6 more of their income to expenditures on children than their husbands do. But this is only one of the channels through which education improves health. It also increases the willingness to seek medical care and improves sanitation practices. Educating an extra 1000 girls an additional year in 1990 would have c, st approximately $30,000. 7 The best available estimates suggest that each year of schoolirg -educes under five mortality by up to 10 percent. Similar estimates are obtained both from studies of cross sections in individual countries and for studies of cross country variations in infant and child mortality rates. With an average woman in Paldstan having 6.6 children, it follows that providing an additional 1000 women one extra year of schooling would prevent roughly 60 infant deaths.

What would it cost to achieve similar results through investments in health care? Obviously the answer differs across health care investments. For example, cost effectiveness estimates suggest that programs of supplementary antenatal feeding cost in the neighborhood of $700 per life saved. Other commonly recommended health interventions are more expensive; measles immunization programs outside of high risk environments, for example, cost $1000 per life saved. I Taking $800 as the cost of saving a life with health care interventions, the cost of achieving the same reduction in mortality that would accrue from devoting $30,000 to educating another 1000 girls is $48,000. As this calculation ignores any other benefits of reduced child morbidity, it underestimates the returns to female education as a health care investment.

Educated women also choose to have fewer children. Econometric studies within individual countries looking at the effects of education on fertility find that an extra year of female schooling reduces female fertility by approximately _5_ to 10 percent, or in the case of Pakistan by about .7. 9 Thus a $30,000 investment in educating 1000 women would avert 500 ' The World Bank's best estimate of the average recurrent cost of one year of secondary school in Pakistan is $28.7. On the one hand, the marginal cost will be higher for girls. On the other hand, primary school is cheaper than secondary school so our use of $30 as the recurrent costs of one year of school is conservative.

3 Jamison and Mosley's study, described in Chapter 1 of Disease Control Priorities in Developing Countries (1990), gives costs for a wide variety of health interventions. The cost of supplementary antenatal feeding per discounted healthy life year gained is $25. The cost of measles immunization per discounted healthy life year gained outside of high risk environments is $40. The cost of immunization for tuberculosis and leprosy per discounted healthy life year gained is $75. The cost of improved cholera immunization per discounted healthy life year gained is $200.

9 A study by Dennis de Tray (1972) finds the elasticity of fertility with respect to female education is -0.3. At a level of three years of schooling an additional year would reduce fertility by 10%. Other more recent studies confirm this magnitude. In Kenya (Schafgans, 1991) a woman with secondary education has one fewer child than a woman with five to eight years of