Son preference and sex differentials in receipt of key dimensions of children’s healthcare: Evidence from Pakistan

Abstract

Almost all research on son preference and the consequent sex differentials in child health has focused on India. Pakistan—a country with the second strongest stated desire for sons, no evidence of sex-selective abortion, and relatively high fertility—offers a different context in which to understand unequal health outcomes for boys and girls. I use three rounds of the Pakistan Demographic and Health Survey to examine sex differentials in child healthcare receipt across different family contexts. I find evidence of generalized discrimination: all girls, regardless of sibling composition or birth order, are less likely to receive full immunization or medical treatment. I do not find evidence that girls with older sisters face greater discrimination than other girls. For boys, I find some evidence of selective preferential treatment: among larger families, first sons are more likely to receive healthcare than other sons or daughters.