susceptibility to disease, and intellectual impairment. This may be due either to nutritional reasons (insufficient nutrition to the fetus) or physiological factors (the growth potential of a fetus may be constrained in a stunted woman). In turn, the potential damage to low-birth weight babies from being born undernourished is compounded when they remain undernourished during infancy and early childhood. A malnourished or anemic mother may be unable to produce the quality or the quantity of breast milk needed to help her low-birth weight baby; and without breast milk, an infant's immune system does not develop properly. It becomes prone to diseases such as malaria, respiratory tract infections, and pneumonia. Early weaning also puts a child at severe risk of infections and disease. In addition, to the extent that a malnourished mother has a low life expectancy, it may induce her to take her daughters out of school, because a shorter time horizon lowers the value of educational investments. This may lead to persistence in poor health for women, through the “education channel” discussed later.

<mark>Evidence that a mother’s poor health actually affects the health of their children</mark> _<mark>in utero</mark>_ <mark>, that is, even before they are born, includes Lim et al. (2002) and Field, Robles, and Torero (2007) . Lim et al. (2002) found that the nutritional status of Korean women in prepregnancy (with respect notably to folate, a B vitamin essential for cell growth and reproduction, as well as iron, and calcium intakes) affects pregnancy outcomes. In a study of Tanzania, Field, Robles, and Torero (2007) found that children who benefited from iodine supplements</mark> _<mark>in utero</mark>_ <mark>exhibited higher rates of grade progression at ages 10 to 14. Furthermore, the effects appear to be substantially larger for girls, consistent with the evidence indicating greater cognitive sensitivity of the female fetus to</mark> _<mark>in utero</mark>_ <mark>iodine deprivation. Thus, a mother’s lack of iodine intake during pregnancy may also help to explain gender differences in schooling, as discussed later.</mark> _<mark>A contrario</mark>_ <mark>evidence that low life expectancy for mothers may adversely affect their daughters’ health and education prospects is provided by Jayachandran and Lleras-Muney (2009), in a study of Sri Lanka between 1946 and 1953. They found that the increase in life expectancy of girls associated with a large drop in maternal mortality was accompanied (for every extra year of life expectancy) by an increase in female literacy of 0.7 percentage points and years of education by 0.11 years. Finally, there is also evidence that maternal</mark> _<mark>mental</mark>_ <mark>health may have a sizable effect on child development, with maternal depression significantly increasing the odds that a child will experience growth faltering (that is, low height for age) and poorer education outcomes (see Das et al. (2009)).</mark><sup>3</sup> Another aspect of the mother-to-child transmission of health that has received much attention in recent years is related to the AIDS/HIV epidemic. As documented by the United Nations (2010), the number of women receiving treatment for prevention of mother-to-child transmission of HIV has increased threefold in recent years, from 15 percent in 2005 to 45 percent in 2008. There have been some notable successes in prevention, most notably in Lesotho (see Box 1). However, in 2008 only 21 percent of pregnant women worldwide were receiving HIV testing and counseling, while only one third of those identified as HIV-positive during antenatal care were subsequently assessed for eligibility to receive antiretroviral

> 3However, these associations could also reflect genetic links between parents and children.

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