Background

Achieving gender equality in education is an important development goal.  We tested the hypothesis that the gender gap in adolescent education is accentuated by illnesses among young children in the household.

Results

In our sample of 120708 adolescent boys and girls residing in 38 countries, girls were 5.08% less likely to attend school than boys in the absence of a recent illness among young children within the same household (95% confidence interval [CI], 5.50%–4.65%). This gap increased to 7.77% (95% CI, 8.24%–7.30%) and 8.53% (95% CI, 9.32%–7.74%) if the household reported 1 and 2 or more illness episodes, respectively. The gender gap in schooling in response to illness was larger in households with a working mother. Increases in child vaccination rates were associated with a closing of the gender gap in schooling (correlation coefficient = 0.34, P = .02).

Conclusions

Illnesses among children strongly predict a widening of the gender gap in education. Investments in early childhood health may have important effects on schooling attainment for adolescent girls.