One of the Millennial Development Goals developed by the United Nations to improve health internationally is to strive for gender equality in education. Yet in some low and middle-income countries (LMICs), if a young child is sick, it is often the older female sib who is required to stay home and care for their younger sib even if it means missing school to do so. So how common is this need to remove girls from school to provide home care while parents work? Alsan et al. ( 10.1542/peds.2016-3175) address this question in a provocative study involving more than 120 thousand teenage boys and girls in 38 LMIC countries over 14 years (1999-2013). Sadly the study shows that girls are less likely than boys to attend school regularly and this gap widens if there is a young child under 5 years of age sick at home during the school year especially if there if a parent is a working mother. While some reduction in adolescent days missed improved when children in a home were vaccinated, the gap did not close up. So what can we do about this?
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