Moving beyond the mother-child dyad: Womenʹs education, child immunization, and the importance of context in rural India

The argument that maternal education is critical for child health is commonplace in academic and policy discourse, although significant facets of the relationship remain empirically and theoretically challenged. While individual-level analyses consistently suggest that maternal education enhances child health outcomes, another body of literature argues that the observed causality at the individual-level may, in fact, be spurious. This study contributes to the debate by examining the contextual effects of womenʹs education on childrenʹs immunization in rural districts of India. Multilevel analyses of data from the 1994 Human Development Profile Index and the 1991 district-level Indian Census demonstrate that a positive and significant relationship exists between the proportion of literate females in a district and a childʹs complete immunization status within that district, above and beyond the childʹs own motherʹs education as well as district-level socioeconomic development and healthcare amenities. However, results also indicate that the effect of maternal education cannot be downplayed. Thus, increasing womenʹs literacy at the community level, in addition to motherʹs access to higher education—such as matriculation and beyond—at the individual-level, emerge as effective developmental tools.