title: Fertility decline, girls' well-being, and gender gaps in children's well-being in poor countries.
abstract: The influences of recent dramatic declines in fertility on girls' and boys' well-being in poorer countries are understudied. In panels of 67-75 poorer countries, using 152-185 Demographic and Health Surveys spanning 1985-2008, we examined how declining total fertility and women's increasing median age at first birth were associated with changes in girls' well-being and gender gaps in children's well-being, as reflected in their survival, nutrition, and access to preventive healthcare. In adjusted random-effects models, these changes in fertility were associated with gains in girls' survival at ages 1-4 years, vaccination coverage at ages 12-23 months, and nutrition at 0-36 months (for women's later first childbearing). Declining total fertility was associated with similar gains for boys and girls with respect to vaccination coverage but intensified gender gaps in mortality at ages 1-4 years and malnutrition at ages 0-36 months, especially in higher-son-preference populations. Later increases in women's median age at first birth-reflecting more equitable gender norms-were associated with declines in these gaps. Promoting equitable investments in children through family planning programs in higher-fertility societies is warranted.
authors.affiliation: Asa Griggs Candler Chair of Global Health, Hubert Department of Global Health and Department of Sociology, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA, kyount@emory.edu.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Yount
authors.forename: Sarah
authors.initials: S
authors.lastname: Zureick-Brown
authors.forename: Nafisa
authors.initials: N
authors.lastname: Halim
authors.forename: Kayla
authors.initials: K
authors.lastname: Lavilla
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D015988:Cohort Effect; D003906:Developing Countries; D005260:Female; D005298:Fertility; D006297:Health Services Accessibility; D006306:Health Surveys; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D015596:Nutrition Assessment; D010549:Personal Satisfaction; D016019:Survival Analysis; D055815:Young Adult