Abstract

Parents face trade-offs between investing in child health and other fitness enhancing activities. In humans, parental investment theory has mostly been examined through the analysis of differential child outcomes, with less emphasis on the actions parents take to further a particular offspring’s condition. Here, we make use of household data on health-seeking for children in a high mortality context where such behaviours are crucial for offspring survival. Using Demographic and Health Survey (DHS) data from 17 sub-Saharan African countries, we examine whether maternal factors (age, health, marital status) and child factors (birth order, health, sex, age) independently influence parental investment in health-seeking behaviours: two preventative behaviours (malaria net use and immunization) and two curative ones (treating fever and diarrhoea). Results indicate that children with lower birth order, older mothers and mothers with better health status have higher odds of investment. The effects of a child’s sex and health status and whether the mother is polygynously married vary depending on the type of health-seeking behaviour (preventative versus curative). We discuss how these results square with predictions from parental investment theory pertaining to the state of mothers and children, and reflect on some potential mechanisms and directions for future research.

Highlights

  • A child is highly dependent on its parents when in need of healthcare

  • We aim to offer a complement to studies that contribute with detailed examinations of parental investment dynamics in small-scale populations, by drawing on the breadth of cross-country data and by conceptualizing health-seeking behaviour as a form of parental investment

  • We report on the results from the models on health investment; unless otherwise stated, the effects are consistent across the four outcomes

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Summary

Introduction

A child is highly dependent on its parents when in need of healthcare. When parents do not take action to prevent or cure illnesses that pose a threat to child survival, it is often considered to be the result of constraints, such as lack of resources or lack of knowledge. Considerable variation in parental health-seeking exists even between households with comparable levels of education, wealth and healthcare access [5,6,7]. This implies that other factors, such as characteristics of the parents and children, can help explain investment biases within and between households. Evolutionary models provide one framework with which to predict how much a parent should invest either in a particular offspring or in alternative fitness enhancing functions. Parental investment theory highlights that the health of a particular offspring— important for the offspring’s fitness—is not the only priority of the parent

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