capital Flows, and Total Debt

Service.c) Poverty & Inequality as measured by Poverty Headcount Index, PovertyGap (depth of poverty), Gini Coefficient (Gini Index).

d) Others include: Overall aggregate measure of political freedom and civilliberties by Freedom House, HIV Prevalence Rate, Domestic ConflictIndex, Adult Literacy Rate.

Data on these variable were collected and adapted form existing databases mainlyfrom World Development Indicator CD-Rom (2000/2001) of the World Bank;UNICEF; UNESCO; OECD; U.S. Bureau of the Census; International Data Base,Cross National Time Series (CNTS) Database-from Alexander Library-Rutgers

University; and The Freedom House.

The macro level data are basically annual averages or changes during the decade(1990-2000), except when constrained by missing data sets. Data on somevariables, for example log term GDP per capita growth rate, was of coursecollected starting from 1960 to see the impact of a log term and short termeconomic progress on child wellbeing. Any data set with a specific period of timeis specified in the paper. The details of variables and data types collected, as wellas its sources, are presented in Annex-1.

2.2.3 Data Analysis and Presentation

A series of Data Mining procedures were followed, as an analytic process, toexplore consistent patterns and/or systematic relationships between variables,and then to validate the findings by applying the detected patterns to the data setsor subsets. The data were organized using MS Excel-2002 and all simple andsophisticated analysis were done using SPSS (Statistical package for SocialScientists) version 11 for Windows. Necessary graphics were developed usingboth MS Excel and SPSS graphic facilities.

Stage 1: Exploration. This stage started with data preparation which involvedcleaning data; data transformations using logarithmic, quadratic, and inverse

functions; selecting subsets of records. In this process regions or islands politicallydependent on another country were excluded from the sample. Small countries orsmall independent islands with a population of considerably less than one millionwere also excluded as they are less representative and bias estimation ofparameters for functional relationship. Somalia is intentionally excluded for 2reasons. 1) Next to United States, Somalia is the only country in the world that hasnot signed CRC; 2) Due to the continuous war the country was statelessthroughout the decade and many data were missing. Thus only data from 105developing countries included in this paper (see annex-2 for list of countries.)


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Stage 2. Exploratory analyses. Depending on the nature of the variables, at thisstage, exploratory analyses were extensively carried out using a wide variety ofgraphical and statistical methods in order to identify the most relevant variables(from more than 100 direct and transformed variables) and to determine thepattern of association and the general effect of explanatory variables on

dependent variables.See annex --- for details of the direct and transformed variables.

Stage 3: Model building and validation. This stage involved considering variousmodels and choosing the best one based on their predictive performance (i.e.,explaining the variability in question and producing stable results). Thesignificance of contribution of each explanatory variable in affecting the childwellbeing indicators was tested by including and excluding from the modelalternatively.

Stage 4: Deployment. That final stage involved using the model selected as bestin the previous stage and applying it to the data in order to generate predictions

or parameters estimates of the expected outcome. At this stage, the main analysiswere Multiple Regression using Generalized Regression Model (GRM) in whichlinear, semi log linear and semi-quadratic linear models were used - based on thenature of each explanatory variable and its association with the dependentvariable(s).

The data analyzed at aggregate level were primarily used to generate informationto test the hypothesis and give answer to the research question- what hamperedthe achievement of the three selected goals set by the world submit for children ?.The results of my analysis were compared and contrasted with previous studiesand literature for the synthesis of the information and to draw up conclusions.

2.2.4 Data limitation

There were a number of missing data for most of the variables included in this paper.Complete set of data required for this paper were only available for some countries,despite a series of effort to pool from various sources. Consequently data used inregression analyses range from 34 to 51 countries. However, as the qualities of the datawere crosschecked from different sources, the author believes that missing data cases didnot have much influence on the result of the analyses.


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III. The Status of Children in Global Context

3.1 Children in global demographic context

Globally young people under the age of 18 represent more than one third of the

worlds population. According to U.S. Bureau of the Census, International DataBase; of the total population of the world in mid 2000 which was estimated to be6,078,270,552 (M/F ratio being 101.4) under 19 children population was about2,376,472,672, which is nearly 40% of the world population (fig1). If we look forunder 15 years old children, the economically in active group they account forabout 30% of the world population, or they are 1,815,145,237, (M/F ratio being105.2.). The population of the most vulnerable group, under 5 children, wasabout 607,770,690, which is exactly 10% of the world population.

The share of children in Developing Countries is considerably higher than that ofthe world average (fig.1). Of the total population of 4,886,299,890 (M/F ratio

103.2) in Developing Countries; under 19 children were estimated to be 42.5%(2,077,104,987) M/F ratio being 105.3 while under 15 children are about 33%(1,597,456,528) M/F ratio being the same.

Fig.-1 Relative population (percent) of children of different age category in the globand different groups of countries (by the year 2000)

0

5

10

15

20

25

30

35

40

45

WORLD LESS DEVELOPED

(DEVELOPING) COUNTRIES

MORE DEVELOPED

COUNTRIES

PercentChildren(age0-4)



Sources: Graph & summary produced by the Author from U.S. Bureau of the Census, International Data Base

When we dissect the data further by regions, we can observe considerablevariations between regions of Developing Countries (fig. 2). While Asia(excluding Middle East) and Latin America and the Caribbean are closer to worldaverage for the three age categories of children, the proportion of children in Sub-Saharan Africa is much higher than the world average as depicted in thefollowing figure (fig. 2). Of the total population of Sub Saharan Africa- 656,548,110


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(M/F ratio-99.5), more than 55% (362,444,385; M/F ratio 101.1) are children underage of 19 years, and under 15 years old children account for 44%. The populationof the most vulnerable group, under 5 children, was about

,

,

7

, which isalmost 17% of the Sub-Saharan African population.

Fig.-2 Relative population (percent) of children of different age category indifferent regions of Developing countries (by the year 2000)

0

10

20

30

40

50

60

SUB-SAHARAN

AFRICA

NORTHERN

AFRICA

NEAR (MIDDLE)

EAST

ASIA

(EXCLUDING

MIDDLE EAST)

LATIN AMERICA

AND THE

CARIBBEAN

Percent Children(age 0-4)



Sources: Graph & summary produced by the Author from U.S. Bureau of the Census, International DataBase

Although there is considerable variation between regions of the DevelopingCountries (fig. 2) and in the world as a whole, the only country in the worldwhere share of children under age of 19 falls below 20% are Italy and Monaco 1.Among the developing countries excluding Hong Kong and Singapore, which areof course categorized by DAC (2003) as more advanced developing countries,the proportion of children under 19 year age, ranges form 26.7% in St. Helena(islands in south Atlantic with autonomous territory status) to 61.9% in Uganda;while proportion of children under the age of 15 ranges from 19.4% to 51.1% forthe same countries respectively.

Despite this significant share of world population, adequate emphasis was notrendered and considerable research was not done with regards to childdevelopment in developing countries, where children have been facing a numberof socioeconomic problems and become victims of poverty, poor governance, civilunrest, etc. Subsequently, they deprived the right to education and adequatenutrition. In worst scenario, which is not uncommon for developing countries,they denied the freedom to survive. We will see in the following section the

1 Monaco is a tiny town with about 31,000 people, but independent state in southern France.


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situation and status of children in developing countries in details in terms ofmortality, nutrition and education before we proceed to analysis of the influenceof various factors on the life of children.

3.2 Child mortality in developing countries during the decade

The first goal of the World Summit for Children was, between 1990 and 2000, thereduction of under-five child mortality rate (U5CMR)2 by one third (33%) or to 70per 1,000 live births (LB), respectively, whichever is less.

In the world as a whole (see table-1 below), there was a big move between 1960 to1990, and U5CMR declined from 198 to 93 per 1000 LB- with average annual rateof reduction of 2.5%. This pace was slowed during the decade of the summit andU5CMR was only reduced by about 10 per cent over that period. Currently theworld U5CMR stands at 83 per 1000LB.

Under-five mortality in developing countries declined from 103 per 1,000LB in1990 to 93 per 1,000 LB in the year 2000. Ten years ago, it was the children ofAfrica, of Sub-Saharan Africa (SSA) in particular, whose needs were most acute,and yet it is in this region that the least progress has been made during thedecade. Only 3% reduction of U5CMR was attained in the region, which isextremely low as compared to not only the target but also in eyes of the progressmade by other regions: Middle East and North Africa (20%), South Asia (22%),East Asia and Pacific (24%) and Latin America and Caribbean (31%). SSA is stillthe region with the highest child mortality rate. In this region 175 of 1 000newborns (17.5%) do not live to the age of five.

Table-1 Under 5 child mortality rate and its rate of reduction in developing regions ofthe World (1960-2000)

Regions/Groups ofcountries

Under-5 mortality rateper 1000 live birth

Average annual rateof reduction (%)

Decadereduction

(%)1960 1990 2000 1960-90 1990-2000 1990-2000

Sub-Saharan Africa 254 181 175 1.1 0.3 3

Middle East andNorth Africa

250 80 64 3.8 2.2 20

South Asia 244 128 100 2.1 2.4 22

East Asia and Pacific 212 58 44 4.3 2.7 24

Latin America and

Caribbean

153 53 37 3.5 3.7 31

Developing countriesin general

223 103 91 2.6 1.2 11

World Average 198 93 83 2.5 1.1 10Source: UNICEF - The state of the Worlds Children 2002.

2Under-5 mortality rate is defined as the probability that a newborn baby will die before reachingage five, if subject to current age-specific mortality rates. The probability is expressed as a rate per1,000 live births (LB)-UNICEFs State of the Worlds Children 2002.


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Out of 62 countries, for which data on female-male child mortality difference isavailable (WDI, 2001), 22 countries are neutral (+/- 1%), while 20 countries foundto be biased against female and the same number of countries found to be biasedagainst male. Nigeria is exceptional country where female male child mortalityrate difference is too alarming (84 per 1000 LB); i.e the rate of female child

mortality per 1000 LB of female is higher than rate of male child mortality per1000 LB of male by 84. Excluding Nigeria as unique outlier, the median is zero,mean = -07, SD =6.48. This implies that that although there is no considerabledifference between male and female child mortality rate in developing countriesas whole, there is too much variation among countries.

Ironically U5CMR has increased in 13 developing countries. The list of developingcountries where child mortality has actually increased during the decade includes9 Sub-Saharan Africa countries (Angola, Botswana, Cameroon, Cte dIvoire,Kenya, Rwanda, South Africa, Swaziland, Tanzania, Zambia, Zimbabwe), Algeriaand Iraq (in North Africa & Middle East), Cambodia from East Asia and Pacific,

and Kazakhstan and Uzbekistan from CEE/CIS and Baltic States region

Despite overall inadequate achievement of the envisaged goal, more than 40developing countries achieved the targeted one third reduction of U5CMR. Manyof the countries that achieved the goal are those enjoyed reasonable economic prosperityduring much of the decade. But some upper middle income countries, with positive

per capita GDP growth rate during the decade, did not achieve the goal. Forexample Argentina, Barbados, Costa Rica, Panama, Saint Lucia, Trinidad andTobago, Uruguay (from Latin America & Caribbean); Botswana, Gabon,Mauritius and Seychelles (from SSA), and Bahrain and Lebanon (from MiddleEast). On the other hand some very poor countries with per capita income of less than

US$ 760, and

withn

il or meager per capita GDP growth rated

urin

g thed

ecad

e,d

id

achieve the goal; for example, Bangladesh, Bhutan, Comoros, Lao, Nepal, Nicaragua.Why did this happen? What intervening factors played the role? This is part of theissue we are going to look into- in details- in the subsequent sections.

3.3 Child nutrition status in developing countries during the decade:

In 1990, 177 million children under five years of age in developing countries weremalnourished (underweight), as indicated by low weight-for-age ratio3. Anestimate of ACC/SCN (2000) indicates that 149 million children weremalnourished in the year 2000.

3 Under weight is defined as low weight- for- age at less than 2 standard deviations of the

median value of the NCHS/WHO international growth reference. Under weight (low weight- for-age ) is different from Wasting: low weight- for- height and Stunting: low height-for-age. Lowweight-for-age reflects body mass relative to chronological age. It is influenced by both the heightof the child (height-for-age) and his or her weight (weight-for-height), and its composite naturemake it superior to both though its interpretation is sometimes complex. (WHO,www.who.int/nutgrowthdb/intro_text.htm)


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The prevalence of under-five malnutrition4 in developing countries as a wholedecreased from 32.1 percent to 26.7 percent (fig-3). The goal to reduce malnutritionin under-five children by halfhas been, therefore, very far from being achieved.

Fig.-3 Prevalence of Under 5 Child Malnutrition in Developing Regions of the World

(1990 and 2000)

0

10

20

30

40

50

60

%o

fUnder5ChildrenUnderweigh

Afric

a

Easte

rnA.

Wester

nA.

North

ernA.

Asia

SouthCe

nteral

SouthEa

st

Latin

A.&the C

aribbean

Carib

bean

Centreal

America

SouthAm

erica

All D

evelo

pingCo

untries

1990 2000

Source: Graph producedby Author basedondata from ACC/SCN (2000) Fourth Report on the World

Nutrition Situation.

When we look into the regional differences, of course some regions madeconsiderable progresses. The most remarkable progress has been in Latin Americaand Caribbean, which shows a decrease in child malnutrition rates from 10.2 to6.3 percent. This is particularly due to progress registered in South Americacontinent that registered a decrease in child malnutrition rates from 8.2 to 3.2percent, where as, in contrast there was no progress in Central America, althoughmalnutrition rate of about 15% is better in the eyes of other regions. Progress waslow in Asia (as a continent), where rates decreased from 36.5 to 29 percent and thenumber of under five underweight children fell by some 33 million (from 141.31million to 107.91 million). This implies that still, more than two thirds of theworlds malnourished children (some 108 million out of 149 million) now live inAsia as a continent. Despite the heralded economic progress, Asia-especiallySouth Central Asia- is the region where malnutrition rate is the highest (43.6%).And it is in this region where 50% of the world malnourished children live.

4Prevalence of child malnutrition (low weight-for-age) is the percentage of children under five whoseweight for age is less than -2 standard deviations of the median value of the NCHS/WHOinternational growth reference population aged 0 to 59 months/under 5 year age (WDI, 2001)


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In Africa the prevalence of malnutrition is closer to world average. However, it isthe continent that shows retrogression in feeding its children, except in NorthAfrica region. The absolute number of malnourished children in Africa hasincreased from 30 million in 1990 to 38 million by the end of the millennium. Whythis did happen? Was it due to pervasive poverty, or war and domestic conflict or

inadequate attention of the government of African nations, who usually like toinvest in military than social services or other hidden factors? We will see theanalysis in relation to these and other factors in subsequent section of this paper.

Although gender disaggregated data was not available to look into the genderdisparity in malnutrition, ACC/SCN Fourth Report on the World NutritionSituation reveals that there are no differences in prevalence rates for boys andgirls for under weight, stunting or wasting (ACC/SCN, 2000, pp: 8)

3.4 Child Education (Primary school enrolment) in developing

Countries during the decade:

According to UNESCO Institute for Statistics data base, net enrollment ratio(NER)5 in the developing countries of the world increased on the average from79.8% in 1990/91 to 82.1% in 2000/01, while the world average moved from 81.9to 83.6 respectively. This implies the World Summit goal of universal access tobasic education has not been achieved. The 2002 Education for All GlobalMonitoring Report of UNESCO depicts that there are still more than 100 millionchildren of school age who remain out of school. According to the report nearlyall out-of-school children live in developing countries, and a majority of them aregirls

The breakdown of NER by regions shows that there are considerable variationsbetween the regions. Some regions, in fact, are barely keeping up with the growthin the number of school-age children and a few are falling back (fig-4)

The most notable progress has been in Latin America and Caribbean, NorthAfrica, and Oceania where net enrollment increased by 9.7%, 8.8% and 7%respectively. South-central Asian enrollment also increased by 6%. The EasternAsia and South-Eastern Asia regions, where the net enrolment ratios have beencloser to 100 per cent by 1990/91, fell back in 2000/01 by 4.2 and 1.1 percentrespectively. However, in these regions NER still stands above 90%, which is farabove the world average. The region far away from the Summit goal of universalaccess to basic educationis sub-Saharan Africa, which stands at 57.7% of NER.

5 The net enrolment ratio (NER) expresses the number of pupils at a given level of schooling-

taking into account the age structure of those enrolled- as a proportion of the number of childrenin the relevant age group by excluding all those children who are older or younger than theofficially school-eligible age group. (UNESCO, 2002)


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Fig.-4. Net Enrollment Ratio in Primary School in Different Regions of theWorld: 1990/91 and 2000/01 comparison

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

NetEnro

mentRat

oInPr

mary(Tota

)

North

ernAfric

a

Sub-S

ahara

nAfric

a

Latin

Ame

ricaa

ndC

aribbea

n

Easte

rnAsia

Sout

h-Cen

tralAsi

a

Sout

h-Eas

ternAsi

a

Wes

ternAs

ia

Oceani

a

Deve

loping

Reg

ionsA

verage

Wor

ldA

verage

1 99 0/ 91 2 00 0/ 01

Source: Graph produced by Author based on UNESCO data base

The breakdown of net enrolment ratio by region gave us some more insight but itstill masks considerable variations between and within countries. Despite thesteady progress seen in the regions of the Latin America and Caribbean and in the

Arab States, there is overall variability within all regions. Some countries, in fact,are barely keeping up with the growth in the number of school-age children and afew countries are falling back.

Out of 73 developing countries, for which data is available both at the beginningand end of the decade, the rate of enrolment was worsened in 28 countries. Theseincludes 9 countries in SSA (Angola, Botswana, Comoros, Kenya, Mauritius ,Namibia, South Africa, Tanzania, Zimbabwe), six countries in East Asia andPacific (Indonesia, Korea-Republic of, Mongolia, Myanmar, Philippines, Samoa),four from Latin America and Caribbean (Jamaica, Paraguay, Uruguay, andVenezuela), six from North Africa and Middle East (Bahrain, Djibouti, Oman ,

Saudi Arabia, Syrian Arab Republic, United Arab Emirates), 2 countries fromCEE/CIS and Baltic States (Georgia and Kyrgyzstan), and 1 form South Asia(Nepal)

On the other hand 18 out of 73 developing countries have managed to increase netprimary enrolment by more than 10% during the decade. These includes 8 Sub-Saharan Africa countries (Chad, Cte d'Ivoire, Eritrea, Ethiopia, Malawi,Mauritania, Senegal, and Togo); Argentina, Brazil, Colombia, and Suriname (from


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Latin America and Caribbean); Lao and Vanuatu (from East Asia and Pacific);Bangladesh and Pakistan (from South Asia); Morocco (from North Africa andMiddle East) and Tajikistan (from CEE/CIS and Baltic States).

The following figure (fig-5) further depicts how variability looks like between andwithin the regions. The figure shows that the variation is much higher amongSSA and North Africa and Middle East, the majority of them being Arab statesand very low among East Asia and the Pacific countries. Variation in CEE/CISand Baltic States, South Asia as well as Latin American and Caribbean regionsalso attract attention as to what are the causes or intervening variables associatedwith the variations. The three to four-fold difference in NERs between the topand bottom ranking countries of sub-Saharan Africa, and of the Arab States andNorth Africa calls for a further and close look into the issues. We will see this inthe following sections (section-IV on wards).

Fig.-5 Variation in Net Enrollment Ratio-Primary School in Different Regionsof Developing World in the Year 2000/01

102.

.

107.

.2 99.0

109.

.7

92.

92.

9.

0.

.

9.2

81.

80.7

32.

.3

30.

0.0

20.0

40.0

60.0

80.0

100.0

120.0

CEE/CIS and Baltic

States (5/10)

East Asia and

Pacific (16/30)

Latin America and

Carribean (24/33)

North Africa and

Middle Eastmercia

(16/21)

South Asia (4/8) Sub-Saharan Africa

(32/47)

NetEn

r

entRatio-Primar

Max

Median

Min

Tajikistan

Armania

Korea Rep.

Lao PDR

Argentina

Nicaragua

Tunisia

Djibuti

Saudi Arabia

Maldives

Pakistan

Uganda

Niger

Malawi (100)

Ethiopia (47%)

Kenya (68%)

Source: Calculated and Graph produced by the Author from UNESCO data base

The female-male difference in getting access to primary education

From a strategic point of view, one of the key aspects that deserve attention withregard to primary education is the gender dimension. Although it is beingnarrowed down in some regions and countries, the gender gap in terms of thedifference in school enrolment ratios between girls and boys is, in most cases, to

the disadvantage of girls.


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Fig.-6 Net Enrollment RatioPrimary Education in the Year 2000/1 inDeveloping Regions of the World by Sex.

93.6

89.2

60.4

55.0

97.196.0

92.194.9

85.5

72.4

92.490.6 90.0

80.1

86.0

79.5

84.8

79.1

85.9

81.1

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

NetEnro

mentRatio-PrimaryEduca

tion

North

ernAfr

ica

Sub-S

ahara

nAfrica

Latin

Ame

ricaa

ndC

aribbea

n

Easte

rnAsia

South

-Cen

tralAsia

South

-Easte

rnAsia

West

ernAsia

Oceania

Deve

loping

Regio

nsAver

age

Worl

dAvera

ge

Mal

F

al

Source: Graph produced by the Author from UNESCO data base

The gap has narrowed considerably in recent years in the two regions where itwas the greatest: in South Central Asia (Middle East) and North Africa (Table-2).Despite considerable progress, there is a great deal more to be done in these

regions and elsewhere. In sub-Saharan Africa and Western Asia Female-Maledifference in NER of Primary Education has almost remained unchanged over thepast 10 years. Ocean has a sub-region in getting worse in widening the gap duringthe decade while East Asia sub-region became a favorite for girls.

Table-2 Female-Male Gap in NER in the Developing Regions of World (1990 & 2000)

Region

Female- Male Gap in NER of

Primary Education Change in the

gap1990 2000

Northern Africa -13.7 -4.3 9.4Sub-Saharan Africa -8.3 -5.3 3.0

Latin America and Caribbean -1.1 -1.0 0.1

Eastern Asia -3.8 2.8 6.6South-Central Asia -28.0 -13.1 14.9

South-Eastern Asia -3.9 -1.9 2.0Western Asia -12.0 -9.9 2.1

Oceania -2.8 -6.5 -3.7Developing Regions Average -12.2 -5.6 6.6

World Average -10.4 -4.9 5.5Source: Calculated by Author from UNESCO data base


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Large disparities persist both among and within countries the latter oftenhidden by national averages. Out of 72 developing countries, for which data areavailable both for 1990/91 and 2000/01 academic year, Female -Male difference inNER-in primary education was worsened in 22 countries. These include eightcountries from Sub-Saharan Africa region (Angola, Burkina Faso, Burundi, Cte

d'Ivoire, Eritrea, Ethiopia, Mauritius, Mozambique, South Africa), six countriesfrom Latin America and Caribbean (Argentina, Brazil, Chile, Colombia, Cuba,Suriname), Kazakhstan, Kyrgyzstan, Tajikistan from CEE/CIS and Baltic States,Samoa and Thailand from East Asia and Pacific, and Pakistan from south Asia

On the other hand some 28 countries were able to narrow down the gender gap ineducation. Some are even turn out to be favoring girls in primary education. Themajority are East Asian and pacific countries (9), which include Indonesia, Lao,Macau, Malaysia, Mongolia, Myanmar, Philippines, Vanuatu and Viet Nam, 8countries from North Africa and Middle East (Algeria, Bahrain, Egypt, Morocco,Oman, Saudi Arabia, Syrian Arab Republic and Tunisia; about eight countries

from SSA (Comoros, Ghana, Kenya, Madagascar, Malawi, Mauritania, Senegaland Tanzania); five Latin America and Caribbean countries (Bolivia, Mexico,Paraguay, St. Lucia, and Trinidad and Tobago); Bangladesh from South Asia and

Georgia from CEE/CIS and Baltic States.

Courtiers known for discriminating girls in primary education as compared toboys, i.e. where Female-Male differences in NER for primary education exceeded -10% by the beginning of the new millennium, are Yemen (-35%), Chad (-23%),Pakistan (-20%), Central African Republic (-19 %), Togo and Cte d'Ivoire (-18%),Burkina Faso, Ethiopia and (Niger (-12%), Guinea (-11%), Nepal, Burundi andCambodia (-10%)6

Even in countries where quantified gaps are minimal, inequalities in educationalcontent, methods and facilities may exist, resulting in major differences inachievement. In countries where the economy is declining and enrolments arefalling, girls may fall behind even further. Where access to information andcommunication is low, illiteracy is high and traditional beliefs and practicesremain strong, girls may be expected to become housekeepers, child minders andwives at an early age. We will, in the subsequent sections see how and the extentto which these situations imposed influences on the under achievement of theSummit goal of universal access to primary education, and impose discriminatoryeffect on girls education.

6There was no data for 1990/91 academic year for Cambodia, Guinea, andYemen to talk about progress if

there is any.


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IV. What hampered the World Summit for children?

4.1 Review of End-decade report of the United Nations Secretary-General and other UN Agencies.

The end-decade review report of the United Nations Secretary-General (2001),with the title We the Children, indicated that lack of commitment andinsufficient investment by government and donors, chronic poverty, thepandemic of HIV/AIDS, lack of essential care for the newborn baby, andunprecedented levels of ethnic conflicts and civil wars as the most prominentobstacles to meeting the needs and fulfilling the rights of children.

According to Secretary General Report (2001), the success of some countries canbe attributed to specific child-friendly policies, strategies and programmes andconcrete measures taken at the national and sub-national levels, to save childrenslives. However, in some cases the impact of effective policies and programmes

was, unfortunately, overwhelmed by such disasters as war, economic crisis, andnatural disasters and, especially, the AIDS pandemic in sub-Saharan Africa (UN,2001)

The United Nations Administrative Committee on Coordination the Sub-Committee on Nutrition (ACC/SCN) Fourth Report (2000) on the WorldNutrition Situation depicts that poverty, low education level and status of womenand poor care during pregnancy, as well as high population densities andunfavorable child-care practices, are major underlying causes of malnutrition inAsia, especially in South Asia, where malnutrition is most prevalent. The Reportalso indicated that weaknesses in public sector administration and sometimes a

lack of commitment to support local initiatives have hampered theimplementation of nutrition policies which aimed to empower families andcommunities. Conflicts, natural disasters and the HIV/AIDS pandemic have alsogreatly exacerbated the situation of malnutrition (ACC/SCN, 2000).

Office of the High Commissioner for Human Rights/ Committee on the Rights ofthe Child, on its Tenth Anniversary of the Convention on the Rights of the ChildCommemorative Meeting, deliberated the fact that economic policies are neverchild-rights neutral. And the committee calls on civil society to assist it in seekingthe support of key international leaders, and in particular the High Commissionerfor Human Rights, the Executive Director of UNICEF, and the President of the

World Bank, to examine how macro-economic and fiscal policies impact onchildren's rights, and how these policies can be reformed so as to make them morebeneficial to the implementation of the rights of the child (Palais des Nations,1999).

On the other hand, UNICEF report on The State of the World's Children 2002argued that there is no fixed relationship between the annual reduction rate of theU5CMR and the annual rate of growth in per capita GDP. But, if growth is good


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for poor as David Dollar & Aart Kraay (2001) were arguing, and if poverty is oneof the biggest obstacles (according UN Secretary General Report (2001), thereshould have been a robust relationship between growth and the rate of reductionof U5CMR. These contrary and also contradictory views call for looking into otherfactors which determine the ratio at which economic progress contributed to

social progress.

The study report by the World Bank The Role and Effectiveness of DevelopmentAssistance: Lessons from World Bank Experience and the comment of theSecretary General of the United Nations with regards to the lack of commitmentand insufficient investment by government and donors is seems to be at oddswith each other. The study report of the World Bank indicates that Governmentsof developing countries, with the support of the development community andnon-governmental organizations (NGOs), have accelerated growth and povertyreduction by improving their policies, institutions, and through well designedprojects and programs. The study report further emphasized that well-allocated

foreign aid has been an effective means of supporting poor countries and poorpeople in their efforts to improve their lives. And with improved allocation andbetter design and delivery of assistance, aid is more effective today than everbefore (World Bank 1998, 2002). But the statistical evidence of world bank studymainly demonstrated how large-scale financial aid and (good) policy interactioncan generally affect poverty reduction, and didnt come up with how financial aidcan specifically affected child wellbeing. There is also strong argument from somescholars that the World Bank's success story rests on an extremely weakfoundation from aid-loan allocation and statistical point of view (PeterNunnenkamp, 2002).

On the other hand the Realty of Aid Report (2002) strongly argues the negativeeffect of massive multilateral and bilateral `aid loans' as related to debt service.According to the Report the evolution of the debt crisis, that emanate frommassive multilateral and bilateral `aid loans' tied to debt repayments andstructural adjustment policies, were in fact pressed developing countrygovernments to service their debts to Northern creditors at the expense of meetingextreme and expanding social needs.

Overall, although there are a number of hypotheses, suggestions, debates and insome cases findings as to what intervening factors affecting child wellbeing,particularly in the case of child mortality, child nutrition and child education;

there are inadequate empirical research and findings as to the circumstances orfactors that hindered the achievement of the Summit goals and/or contributed to

the variations among the regions and among the countries within and across theregions. Moreover, although previous studies and country experiences havesuggested a number of factors or circumstances that affect the performance of agiven countrys socio-economic development; the mechanism through which it isassociated with child wellbeing has yet to be explored.


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4.2 The theoretical Framework

From the above background, starting hypotheses, and theoretical point of viewwe can develop a framework of the major hindrances or circumstancesdetrimental to child wellbeing. The framework, theoretical construct, is bestillustrated in the schematic diagram (fig.-7) presented below to ensure

Preoperational Explication of the Construct for the mechanism through whicheach is associated with child wellbeing. Based on the background information ofthe preceding sections, four major (broad) forces and three contributing factorsassumed to be the most probable intervening variables detrimental to childwellbeing (measured in terms of child mortality, child nutrition and primary schoolenrolment.) The four major broad forces included in the theoretical constructinclude:

(1)Unhealthy (macro)economic performance.(2)Misdirected priority in budget allocation by government(3)High level of poverty and inequality.(4)Low level of foreign aid/financial flows & high dept service;

The other contributing factors include:(a)Bad governance and low civil liberties;(b)Prevalence of HIV/AIDS and domestic conflict,(c)Low levels of literacy (especially mothers).

These determinants will, of course, be measured using a number of variables orindicators when we come to empirical analysis. The inclusion of four broad forcesand three contributing factors and further split of the broad forces into a numberof variables or indicators will ensure the construct validity; as this certainlyovercome Mono-Operation Bias.

Measuring child wellbeing in terms of child mortality, child nutrition and enrollmentin primary education instead of picking one indicator- such as child mortality whichis referred as the single most important indicator of child wellbeing (UNICEF,2002) will also overcome Mono-MethodBias.

As depicted in the schematic diagram, the mechanism through which each factoraffects child wellbeing is quite complex. On one hand it is not very direct and onthe other there are interactions between the broad forces. This, Interaction ofDifferent Factors (Treatments) as threats to construct validity will be checkedand controlled in regression analysis in section V.

Although looking into the details of how each broad factor interacts with eachother is the major concern in development economics research, this is beyond thescope of this paper. Thus, in the following sub-sections, we will see mainly howeach major broad forces and contributing factors are affecting and/or associatedwith child wellbeing. This will be based on theoretical insights, empiricalevidences of previous research work which will be substaintiated by the findingsfrom my simple statistical and more rigorous econometric analysis of the data ofthe last decade.


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Determinants of Child Wellbeing in Developing Countries-Lessons from the Wo

Dereje Dejene Engdashet: MA Dissertation UA-IDPM; October 2003

Fig. 7: Schematic framework (Theoretical Construct) of Factors Affecting Child wellbeing in Developing Cou

Note: 1) Factors written in bold fonts are broad factors (major determinants) while operational mechanisms are presented in normal fo2) Solid lines arrows ( ) indicate how broad factors (major determinants) affect child wellbeing through operational m echanhow broad factor (major determinant) affect each other.

Low level ofknowledge aboutappropriate childcare practices

Inappropriatechildcarepractices

High child mortality

Low/inadequatefinancialresources

for healthandeducationservices stems.

-Poor health service(Inadequate healtheducation, inadequateimmunization, lack oftreatment for sickchildren, inadequate

maternal care)- Lack of clean water

- Inadequate &Poor health andwater facilities- Inadequatesupplies andlogistics for healthervice tem

Malnutrition

(2) Misdirected priority in

budget allocation by

government

(4)Low level of foreign financialsupport & high dept service

Lack of access toeducational services

- Inadequate andpoor educationfacilities- Inadequatesupplies andlogistics for

education service

Low primaryschool

enrollment

(c) Low level of literacy(Mothers)

(1)Unhealthy(macro)economicperformance:[-low realGDP per

capita,

-high rate of

inflation,

-unfavorable

trade

balance, etc

(a) Bad

governanceand low civil

liberties

(b) HIV/AIDS a

Domestic Confl-Low level of civil society and other stakeholders initiativesand involvement in community development processes

- Civil un-rest & political instability

Destruction of national asocioeconomic system &directly cost human live


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Determinants of Child Wellbeing in Developing Countries-Lessons from the World Summit for Children

Dereje Dejene Engdashet: MA Dissertation UA-IDPM. October 2003 Page 24

4.3 Macroeconomic Performance and Child Wellbeing

4.3.1 The link between macroeconomic performance and child wellbeing

Why some developing countries grow rapidly and others do not is one of the

most compelling questions in Economics (Aziz & Wescott (IMF), 1997), butdevelopment questions like why some developing countries rapidly improve thewellbeing of their children and others do not is not yet the common debate ofeconomists.

As defined in a number of literatures, Macroeconomics is the study of economicbehavior in the aggregate. The primary topics to be analyzed in the field ofmacroeconomics, accordingly, include: sustainable rates of economic growth, theemployment of resources, stability of prices essential to the proper functioning of a marketeconomy, and the international linkages that bind individual nations into a worldeconomy. These topics are all in support of determining the best way to improve

living standards for each person, country, and region around the planet (DouglasRuby, 2002).

Lovell C.A. K, et al (1995) defined macroeconomic performance in terms of theability of a country's macroeconomic managers to provide four services to theircitizens: a high level of real GDPper capita, a low rate of inflation, a low rate ofunemployment and a favorable trade balance. John Micklewright (2000), in hisarticle of Macroeconomics and Data and Children, has categorized economicstatistics that enter the macroeconomic debate under five headings. These include:budgets, interest rates, prices, incomes, and labour markets. Although theyemphasized on the four objectives as the primary performance indicators of

macroeconomic performance, Lovell C.A. K, et al (1995) also indicated that othereconomic objectives, such as: the pursuit of an equitable income distribution isanother indicator which comes to mind while assessing macroeconomicperformance. As input to these objectives, macroeconomic managers areresponsible to design polices and appropriate budget allocation for the welfare ofthe society.

Stefan deVylder (2000) has argued that macroeconomic polices are rarelydiscussed in connection with children, while there is no such things as child-neutral policies. When, for example, monetary polices are discussed, very few

economists and politicians consider their effect on children. But different

categories of people and different age groups are affected quite differently. Andthe impact of certain economic polices may not be the same for girls and boys.Stefan deVylder (2000). By the same token macroeconomic performance, in termsof the different parameters described above, affects different categories of peopleand different age groups differently. An empirical study conducted in Peru, toidentify socio-economic groups most vulnerable to welfare declines during amacroeconomic shocks, depicted that households with more children are among

the more vulnerable groups. (Paul Glewwe and Gillette Hall,1998)


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To illustrate the different ways in which economic polices affect the situation ofchildren, Stefan deVylder (2000) used a set of concentric circles moving outwards(see fig.-8). The diagram depicts that the hub are polices and legislations whichare closer and explicitly target children, such as the public provision of primary

health care, and primary education. According to Stefan deVylder (2000), whiledirect health sector intervention including preventive action such as vaccinationcampaigns are exceedingly important, and would belong to the inner circle;(fig.-8 below), sustained declines in infant mortality and improvement in childhealth are achieved predominantly through changes in outside factors.

A sustainability study of education projects conducted by the OperationEvaluation Department (OED) of the World Bank (World Bank (1990), cited inDaniel Kaufmann and Yan Wang (1995)) reported that the external economic andpolicy environment affects sustainability through the fiscal resources theborrower makes (or does not make) available to support educational

development, or through policy measures to back up specific sub-sectors.

Fi.-8 Children at the Center: Successive Economic Environments that AffectChild Wellbeing

Source: Stefan deVylder (2000b)-CRIN Newsletter No. 13

Overall, previous studies and country experiences have suggested that project orsector performance in education and health is associated with the economy-widepolicy environment and macroeconomic performance of a country. Themechanism, however, through which one is associated with another has yet to beexplored.


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In the theoretical construct presented above (fig.-7) we has seen that Unhealthy(macro) economic performance [low real GDP per capita growth, high rate of

inflation, unfavorable trade balance, etc] make the economy to avail low/inadequate financial resources for health and education service systems andsubsequently resulted in inadequate & poor health and education facilities,inadequate supplies and logistics for health and education service, there by poorhealth service (Inadequate health education, inadequate immunization, lack oftreatment for sick children, inadequate maternal care), and deprive children tohave access to educational services and finally end up with high child mortality,high child malnutrition rate and low enrolment rate to primary education

The economy wide policy responsible for unhealthy macroeconomic performancemanifest in terms of macroeconomic parameters: level of real GDP per capitagrowth, rate of inflation, rate of unemployment, trade balance, interest rates,

budget allocation and deficits. Of these parameters some are less relevant for

developing countries. For example rate of unemployment. Unlike industrializedcountries, unavailability and unreliability of data in developing countries is madeit difficult and unreliable to measure macroeconomic performance of thesecountries in terms of rate of unemployment. Unemployment in most ofdeveloping countries is also disguised as the major occupation is traditionalagriculture and/or informal sector (micro and medium enterprises or incomegenerating activities.) Trade balance of developing countries mostly coveredthrough foreign aid/ finance and this disguise its positive or negative effect. Rateof inflation is more important for developing countries people as they are, in mostcases, living on regular wage or seasonal production. Therefore, I will mainlyconcentrate on how real GDP per capita growth rate, and rate of inflation as key

indicator of macroeconomic performance of developing countries affect and/orassociated with child wellbeing, and contributed to the (under) achievement ofthe World Summit goals for children. Government budget allocation is handledseparately in the subsequent section (section 4.4)

4.3.2 Economic growth and child wellbeing.

The positive correlation between economic growth and the well-being of childrencan be intuitively felt and illustrated by comparing the status of child well-beingof high income countries with that of low incomes. Industrialized countries thatachieved average GNI per capita of US$ 28077 by end of the millennium perform

much better than do poorer countries that able to reach average GNI per capita ofonly US$ 290. For example the U5CMR is 6 per 1000 LB in high income countriesvis--vis 161 per 1000 LB in poorer countries. Under 5 malnutrition rate (%underweight) was nil in high income countries vis--vis 37 percent in poorercountries. And NER-primary school was 96 for Industrialized Countries, while itwas 58 for the poorest (least developed) countries.


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However, Stefan deVylder (2000) stressed that economic growth is not enough;the pattern of growth is at least as important as the rate of growth. Moreover,John Micklewright (2000), indicated that national income per head may be only arough guide to the average income of families with children or that of any othergroup. For example the USA has the highest GNP per capita of any large country

but despite this it ranks 12th in a group of 25 industrialized countries in terms ofthe proportion of children beneath a common absolute poverty line (Bradbury etal, 1999, cited in John Micklewright, 2000). Why economic growth not enough?

The 1996 Human Development Report of UNDP, which focused on Economicgrowth and human development, identified five patterns of growth which are notcompatible with sustainable human development. These includes

Job less growth, where the overall economy grows but doesnt expand theopportunity for employment;

Voiceless growth, where growth in the economy does not be accompaniedby an extension of democracy or empowerment.

Ruthless growth, where the fruit of economic growth mostly benefit therich, leaving the majority of the people struggling in eve-deepeningpoverty;

Rootless growth, which cause peoples identity to wither; and Futureless growth, where the present generation squanders resources

needed by future generation.

The Report (UNDP, 1996) argues that economic growth, if not properly managed,can be jobless, voiceless, ruthless, rootless and futureless, and thus detrimental tohuman development. The quality of growth is therefore as important as itsquantity for poverty reduction, human development and sustainability. Stefan

deVylder (2000) emphasized thatfor a growth to be truly chil

dbe

neficial, it

needs tobe inclusive, sustainable andequitable.

4.3.2.1 Economic growth and the progress in reduction of under five child mortality rate

The following figure (fig.-9) illustrates the association of U5CMR-decadereduction (1990-2000) with GDP per capita average annual growth rate during thedecade (1990-2000) as well as long term trend of GDP per capita growth rate forthe period of 1960-90. The two variables are tested here from the assumption thatchange in the human wellbeing is most probably more affected by long term

economic phenomenon than short term.

From the figure we can sense that there is a sort of positive association betweenreduction of U5CMR during the decade (1999-2000) and GDP per capita growthrate during the same decade as well as long term GDP per capita growth rateduring the pervious three decades (1960-90).


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Fig.-9 Scatter plot of Under 5 Mortality rate -Decade reduction (%), 1990-2000 vs.GDP per capita average annual growth rate (%): (a)1990-2000 and (b) 1960-1990.

GDP per capita average annual growth rate (%) 1990-2000

100-10

U5

CMR-Decadereduction(%)1990-2000

60

40

20

0

-20

-40

Zambia

Viet Nam

Uruguay

Uganda

TurkmenistanTajikistan

Swaziland

Sudan

South Af rica

Sierra Leone

Saudi Arabia Peru

Oman

Nigeria

Myanmar

Morocco

Mongolia

Mauritania

Malaysia

Lao PDR

Kyrgyzstan

Korea, Rep. of

Kenya

Kazakhstan

HaitiGhana

Georgia

Gambia

Ethiopia

Congo, Dem. Rep.

China

Chile

Cameroon

Cambodia

Burundi

Burkina Faso

BrazilBhutan

Armenia

Argentina

GDP per capita average annual growth rate (%) 1960-90

86420-2-4

U5CMR-Decaderedu

ction(%)1990-2000

60

40

20

0

-20

-40

Zambia

Thailand

Sw aziland

Sudan

South Af rica

Rw anda

Philippines

Pakistan

Oman

Nigeria

Niger

Nicaragua Nepal

Morocco

Mexico

Mauritius

Mali

Malaysia

Libya

Lesotho

Korea, Rep.

Kenya

Iran

Indonesia

IndiaGhana

Gambia

Ecuador

Dominican R..

Cte dIvoire

Congo, DR.Congo

China

Cameroon

Burundi

Burkina Faso

BrazilBolivia

Benin

Bangladesh

Argentina

Afghanistan

(a) Pearson Correlation (r)=.415 (P


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Although reduction of U5CMR is significantly associated with both the decadeand the long term GDP per capita growth rate, it appears to be that the associationis much stronger with the former than with the latter. Beside the existence ofsome outliners, under both circumstances, which are vividly seen on the scatterplot, the loose association conquers the above argument of UNDP (1996) and

Stefan deVylder (2000).

The close look into countries depicts that out of 68 developing countries that haveachieved, on the average, positive per capita GDP growth rate during the decade,only 23 countries (34%) have achieved U5CMR reduction of 33% or above. On theother hand out of 32 DC countries that have faced, on the average, negative or nilper capita GDP growth rate during the decade, 4 countries (12.5%) have achievedU5CMR reduction by 33% or above.

When we examine the economic performance of 27 countries developingcountries, where U5CMR increased or made no progress at all, 11 country (41%)have registered, on the average positive per capita GD

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