Research Economic Seminar: Uncovering the role of education in the uptake of preventive measures against malaria in the African population

In many African countries where malaria is endemic, this life-threatening disease is a leading cause of death. What role does education, in particular numeracy and literacy, play in malaria prevention and treatment-seeking? In this study we apply a birth cohort approach, which allows us to cover a time span of 60 years, and therefore, to provide a comprehensive view on the evolution of education as well as malaria prevention and treatment-seeking attitudes adapted among sub-Saharan African cohorts born during the 20th century. We use three different indicators to measure malaria control behavior: the share of respondents using insecticide-treated bednets (ITNs), the share of pregnant women taking antimalarial drugs, and the share of respondents taking their child to a medical facility when suffering from malaria symptoms like fever and cough. Our descriptive results suggest that younger birth cohorts are more likely to adapt malaria control measures than older ones. This is in line with an increase in the literacy rate we observe across the cohorts. The spatial distribution of numeracy remains rather constant across the cohorts, high in regions where it was initially high and low in regions where it was initially low. Based on a sample of 33 African countries, 407 regions, and a total of 1,960 observations, we perform multiple regressions using the pooled OLS estimator. We find that being numerate as well as being literate is positively associated with malaria protection and health-seeking behavior, though the numeracy coefficients are of larger magnitudes. We account for the most relevant factors including socio-economic status, women in health-care decision-making, media exposure, urban-rural settings and climatic conditions. The findings of the IV approach suggest that the influence of education on malaria prevention and treatment-seeking behavior is causal.