Do Gender Inequality Index and Skilled birth attendance go together across countries?

Across 160 countries the link before adjusting for anything is r = -0.69, on a scale from -1 (opposite) to +1 (in step). A version that uses only each country's rank gives -0.75.

Does the link hold within countries over time, not just across countries?

Comparing each country only with itself across 1990-2022, and setting aside what happened worldwide in each year, the link is -0.053 (131 countries, 2,188 country-years). Using year-to-year changes, it is -0.012.

Does Gender Inequality Index cause Skilled birth attendance?

This analysis cannot answer that. It shows only that the two go together. A link between two country measures, adjusted or not, does not show that either one changes the other. Country figures also say nothing about individual people.

Gender Inequality Index vs. Skilled birth attendance

Fades after adjusting for income

Across 160 countries, Gender Inequality Index and Skilled birth attendance rise and fall together at r = -0.69 (on a scale from −1 to +1, where 0 means no link). Comparing only countries with similar income (GDP per person) shrinks it to -0.23, which could easily be chance (q = 0.17, allowing for the many pairs tested, and allowing for countries in the same region being alike). So the first figure mostly shows richer countries differing from poorer ones, not a link between these two things.

Comparing countries across the middle half of gender inequality index, 0.175 to 0.493 points, skilled birth attendance is worse by 17.8% of births at the top of that range than the bottom. Comparing only countries with similar national income, the gap is 8.68% of births.

Link before adjusting (r)-0.685p = 1.6e-23 · 160 countries

After adjusting for national income-0.232p = 0.003 · likely range [-0.37, -0.08]

p, allowing for regions0.047standard error 0.093 · 7 regions

Check for luck (q)0.175across 12,497 pairs

How to read these.r runs from −1 (one goes up as the other goes down) to +1 (they rise together), and 0 means no link. Adjusting for national income means comparing countries with the same GDP per person, so differences in wealth can’t explain the link. Income is used in percentage terms, since an extra $1,000 means more to a poor country than to a rich one. p is how likely a link this strong would be if there were really none. Below 0.05 means it is unlikely to be chance. Very small values are written in short form: 1.1e-32 means a decimal point followed by 31 zeros and then 11, so very close to zero. The likely range is where the true figure probably lies, and a range that crosses zero means the link could easily be chance. Countries in the same region tend to resemble each other, so the third figure allows for that, which gives a fairer p. The standard error is the typical size of the error in r. Finally, testing this many pairs means some will look strong by luck alone. A q below 0.05 means this link is unlikely to be one of those.

Gender Inequality Index · index, 0 to 1link with income -0.89 · proxy

Skilled birth attendance · % of birthslink with income +0.69 · high

Both of these rise and fall closely with national income, so a strong link between them before adjusting was close to certain. Read the adjusted figure, not the first one.

“Link with income” is how closely each measure tracks GDP per person across countries, from −1 to +1.

Every country as a dot

best-fit line line after adjusting

Four ways to measure the link

Method	r	p	Countries
Standard (Pearson), not adjusted	-0.685	1.6e-23	160
By rank (Spearman), not adjusted	-0.754	1.2e-30	160
Standard (Pearson), adjusted for national income	-0.232	0.003	160
By rank (Spearman), adjusted for national income	-0.384	5.9e-7	160

The rank version uses only each country’s place in line, from lowest to highest, so a few extreme countries count for less. The adjusted and unadjusted versions use the same 160 countries: those that report both measures and GDP per person. So the gap between them comes from the adjustment, not from a change in which countries are counted. Drop in the size of r after adjusting: +0.453 (a minus sign means it grew).

How solid is it?

Leaving out one country at a time, r ranges from -0.252 (without TLS) to -0.191 (without NGA). The bar above shows that range on a scale from −1 to +1, with the solid line at the full result. The single country that moves r most: NGA (+0.041).

Within each region

Countries are not separate, unrelated cases, and neighbors share a lot. A link that holds inside each region is far more believable than one that shows up only when comparing regions.

	n	r
East Asia & Pacific	23	-0.05
Europe & Central Asia	40	-0.14
Latin America & Caribbean	28	-0.47
Middle East, North Africa, Afghanistan & Pakistan	18	-0.08
Sub-Saharan Africa	43	-0.48

By income third

If the link shows up only in the richest third of countries, it is a feature of rich countries, not a general pattern.

	n	r
Poorest third	54	-0.46
Middle third	53	-0.26
Richest third	53	-0.18

By largest religious group

Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.

	n	r
Christians	96	-0.14
Muslims	45	-0.44

By last european coloniser

	n	r
France	22	-0.30
Never a European colony	20	-0.21
Spain	18	-0.37
United Kingdom	55	-0.29

Without outliers (countries far outside the middle half of countries on either measure, by more than one and a half times the width of that middle half): r = -0.223 after dropping 15 countries.

Two series, one country

Both measures over the years for one country you pick. The two charts are stacked so they share only the years along the bottom.

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Over time, within countries

Everything above compares countries with each other at one moment. This section compares each country only with itself over 33years. So a link here can’t come from anything about a country that stays the same, such as its history, geography, institutions or culture.

Within countries over time, there is no link that is clearly more than chance (r = -0.053, comparing each country only with itself over the years, and each year only with the same year elsewhere). Whatever the cross-country picture shows, countries whose gender inequality index moved did not tend to see their skilled birth attendance move with it.

Across countries (adjusted)-0.232for comparison

Within countries-0.337each country vs itself

…and vs the same year elsewhere-0.053q = 0.452 · 131 countries

Year-on-year changes-0.012q = 0.747

Read with care.

Much of the within-country association disappears once shared global year effects are removed, which points to a common worldwide trend rather than a country-level relationship.

2,188 country-years (one country in one year), 131 countries, 1990–2022, about 17 years each on average. Share of the variation that happens within countries over time: 14% for Gender Inequality Index, 15% for Skilled birth attendance. The margins of error allow for each country appearing many times, and for each year’s value being close to the year before.

Year-to-year changes are a cautious test, not a final answer. Looking only at changes from one year to the next removes each country’s own trends. But it also makes measurement mistakes louder, which pulls the results toward zero. A near-zero result here is weak evidence of no link, not proof.

With one measure years behind the other

Same year (lag 0): -0.053. A peak away from zero does not show which comes first. These series change slowly — this year’s value is close to last year’s. That makes the curve smooth and nearly symmetric, whatever produced the data. Even a sharp peak at one lag (a gap of some years) would not prove that one measure changes the other.

This curve peaks at the edge of the window (lag +10), so it is still drifting where the search stops. That pattern usually reflects a slow trend left over in the data, not a link with real timing. The peak value should not be read as the “true” link at the right lag.

The data

	index, 0 to 1	% of births	Years
Nigeria NGA	0.677	50.7%	2023, 2022
Somalia, Fed. Rep. SOM	0.675	31.9%	2023, 2019
Chad TCD	0.67	47.2%	2023, 2019
Afghanistan AFG	0.661	61.8%	2023, 2020
Liberia LBR	0.646	84.4%	2023, 2020
Guinea-Bissau GNB	0.632	53.8%	2023, 2019
Haiti HTI	0.618	41.6%	2023, 2017
Mali MLI	0.612	67.3%	2023, 2018
Guinea GIN	0.609	55.3%	2023, 2018
Congo, Dem. Rep. COD	0.604	85.2%	2023, 2018
Mauritania MRT	0.603	70.4%	2023, 2021
Niger NER	0.591	43.7%	2023, 2021
Cote d'Ivoire CIV	0.589	84%	2023, 2021
Sudan SDN	0.588	77.7%	2023, 2014
Papua New Guinea PNG	0.584	56.4%	2023, 2018

United Nations Development Programme, Human Development Report 2025
World Bank, World Development Indicators

Sources

Gender Inequality Index

United Nations Development Programme, Human Development Report Office · via Our World in Data · CC BY 3.0 IGO · updated annual

Built from deaths in childbirth, births to teenagers, seats in parliament, secondary schooling, and the share of women and men in the workforce. Five of those inputs are on the site and flagged. It is kept out of the gender score, for the same reason the HDI is kept out of the economy score.

Skilled birth attendance

Births attended by skilled health staff (% of total)

UNICEF and WHO · CC BY 4.0 · updated quarterly

Based on surveys, so a country reports it every few years rather than yearly.

How this was computed

Data used: most recent value in 2010-2025; values come from 2012–2023. To adjust for income, each measure is first predicted from GDP per person (in percentage terms, on a log scale) with a straight-line fit. Only what is left over is then compared. This is called a partial correlation. The line is drawn the standard way (ordinary least squares), which picks the line that comes closest to all the countries at once. The error margins allow for countries in the same region resembling each other, using 7 World Bank regions. The q-value corrects for testing all 12,497 pairs at once, using the Benjamini–Hochberg method. Underlying data last updated DYB 2024. How the country data works · explore Gender Inequality Index and Skilled birth attendance

This page shows that two measures go together. It does not show that Gender Inequality Index changes Skilled birth attendance, or the reverse. These figures also describe countries, not individual people. See the ecological fallacy.