Access to antenatal care and children's cognitive development: a comparative analysis in Ethiopia, Peru, Vietnam and India

Early life interventions are considered essential for reducing the burden of health inequalities over the life course. This paper tests this issue empirically focusing on whether access to antenatal care can later reduce children's health and educational inequalities. Data came from the Young Lives Project for Ethiopia, Peru, Vietnam, and the State of Andhra Pradesh in India. We selected children born in early 2001/2002 and who were followed longitudinally in 2006/2007. We used multilevel mixed effects linear regression models to estimate the parameters of interest. We found a positive and significant relationship between mothers' access to antenatal care and their children's cognitive development in all countries. In addition, we found a positive and significant relationship between antenatal care and children's cognitive development for stunted children but only in Peru and Vietnam. We conclude that (1) antenatal care has the potential to change the negative consequences of early nutritional deficiencies on later cognitive development in Peru and Vietnam; (2) differentials in the quality of antenatal care services could explain the cross-country differentials in the role of early life interventions found here.