Early Life Public Health Intervention and Adolescent Cognition : Evidence from the Safe Motherhood Program in Indonesia

Between 1990 and 1996, over 54,000 midwives were introduced in most of Indonesia’s nonmetropolitan villages as part of its safe motherhood strategy. I combine the variation in the availability and timing of the program arrival with the biology of cognition and the panel dimension of Indonesia Family Life Survey to carefully examine the long run impact of the program on cognition. In addition, I also examine program impacts on measures of schooling. The paper empirically tests and corroborates the findings in the biological literature that the fetal period and the first two years of life are critical periods in brain development during which environmental influences could have persistent effects on cognitive development. In addition, the results also support recent biological findings that show the importance of maternal health and nutritional status prior to conception for child’s long term development. ∗I am grateful to Elizabeth Frankenberg, Amar Hamoudi, John Strauss, Alessandro Tarozzi, Duncan Thomas, and Jacob Vigdor as well as to the participants of 2011 NEUDC and Duke Economics Development Lunch seminar, particularly Ryan Brown and Dan LaFave for helpful comments and suggestions. This work is supported by International Institute for Education/Hewlett Foundation Dissertation Fellowship Program, the Population Reference Bureau Fellows Program and partly by World Bank (Indonesia). All opinions and errors are mine. Please direct correspondence to: ava.cas@duke.edu.