costs of teen childbirth

Estimating the Economic Costs of Teenage Childbirth

Yung-Ting Bonnenfant, Ghada Al-Attar, Ann Herbert, David Bishai

Johns Hopkins Bloomberg School of Public HealthDecember 20, 2013

Research Questions

•How many years of schooling are lost among girls who experience teenage childbirth in 76 countries around the world?

•What are the economic costs of teenage childbirth as a result of years of schooling lost?

Methods: Data and Sample•Data: Demographic and Health Surveys (DHS)

▫Used latest unrestricted recoded standard DHS in each country at the time of the analysis DHS dates ranged from 1987-2012

•Sample included:▫ Women with at least 1 year of schooling

Teen childbirth is unlikely to affect the educational attainment of women who never started school

▫Women were between the ages of 13-54 Most DHS data sets restricted the ages to 15-49

Methods: Variables• Dependent variable: years of schooling

• Key independent variable: teen childbirth▫Yes - if she gave birth before the age of 20▫No - if she gave birth ≥ 20 years or had 0

children ever born

• Multivariate analyses also adjusted for:▫current age/period, religion, ideal family size,

wealth, son preference, and the respondent’s number of siblings Some countries were missing some of these

variables (see table footnotes)

Methods: Analysis• Imputation

▫ Missing values for ideal # children and ideal # boys and girls (used for son preference) were imputed since these variables contained large numbers of missing values and non-numeric responses

• Stratification: analyses conducted separately by teen marital status▫ Teen unmarried: Age at first marriage/cohabitation ≥ 20 years or

reported never having been married/cohabiting▫ Teen married: Reported age at first marriage/cohabitation < 20 years

• Multivariate fixed effects regression models▫ Estimated years of schooling lost due to a teenage birth, controlling

for other variables thought to influence schooling▫ Produced within-cluster estimates, which control for unmeasured

cluster differences, such as the status of women or the presence of a school in the cluster

▫ Accounted for the clustering of data by primary sampling unit ▫ DHS sample weights used and robust standard errors specified ▫ STATA SE version 13 was used for all regression analyses

Methods: Economic Analysis• Country-specific numbers of 15 year old teen

married and teen unmarried girls expected to lose earnings from a teen childbirth were estimated▫Population estimates came from the DHS, 2012

Revision of the UN World Population Prospects and the UN World Marriage Data 2012

▫Country-specific female labor participation rates for women aged 15-64 were from the 2010 HDI from WB

• Earnings data from Oostendorp 20041 from 43 countries were extrapolated to other countries in the analysis and to 2011 using a regression on time and a GDP quadratic

• Sensitivity analysis was performed with a Monte Carlo model using @Risk software

1 Oostendorp, R. (2004). Globalization and the gender wage gap: World Bank Policy Research Working Paper 3256 World Bank.

Methods: Economic Analysis

• The equation for lost earnings is as follows: ▫ Lost Earnings for a Cohort of Unmarried 15 year Old Girls in

Country “J”= (Cohort Sizej) (Prevalence of Any Schoolingj ) (Prevalence of Being

Unmarried till age 20j) (Prevalence of TeenBirthj|Unmarried, AnySchooling) (Estimated years of schooling lostj |Teen Birth Unmarried, Anyschooling) (Labor Force ParticipationJ ) (Present Value of Lifetime Earningsj) (Percent Earnings Reduction per Year of Lost Schoolingj)

▫ For girls married before age 20 the equation was: Lost Earnings for a Cohort of Married Teen Girls in Country “J”= (Cohort Sizej) (Prevalence of Any Schoolingj ) (Prevalence of Being

Married before age 20j) (Prevalence of TeenBirthj|Married, AnySchooling) (Estimated years of schooling lostj |Teen Birth Married, Anyschooling) (Labor Force ParticipationJ ) (Present Value of Lifetime Earningsj) (Percent Earnings Reduction per Year of Lost Schoolingj)

Table 1a: Summary statistics - AfricaCountry Unmarried as teenagers Married as teenagers

Frequency of ever

attending school

Frequency of teen birth

among womenages 20-49 who ever attended

school

Average years of

schooling among

those with schooling

Frequency of ever

attending school



school

Average years of

schooling among


Benin 2006 55.4% 6.5% 7.3 20.3% 69.2% 4.6 Burkina Faso 2010 48.0% 6.3% 7.6 15.1% 66.9% 5.6 Burundi 2010 62.9% 3.1% 6.0 41.2% 63.5% 4.5 Cameroon 2011 93.5% 23.3% 8.8 66.9% 71.5% 6.5 Central African Rep 1995 49.8% 24.2% 5.0 42.3% 74.4% 4.8 Chad 2004 38.7% 3.3% 5.7 20.8% 78.6% 4.3 Comoros 1996 59.0% 1.0% 6.7 29.0% 65.5% 5.6 Congo, Brazzaville 2005 95.2% 34.5% 8.1 88.6% 78.0% 7.1 Congo, Dem Rep 2007 84.8% 12.4% 7.7 74.0% 73.1% 6.0 Cote d’Ivoire 2012 58.8% 29.7% 8.0 31.8% 74.7% 5.8 Ethiopia 2011 74.1% 3.8% 6.9 30.4% 70.2% 4.9 Gabon 2000 95.5% 49.4% 7.9 91.5% 78.4% 6.6 Ghana 2008 86.5% 13.3% 9.0 66.8% 66.4% 7.3 Guinea 2005 47.4% 17.0% 7.1 13.7% 68.3% 6.1 Kenya 2009 95.3% 21.5% 9.4 85.0% 81.1% 7.4 Lesotho 2009 99.2% 13.2% 8.9 97.9% 64.7% 7.2 Liberia 2007 69.7% 36.8% 6.8 45.1% 73.7% 5.8 Madagascar 2009 86.9% 8.8% 6.2 75.3% 72.9% 4.5

Table 1a: Summary statistics – Africa (cont)Country Unmarried as teenagers Married as teenagers

Frequency of ever

attending school



school

Average years of

schooling among


Frequency of ever

attending school



school

Average years of

schooling among


Malawi 2010 90.7% 16.2% 7.7 80.2% 81.5% 5.5 Mali 2006 38.3% 13.4% 7.5 16.3% 68.6% 5.9 Mozambique 2011 72.2% 29.6% 6.6 64.3% 77.8% 4.9 Namibia 2007 94.9% 30.0% 9.2 83.2% 67.3% 7.4 Niger 2006 44.0% 5.0% 7.5 10.7% 72.9% 4.8 Nigeria 2008 89.2% 5.8% 10.4 41.5% 73.1% 7.8 Rwanda 2010 87.4% 4.7% 5.6 69.5% 59.2% 4.5 Sao Tome & Principe 2009 96.1% 12.3% 7.0 92.5% 77.1% 5.0 Senegal 2011 58.6% 7.4% 7.5 22.7% 61.2% 5.6 Sierra Leone 2008 60.7% 24.8% 8.3 20.7% 75.0% 6.3 South Africa 1998 94.9% 33.6% 9.6 86.1% 66.8% 8.1 Sudan 1990 57.8% 0.6% 8.5 36.1% 72.2% 5.3 Swaziland 2007 94.6% 46.5% 9.2 83.1% 81.5% 7.5 Tanzania 2010 88.5% 22.2% 7.8 73.5% 75.2% 6.4 Togo 1998 64.3% 10.6% 5.5 38.6% 73.1% 4.3 Uganda 2011 93.2% 20.6% 7.9 81.2% 82.1% 5.6 Zambia 2007 94.2% 25.7% 8.4 85.6% 80.3% 6.1 Zimbabwe 2011 98.8% 14.5% 10.0 96.3% 76.6% 8.4

Table 1b: Summary statistics - AsiaCountry Unmarried as teenagers Married as teenagers

Frequency of ever

attending school



school

Average years of

schooling among


Frequency of ever

attending school



school

Average years of

schooling among


Bangladesh 2011 89.0% 1.4% 9.8 69.4% 76.9% 6.3 Cambodia 2010 87.4% 0.5% 6.7 78.5% 57.5% 4.9 India 2006 83.7% 0.4% 9.9 45.3% 63.3% 7.1 Indonesia 2007 96.0% 1.0% 9.8 90.0% 67.6% 6.6 Kazakhstan 1999 99.7% 0.9% 11.3 99.5% 56.2% 10.5 Kyrgyzstan 1997 99.8% 0.4% 10.9 99.9% 54.4% 10.3 Maldives 2009 90.9% 1.6% 9.4 66.2% 54.5% 7.3 Nepal 2011 81.2% 0.2% 8.4 45.3% 63.1% 6.4 Pakistan 2007 46.8% 0.0% 9.0 28.7% 58.0% 6.9 Philippines 2008 99.3% 1.9% 11.8 97.4% 66.1% 8.5 Sri Lanka 1987 93.0% 0.4% 8.0 83.6% 63.6% 6.0 Thailand 1987 93.5% 0.0% 6.2 88.0% 61.5% 4.7 Timor-Leste 2010 74.1% 0.6% 10.2 63.5% 66.4% 7.9 Uzbekistan 1996 99.9% 0.5% 10.6 99.9% 49.8% 10.2 Vietnam 2002 96.1% 0.2% 8.6 90.4% 50.4% 6.8

Table 1c: Summary statistics - Europe

Country Unmarried as teenagers Married as teenagersFrequency

of ever attending

school



school

Average years of

schooling among


Frequency of ever

attending school



school

Average years of

schooling among


Albania 2009 99.7% 0.3% 10.4 99.3% 45.2% 9.0

Armenia 2010 99.9% 0.1% 12.2 99.9% 59.0% 11.0

Azerbaijan 2006 99.1% 0.1% 11.1 98.5% 53.7% 10.2

Moldova 2005 99.8% 1.3% 11.5 99.8% 49.7% 11.0

Turkey 2003 89.9% 0.0% 7.9 77.9% 63.7% 5.7

Ukraine 2007 100.0% 1.6% 14.0 100.0% 49.8% 13.4

Table 1d: Summary statistics – Latin America & Caribbean


of ever attending

school



school

Average years of

schooling among


Frequency of ever

attending school



school

Average years of

schooling among


Bolivia 2008 96.0% 12.4% 10.2 93.4% 76.8% 7.1 Brazil 1996 96.7% 5.6% 7.6 91.5% 67.0% 5.5 Colombia 2010 99.1% 12.7% 9.9 96.7% 73.5% 7.7 Dominican Republic 2007 98.2% 3.9% 11.0 93.4% 71.2% 8.1 Ecuador 1987 94.7% 5.1% 8.6 88.8% 75.2% 6.2 Guatemala 1995 79.7% 4.2% 7.2 57.1% 76.4% 4.7 Guyana 2009 99.2% 18.2% 9.7 97.1% 70.5% 8.1 Haiti 2006 83.1% 3.5% 7.2 65.3% 60.2% 5.7 Honduras 2012 96.8% 8.5% 9.2 91.9% 76.1% 6.4 Mexico 1987 94.4% 2.6% 7.9 80.2% 76.3% 5.5 Nicaragua 2001 92.6% 4.7% 8.7 80.0% 75.4% 6.3 Paraguay 1990 97.8% 9.6% 7.7 96.1% 68.3% 5.6 Peru 2000 96.9% 7.4% 10.3 90.6% 74.7% 7.3 Trinidad & Tobago 1987 99.2% 2.6% 8.5 98.5% 61.3% 7.2

Table 1e: Summary statistics – Middle East & North Africa


of ever attending

school



school

Average years of

schooling among


Frequency of ever

attending school



school

Average years of

schooling among


Egypt 2008 80.7% 0.0% 11.8 55.7% 58.5% 8.7 Jordan 2007 97.6% 0.2% 12.4 94.3% 60.6% 9.9 Morocco 2004 59.9% 0.1% 8.4 25.5% 58.8% 5.8 Tunisia 1988 52.1% 0.1% 7.0 33.7% 56.4% 5.5 Yemen 1991 16.9% 0.0% 10.1 9.4% 68.8% 5.7

Table 2a: Years of schooling lost from a teen birth among those with any school attendance† - Africa

Country Unmarried as teenagers Married as teenagersYears of

schooling lost for a teen

birth

Standard error

p-value Years of schooling lost

for a teen birth

Standard error

p-value

Benin 2006 -1.16*** 0.25 0.000 -0.21 0.13 0.124Burkina Faso 2010 -1.40*** 0.28 0.000 -0.41* 0.20 0.038Burundi 2010 -0.71* 0.27 0.010 -0.06 0.12 0.648Cameroon 2011 -0.86*** 0.10 0.000 -0.67*** 0.09 0.000Central African Rep 1995c 0.52* 0.23 0.029 0.26 0.16 0.108Chad 2004 -2.48*** 0.66 0.000 -0.22 0.21 0.301Comoros 1996k 0.56 0.95 0.556 -1.52*** 0.34 0.000Congo, Brazzaville 2005 -0.43** 0.13 0.001 -0.82*** 0.12 0.000Congo, Dem Rep 2007 -0.34 0.29 0.246 -0.49*** 0.13 0.000Cote d’Ivoire 2012 -1.21*** 0.18 0.000 -0.43 0.28 0.129Ethiopia 2011 -0.92 0.52 0.078 -0.29 0.19 0.135Gabon 2000c -0.40** 0.13 0.002 -0.38* 0.16 0.020Ghana 2008a -1.38*** 0.24 0.000 -0.98*** 0.19 0.000Guinea 2005 -0.84* 0.38 0.028 -0.89** 0.29 0.003Kenya 2009 -0.99*** 0.15 0.000 -0.78*** 0.14 0.000Lesotho 2009 -0.85*** 0.12 0.000 -0.50*** 0.11 0.000Liberia 2007 -0.22 0.17 0.212 -0.40 0.21 0.053Madagascar 2009 -0.72*** 0.12 0.000 -0.50*** 0.08 0.000

Table 2a: Years of schooling lost from a teen birth among those with any school attendance† - Africa (cont)



birth

Standard error


for a teen birth

Standard error

p-value

Malawi 2010 -0.50*** 0.13 0.000 -0.42*** 0.08 0.000Mali 2006 -1.56*** 0.33 0.000 -0.95*** 0.18 0.000Mozambique 2011 -0.54*** 0.10 0.000 -0.15 0.09 0.074Namibia 2007 -0.99*** 0.09 0.000 -0.89*** 0.23 0.000Niger 2006 -1.45** 0.50 0.004 -0.35 0.19 0.074Nigeria 2008 -0.91*** 0.14 0.000 -0.53*** 0.09 0.000Rwanda 2010 -0.64*** 0.12 0.000 -0.11 0.10 0.259Sao Tome & Principe 2009 -0.78* 0.36 0.032 -0.36** 0.12 0.004Senegal 2011 -1.35*** 0.22 0.000 -0.39 0.27 0.151Sierra Leone 2008 -1.00*** 0.22 0.000 0.00 0.28 0.988South Africa 1998g -0.56*** 0.08 0.000 -0.33* 0.16 0.045Sudan 1990h -3.15** 0.97 0.001 -0.74*** 0.15 0.000Swaziland 2007 -0.87*** 0.10 0.000 -0.97*** 0.26 0.000Tanzania 2010b -0.90*** 0.11 0.000 -0.15 0.08 0.050Togo 1998c -0.42 0.23 0.071 -0.15 0.14 0.292Uganda 2011 -0.85*** 0.22 0.000 -0.62*** 0.13 0.000Zambia 2007 -0.43** 0.14 0.003 -0.29** 0.10 0.005Zimbabwe 2011 -1.26*** 0.12 0.000 -0.60*** 0.09 0.000

Table 2b: Years of schooling lost from a teen birth among those with any school attendance† - Asia


schooling lost for a

teen birth

Standard error

p-value Years of schooling lost for a

teen birth

Standard error

p-value

Bangladesh 2011a -2.43*** 0.56 0.000 -0.98*** 0.06 0.000Cambodia 2010 -1.21*** 0.33 0.000 -0.31*** 0.07 0.000India 2006a -2.20*** 0.32 0.000 -0.67*** 0.04 0.000Indonesia 2007 -1.08** 0.37 0.003 -0.54*** 0.06 0.000Kazakhstan 1999f -1.20** 0.40 0.003 -0.20* 0.09 0.024Kyrgyzstan 1997f -0.04 0.51 0.933 -0.16 0.08 0.057Maldives 2009e -2.39*** 0.34 0.000 -0.93*** 0.10 0.000Nepal 2011a -4.69*** 0.78 0.000 -0.72*** 0.11 0.000Pakistan 2007e n/a n/a n/a -0.41* 0.19 0.033Philippines 2008a -1.39*** 0.38 0.000 -0.68*** 0.13 0.000Sri Lanka 1987h -1.92* 0.90 0.035 -0.59*** 0.13 0.000Thailand 1987h -3.28*** 0.18 0.000 -0.38*** 0.07 0.000Timor-Leste 2010 -2.84** 0.87 0.001 -0.97*** 0.20 0.000Uzbekistan 1996f -0.54 0.28 0.054 -0.16* 0.08 0.035Vietnam 2002f -3.11*** 0.77 0.000 -0.50*** 0.13 0.000

Table 2c: Years of schooling lost from a teen birth among those with any school attendance† - Europe

Country Unmarried as teenagers Married as teenagers

Years of schooling lost for a

teen birth

Standard error


teen birth

Standard error

p-value

Albania 2009a -0.23 0.65 0.727 -0.61*** 0.11 0.000Armenia 2010e 1.64*** 0.17 0.000 -0.55*** 0.10 0.000Azerbaijan 2006a 0.88 0.57 0.127 -0.35** 0.11 0.002Moldova 2005j -1.40*** 0.31 0.000 -0.55*** 0.09 0.000Turkey 2003e -1.12 1.70 0.510 -0.49*** 0.09 0.000Ukraine 2007a -0.83* 0.34 0.014 -0.66*** 0.13 0.000

Table 2d: Years of schooling lost from a teen birth among those with any school attendance† - Latin America & Caribbean



birth

Standard error


for a teen birth

Standard error

p-value

Bolivia 2008b -1.26*** 0.13 0.000 -0.86*** 0.15 0.000Brazil 1996c -1.59*** 0.17 0.000 -0.45*** 0.11 0.000Colombia 2010e -0.96*** 0.06 0.000 -0.96*** 0.06 0.000Dominican Republic 2007b -1.49*** 0.28 0.000 -0.92*** 0.10 0.000Ecuador 1987k -1.77*** 0.31 0.000 -0.48** 0.15 0.002Guatemala 1995c -1.39*** 0.34 0.000 -0.31 0.19 0.097Guyana 2009a -0.20 0.16 0.227 -0.30 0.16 0.067Haiti 2006 -1.18*** 0.33 0.000 -0.99*** 0.14 0.000Honduras 2012a -1.20*** 0.14 0.000 -0.70*** 0.08 0.000Mexico 1987k -1.66*** 0.34 0.000 -0.26 0.15 0.086Nicaragua 2001i -1.78*** 0.37 0.000 -0.81*** 0.11 0.000Paraguay 1990h -1.73*** 0.20 0.000 -0.45** 0.14 0.001Peru 2000d -1.74*** 0.12 0.000 -0.74*** 0.09 0.000Trinidad & Tobago 1987h -1.27** 0.37 0.001 -0.62*** 0.09 0.000

Table 2e: Years of schooling lost from a teen birth among those with any school attendance† - Middle East & North Africa


schooling lost for a

teen birth

Standard error


teen birth

Standard error

p-value

Egypt 2008a n/a n/a n/a -0.94*** 0.11 0.000Jordan 2007e -2.91*** 0.53 0.000 -1.09*** 0.13 0.000Morocco 2004b -5.66*** 1.50 0.000 -0.56** 0.20 0.005Tunisia 1988k -2.45*** 0.16 0.000 -0.15 0.21 0.475Yemen 1991k n/a n/a n/a -0.45 0.31 0.145

Table 3a: Lifetime earnings (millions of USD) lost due to teen childbirth in cohort of 15 year olds - Africa

Country Cohort of unmarried teenagers Cohort of married teenagers5%

returns to schooling

10% returns to schooling

15%returns to schooling




Benin 2006 -4.08 -8.16 -12.23 -0.80 -1.60 -2.40Burkina Faso 2010 -5.77 -11.54 -17.32 -2.63 -5.27 -7.90Burundi 2010 -1.23 -2.45 -3.68 -0.12 -0.25 -0.37Cameroon 2011 -52.51 -105.02 -157.53 -29.52 -59.03 -88.55Central African Rep 1995 4.52 9.03 13.55 3.99 7.97 11.96Chad 2004 -2.20 -4.39 -6.59 -1.90 -3.80 -5.70Comoros 1996 0.01 0.02 0.03 -0.11 -0.22 -0.33Congo, Brazzaville 2005Congo, Dem Rep 2007Cote d’Ivoire 2012 -36.96 -73.93 -110.89 -5.75 -11.49 -17.24Ethiopia 2011 -21.48 -42.96 -64.44 -11.42 -22.85 -34.27Gabon 2000 -13.70 -27.41 -41.11 -4.60 -9.19 -13.79Ghana 2008 -46.30 -92.59 -138.89 -11.70 -23.40 -35.10Guinea 2005 -5.87 -11.75 -17.62 -4.16 -8.32 -12.48Kenya 2009 -95.66 -191.31 -286.97 -35.20 -70.39 -105.59Lesotho 2009 -3.01 -6.02 -9.03 -1.37 -2.75 -4.12Liberia 2007 -1.54 -3.09 -4.63 -0.89 -1.77 -2.66Madagascar 2009 -9.02 -18.04 -27.07 -24.91 -49.82 -74.73

Table 3a: Lifetime earnings (millions of USD) lost due to teen childbirth in cohort of 15 year olds – Africa (cont)








Malawi 2010 -9.32 -18.65 -27.97 -11.10 -22.20 -33.30Mali 2006 -3.01 -6.02 -9.03 -4.24 -8.48 -12.72Mozambique 2011 -25.80 -51.60 -77.40 -12.96 -25.92 -38.88Namibia 2007 -31.12 -62.25 -93.37 -2.99 -5.99 -8.98Niger 2006 -0.95 -1.90 -2.86 -1.21 -2.41 -3.62Nigeria 2008 -58.65 -117.30 -175.95 -81.41 -162.82 -244.23Rwanda 2010 -4.16 -8.32 -12.49 -0.23 -0.45 -0.68Sao Tome & Principe 2009Senegal 2011 -9.40 -18.79 -28.19 -2.83 -5.65 -8.48Sierra Leone 2008 -5.37 -10.73 -16.10 -0.01 -0.02 -0.03South Africa 1998 -387.88 -775.76 -1163.64 -18.40 -36.79 -55.19Sudan 1990 -2.28 -4.55 -6.83 -12.44 -24.87 -37.31Swaziland 2007 -11.73 -23.45 -35.18 -0.80 -1.59 -2.39Tanzania 2010 -123.55 -247.11 -370.66 -13.52 -27.05 -40.57Togo 1998 -1.88 -3.75 -5.63 -0.53 -1.06 -1.58Uganda 2011 -65.86 -131.72 -197.58 -43.16 -86.33 -129.49Zambia 2007 -16.97 -33.94 -50.91 -7.28 -14.57 -21.85Zimbabwe 2011 -30.77 -61.54 -92.31 -23.73 -47.46 -71.19

Table 3b: Lifetime earnings (millions of USD) lost due to teen childbirth in cohort of 15 year olds – Asia








Bangladesh 2011 -35.41 -70.82 -106.23 -512.82 -1025.63 -1538.45Cambodia 2010 -1.54 -3.08 -4.62 -4.50 -9.00 -13.50India 2006 -57.91 -115.83 -173.74 -534.45 -1068.90 -1603.35Indonesia 2007 -38.30 -76.60 -114.90 -197.08 -394.15 -591.23Kazakhstan 1999 -7.48 -14.95 -22.43 -3.53 -7.06 -10.59Kyrgyzstan 1997 -0.01 -0.02 -0.03 -0.41 -0.82 -1.22Maldives 2009 -0.68 -1.35 -2.03 -0.35 -0.70 -1.06Nepal 2011 -21.43 -42.86 -64.29Pakistan 2007 -8.36 -16.72 -25.08Philippines 2008 -52.88 -105.77 -158.65 -48.68 -97.36 -146.04Sri Lanka 1987 -1.86 -3.72 -5.58 -7.71 -15.41 -23.12Thailand 1987 -1.74 -3.48 -5.23 -54.11 -108.22 -162.33Timor-Leste 2010 -0.12 -0.23 -0.35 -0.33 -0.65 -0.98Uzbekistan 1996 -1.29 -2.58 -3.87 -5.51 -11.02 -16.53Vietnam 2002 -12.45 -24.90 -37.35 -42.32 -84.64 -126.96

Table 3c: Lifetime earnings (millions of USD) lost due to teen childbirth in cohort of 15 year olds – Europe








Albania 2009 -0.06 -0.13 -0.19 -1.90 -3.80 -5.70

Armenia 2010 0.05 0.10 0.16 -1.42 -2.84 -4.27

Azerbaijan 2006 0.45 0.90 1.36 -6.00 -12.00 -18.00

Moldova 2005 -0.51 -1.02 -1.54 -0.83 -1.66 -2.49

Turkey 2003 -0.78 -1.57 -2.35 -53.21 -106.41 -159.62

Ukraine 2007 -7.77 -15.53 -23.30 -11.77 -23.53 -35.30

Table 3d: Lifetime earnings (millions of USD) lost due to teen childbirth in cohort of 15 year olds – Latin America & Caribbean








Bolivia 2008 -37.92 -75.84 -113.76 -24.46 -48.93 -73.39Brazil 1996 -951.30 -1902.61 -2853.91 -124.92 -249.83 -374.75Colombia 2010 -220.94 -441.88 -662.83 -206.21 -412.42 -618.63Dominican Republic 2007 -22.71 -45.42 -68.13 -62.98 -125.96 -188.94Ecuador 1987 -29.45 -58.89 -88.34 -27.81 -55.62 -83.44Guatemala 1995 -16.95 -33.90 -50.85 -4.59 -9.19 -13.78Guyana 2009Haiti 2006 -3.27 -6.55 -9.82 -7.60 -15.20 -22.80Honduras 2012 -12.54 -25.08 -37.62 -16.72 -33.44 -50.15Mexico 1987 -230.35 -460.69 -691.04 -172.26 -344.51 -516.77Nicaragua 2001 -6.98 -13.95 -20.93 -15.28 -30.56 -45.83Paraguay 1990 -28.79 -57.59 -86.38 -6.50 -13.00 -19.50Peru 2000 -182.32 -364.64 -546.96 -127.09 -254.17 -381.26Trinidad & Tobago 1987 -2.51 -5.01 -7.52 -0.73 -1.47 -2.20

Table 3e: Lifetime earnings (millions of USD) lost due to teen childbirth in cohort of 15 year olds – Middle East & North Africa

Country Cohort of unmarried teenagers Cohort of married teenagers







Egypt 2008 -97.91 -195.83 -293.74

Jordan 2007 -0.32 -0.63 -0.95 -3.12 -6.25 -9.37

Morocco 2004 -1.58 -3.15 -4.73 -4.29 -8.57 -12.86

Tunisia 1988

Yemen 1991 -2.35 -4.70 -7.05

Table 4a: Lifetime earnings (USD) lost per girl due to teen childbirth in cohort of 15 year olds - Africa








Benin 2006 -51.46 -102.92 -154.38 -36.19 -72.39 -108.58Burkina Faso 2010 -51.32 -102.63 -153.95 -50.26 -100.53 -150.79Burundi 2010 -12.77 -25.53 -38.30 -13.52 -27.03 -40.55Cameroon 2011 -313.85 -627.70 -941.55 -538.74 -1077.48 -1616.23Central African Rep 1995 61.44 122.87 184.31 80.02 160.04 240.06Chad 2004 -31.50 -63.00 -94.50 -35.48 -70.96 -106.44Comoros 1996 1.89 3.78 5.67 -168.02 -336.04 -504.06Congo, Brazzaville 2005Congo, Dem Rep 2007Cote d’Ivoire 2012 -247.75 -495.49 -743.24 -120.22 -240.45 -360.67Ethiopia 2011 -28.70 -57.39 -86.09 -66.76 -133.52 -200.28Gabon 2000 -1103.78 -2207.55 -3311.33 -1587.05 -3174.10 -4761.15Ghana 2008 -199.30 -398.59 -597.89 -549.81 -1099.63 -1649.44Guinea 2005 -81.95 -163.90 -245.85 -101.30 -202.60 -303.90Kenya 2009 -255.59 -511.17 -766.76 -677.71 -1355.42 -2033.13Lesotho 2009 -146.69 -293.37 -440.06 -415.11 -830.21 -1245.32Liberia 2007 -49.10 -98.21 -147.31 -115.94 -231.89 -347.83Madagascar 2009 -64.88 -129.75 -194.63 -319.97 -639.95 -959.92

Table 4a: Lifetime earnings (USD) lost per girl due to teen childbirth in cohort of 15 year olds – Africa (cont)








Malawi 2010 -75.39 -150.78 -226.17 -282.99 -565.99 -848.98Mali 2006 -44.63 -89.27 -133.90 -59.18 -118.36 -177.54Mozambique 2011 -186.37 -372.74 -559.11 -123.93 -247.86 -371.79Namibia 2007 -1284.48 -2568.95 -3853.43 -2265.68 -4531.36 -6797.03Niger 2006 -15.33 -30.66 -45.99 -12.93 -25.86 -38.80Nigeria 2008 -52.02 -104.04 -156.06 -177.62 -355.24 -532.86Rwanda 2010 -40.58 -81.16 -121.75 -68.28 -136.57 -204.85Sao Tome & Principe 2009Senegal 2011 -88.84 -177.68 -266.52 -82.24 -164.48 -246.71Sierra Leone 2008 -130.47 -260.95 -391.42 -0.57 -1.14 -1.72South Africa 1998 -799.86 -1599.72 -2399.59 -852.19 -1704.39 -2556.58Sudan 1990 -8.02 -16.05 -24.07 -141.95 -283.91 -425.86Swaziland 2007 -939.91 -1879.82 -2819.73 -1606.06 -3212.12 -4818.17Tanzania 2010 -325.43 -650.86 -976.30 -155.47 -310.93 -466.40Togo 1998 -34.46 -68.91 -103.37 -50.06 -100.12 -150.18Uganda 2011 -226.72 -453.43 -680.15 -574.28 -1148.57 -1722.85Zambia 2007 -149.30 -298.61 -447.91 -289.81 -579.62 -869.43Zimbabwe 2011 -256.00 -512.00 -767.99 -630.60 -1261.20 -1891.79

Table 4b: Lifetime earnings (USD) lost per girl due to teen childbirth in cohort of 15 year olds – Asia








Bangladesh 2011 -41.86 -83.72 -125.58 -736.45 -1472.90 -2209.34Cambodia 2010 -10.58 -21.16 -31.75 -270.29 -540.59 -810.88India 2006 -7.19 -14.38 -21.57 -177.24 -354.47 -531.71Indonesia 2007 -21.90 -43.80 -65.69 -693.92 -1387.84 -2081.76Kazakhstan 1999 -58.34 -116.68 -175.02 -611.86 -1223.71 -1835.57Kyrgyzstan 1997 -0.20 -0.41 -0.61 -90.61 -181.22 -271.83Maldives 2009 -198.46 -396.91 -595.37 -1879.04 -3758.09 -5637.13Nepal 2011 -254.14 -508.27 -762.41Pakistan 2007 -40.83 -81.66 -122.50Philippines 2008 -58.81 -117.61 -176.42 -1005.20 -2010.39 -3015.59Sri Lanka 1987 -12.73 -25.47 -38.20 -532.57 -1065.14 -1597.71Thailand 1987 -4.15 -8.31 -12.46 -1070.93 -2141.86 -3212.79Timor-Leste 2010 -9.51 -19.03 -28.54 -321.84 -643.67 -965.51Uzbekistan 1996 -4.78 -9.55 -14.33 -138.51 -277.02 -415.53Vietnam 2002 -15.73 -31.46 -47.19 -496.70 -993.40 -1490.10

Table 4c: Lifetime earnings (USD) lost per girl due to teen childbirth in cohort of 15 year olds – Europe








Albania 2009 -2.22 -4.44 -6.65 -892.58 -1785.17 -2677.75

Armenia 2010 2.50 5.01 7.51 -796.73 -1593.46 -2390.18

Azerbaijan 2006 5.50 11.00 16.49 -816.79 -1633.59 -2450.38

Moldova 2005 -19.88 -39.76 -59.63 -299.86 -599.72 -899.58

Turkey 2003 -1.40 -2.80 -4.21 -893.63 -1787.25 -2680.88

Ukraine 2007 -30.40 -60.80 -91.20 -755.55 -1511.10 -2266.65

Table 4d: Lifetime earnings (USD) lost per girl due to teen childbirth in cohort of 15 year olds – Latin America & Caribbean








Bolivia 2008 -410.86 -821.72 -1232.58 -1687.36 -3374.72 -5062.09Brazil 1996 -610.86 -1221.72 -1832.58 -1970.32 -3940.64 -5910.95Colombia 2010 -619.52 -1239.03 -1858.55 -3498.80 -6997.59 -10496.39Dominican Republic 2007 -316.37 -632.73 -949.10 -3407.29 -6814.58 -10221.88Ecuador 1987 -268.54 -537.09 -805.63 -995.44 -1990.88 -2986.31Guatemala 1995 -133.27 -266.53 -399.80 -390.84 -781.68 -1172.51Guyana 2009Haiti 2006 -37.90 -75.81 -113.71 -427.96 -855.92 -1283.89Honduras 2012 -195.72 -391.45 -587.17 -971.37 -1942.73 -2914.10Mexico 1987 -244.82 -489.64 -734.46 -949.72 -1899.43 -2849.15Nicaragua 2001 -150.97 -301.94 -452.91 -953.64 -1907.28 -2860.93Paraguay 1990 -499.61 -999.22 -1498.82 -914.94 -1829.87 -2744.81Peru 2000 -761.54 -1523.07 -2284.61 -3064.95 -6129.90 -9194.85Trinidad & Tobago 1987 -262.52 -525.04 -787.56 -2995.40 -5990.81 -8986.21

Table 4e: Lifetime earnings (USD) lost per girl due to teen childbirth in cohort of 15 year – Middle East & North Africa








Egypt 2008 -1014.16 -2028.31 -3042.47

Jordan 2007 -5.22 -10.44 -15.65 -730.49 -1460.98 -2191.47

Morocco 2004 -5.60 -11.21 -16.81 -126.61 -253.22 -379.83

Tunisia 1988

Yemen 1991 -50.31 -100.61 -150.92

Table Footnotes• †Results from fixed effect models which controlled for the following variables:

age/period, religion, ideal family size, wealth, son preference, and the respondent’s number of siblings. Exceptions to this list of covariates are noted in lettered footnotes below.

• The DHS data set is missing the following variables:a number of siblingsb religionc wealthd religion, wealthe number of siblings, religionf number of siblings, wealthg religion, wealth, son preferenceh number of siblings, wealth, son preferencei number of siblings, religion, wealthj number of siblings, ideal family size, son preferencek number of siblings, religion, wealth, son preference

• n/a – not applicable since there we no teen births in the sample

• Significance Levels*p<0.05**p<0.01***p<0.001

Results: Summary statistics• Proportion of women with any schooling varied

widely by country▫Unmarried teens usually stay in school longer than

married teens▫School attendance ranged from 9.4% in the teen

married sample in Yemen to essentially universal education in many countries

• Proportion of women (20-49 with schooling) who had a teen birth higher among those who were teen married v. unmarried▫Teen unmarried: ranged from 0% in Egypt, Yemen,

etc. to 49.4% in Gabon▫Teen married: ranged from 45.2% in Albania to 82.1%

in Uganda▫Generally higher levels in Africa than in other regions

Results: Years of schooling lost• A teen childbirth was significantly associated with lost years of

schooling in most countries▫ Teen birth was statistically significant for schooling loss among

unmarried girls in 82.2% of countries (60/73) 3 countries not used because there were no teen births among the

teen unmarried (Egypt, Yemen, and Pakistan) Relationship was negative but not significant in additional 9 countries

Lack of significance partly from low % of teen births among teen unmarried in many countries

▫ Teen birth was statistically significant for schooling loss among married girls in 73.7% of countries (56/76) Relationship negative but not significant in additional 19 countries

• Generally, more years of schooling were lost per teen birth in the teen unmarried v. married samples▫ Teen unmarried: 1+ years of schooling were lost per teen birth in

53.4% of countries (39/73)▫ Teen married: 1+ years of schooling were lost per teen birth in

2.6% of countries (2/76)

Results: Years of schooling lost (cont)

•Footnote▫An anomalous positive and statistically

significant relationship was observed in Central African Republic and Armenia among the teen unmarried In Central African Republic this was probably

due to confounding by wealth because the data did not have a wealth indicator

In Armenia this was probably due to small sample size since there were only 3 teen births among the teen unmarried sample

Results: Teen childbirth and schooling loss over time• An interaction term between teen childbirth and

age was also modeled with fixed effects▫The interaction was statistically significant in

50.7% (37/73) of countries in the teen unmarried sample Less years of schooling are lost over time as result

of teen childbirth among the teen unmarried in 94.6% (35/37) of the countries with statistically significant results

▫The interaction was statistically significant in 25% (19/76) of countries in the teen married sample About an equal number of countries showed fewer

years of schooling lost (10/19) as showed more years of schooling lost (9/19) over time

Results: Economic Costs•Country-specific life time earnings lost due to

teen childbirth went as high as (assuming 10% returns to schooling):▫ $1.9 billion lost for teen unmarried cohort in

Brazil▫$1.07 billion lost for teen married cohort in

India•Except for some African countries, lifetime

earnings lost per girl were higher in the teen married v. unmarried cohort▫Highest loss of earnings per girl occurs in teen

married cohort in Colombia, where $3500 are lost per girl using the lowest estimate

Results: Economic costs

•Total cost of teenage childbirth for a cohort of 35 million teenage girls from 72 countriesReturns to Schooling Total cost Total cost per girl

5% -$5,841,157,841 -$168

10% -$11,682,315,681 -$335

15% -$17,523,473,522 -$503

Results: Economic Costs•Economic costs of teenage childbirth for a

cohort of 35 million teenage girls from 72 countries, using 5% returns to schooling

Conclusions• A teen childbirth is consistently associated with less years of

schooling around the world▫ Magnitude depends on the country and the marital status of

the girl as a teenager

• Billions of dollars are lost globally as a result of teen childbirth through decreased earnings from less schooling▫ Although teen pregnancy will probably not be eliminated for

$168 per girl, dollars invested in effective programs will have some economic returns

• Preventing teen births among teen married girls and the associated loss of schooling/earnings may be difficult▫ Likely many of these teen births are intentional or wanted▫ Postponing the age at first marriage/cohabitation may be a

better way of improving schooling outcomes and avoiding early childbirth in this group

Limitations• Cluster fixed effects models do not control for reverse

causation where school dropout leads to childbirth▫ Estimates should be considered upper bounds of true

relationship▫ A teen childbirth may have occurred years after the woman

dropped out of school• Many factors influence girls’ schooling attainment, and we

were limited by information in DHS▫ e.g. school-level variables, childhood household characteristics,

etc.▫ Fixed effects models help control for unmeasured cluster

differences in variables• Some data sets are 20+ years old & women up to age 54

were used in all data sets, so some estimates may be outdated• The full educational attainment and future teen birth status of

younger members of the data sets (13-19 years) are not known

costs of teen childbirth

Health & Medicine

teen birth years

teen unmarried girls

lost earnings

cohort of married teen

marriedcohabiting teen

school women

year old teen

result of years