placestats

Out of school, primary vs. Skilled birth attendance

Fades after adjusting for income

Across 167 countries, Out of school, primary and Skilled birth attendance rise and fall together at r = -0.54 (on a scale from −1 to +1, where 0 means no link). Comparing only countries with similar income (GDP per person) shrinks it to -0.33, which could easily be chance (q = 0.088, 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. Caution: correlation moves sharply once outliers are trimmed.

Comparing countries across the middle half of skilled birth attendance, 86.6% to 99.7% of births, out of school, primary is better by 5.33% of primary-age children at the top of that range than the bottom. Comparing only countries with similar national income, the gap is 3.93% of primary-age children.

Link before adjusting (r)-0.538p = 6.8e-14 · 167 countries
After adjusting for national income-0.334p = 1.1e-5 · likely range [-0.46, -0.19]
p, allowing for regions0.000standard error 0.046 · 7 regions
Check for luck (q)0.088across 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.

Out of school, primary · % of primary-age childrenlink with income -0.45 · moderate
Skilled birth attendance · % of birthslink with income +0.69 · high

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

Every country as a dot

Out of school, primary · % of primary-age children →Skilled birth attendance · % of births →0.00387%65.6%40.3%100%Angola: 36.8% of primary-age children, 49.6% of birthsAlbania: 0.488% of primary-age children, 99.8% of birthsAndorra: 2.41% of primary-age children, 100% of birthsUnited Arab Emirates: 0.00387% of primary-age children, 99.2% of birthsArgentina: 0.735% of primary-age children, 98.8% of birthsArmenia: 1.08% of primary-age children, 99.8% of birthsAntigua and Barbuda: 1.71% of primary-age children, 99% of birthsAustralia: 0.124% of primary-age children, 96% of birthsAustria: 1.43% of primary-age children, 98.1% of birthsAzerbaijan: 0.0266% of primary-age children, 99.9% of birthsBurundi: 26.5% of primary-age children, 76.5% of birthsBenin: 9.61% of primary-age children, 78.1% of birthsBurkina Faso: 34.3% of primary-age children, 79.8% of birthsBangladesh: 5.86% of primary-age children, 59% of birthsBulgaria: 5.9% of primary-age children, 94.5% of birthsBahrain: 4.75% of primary-age children, 99.6% of birthsBahamas, The: 15.9% of primary-age children, 99% of birthsBosnia and Herzegovina: 2.1% of primary-age children, 99.9% of birthsBelarus: 4.49% of primary-age children, 99.9% of birthsBelize: 10.7% of primary-age children, 94.6% of birthsBermuda: 3.41% of primary-age children, 99.4% of birthsBolivia: 9.25% of primary-age children, 81.1% of birthsBrazil: 2.19% of primary-age children, 98.4% of birthsBarbados: 17.6% of primary-age children, 98.4% of birthsBrunei Darussalam: 3.61% of primary-age children, 99.6% of birthsBhutan: 10.5% of primary-age children, 98.9% of birthsBotswana: 0.535% of primary-age children, 99.8% of birthsCentral African Republic: 37.9% of primary-age children, 40.3% of birthsCanada: 4.99% of primary-age children, 98% of birthsChile: 2.12% of primary-age children, 99.8% of birthsCote d'Ivoire: 12.6% of primary-age children, 84% of birthsCameroon: 3.76% of primary-age children, 69% of birthsCongo, Rep.: 17.1% of primary-age children, 91.2% of birthsColombia: 7.32% of primary-age children, 98.8% of birthsComoros: 20.6% of primary-age children, 82.2% of birthsCabo Verde: 41.8% of primary-age children, 97.3% of birthsCosta Rica: 4.49% of primary-age children, 99% of birthsCyprus: 0.425% of primary-age children, 99.3% of birthsCzechia: 0.809% of primary-age children, 99.8% of birthsGermany: 0.274% of primary-age children, 96.2% of birthsDominica: 3.95% of primary-age children, 100% of birthsDenmark: 0.893% of primary-age children, 95.3% of birthsDominican Republic: 4.93% of primary-age children, 99.2% of birthsAlgeria: 1.57% of primary-age children, 98.8% of birthsEcuador: 4.72% of primary-age children, 99.4% of birthsEgypt, Arab Rep.: 3.51% of primary-age children, 97.1% of birthsSpain: 1.24% of primary-age children, 99.9% of birthsEstonia: 3.39% of primary-age children, 99.6% of birthsEthiopia: 22.5% of primary-age children, 49.8% of birthsFinland: 1.77% of primary-age children, 99.5% of birthsFiji: 2.39% of primary-age children, 99.8% of birthsFrance: 0.204% of primary-age children, 98.2% of birthsGabon: 28.8% of primary-age children, 89.3% of birthsGeorgia: 6.17% of primary-age children, 99.8% of birthsGhana: 4.77% of primary-age children, 78.9% of birthsGuinea: 14.7% of primary-age children, 55.3% of birthsGambia, The: 16.9% of primary-age children, 83.8% of birthsGuinea-Bissau: 30.5% of primary-age children, 53.8% of birthsEquatorial Guinea: 65.6% of primary-age children, 68.3% of birthsGreece: 0.11% of primary-age children, 99.9% of birthsGrenada: 4.94% of primary-age children, 100% of birthsGuatemala: 8.43% of primary-age children, 69.6% of birthsGuyana: 18% of primary-age children, 97.6% of birthsHonduras: 26.6% of primary-age children, 94.1% of birthsCroatia: 1.81% of primary-age children, 99.9% of birthsHungary: 2.81% of primary-age children, 99.7% of birthsIndonesia: 0.877% of primary-age children, 94.7% of birthsIndia: 0.119% of primary-age children, 89.4% of birthsIreland: 1.81% of primary-age children, 99.7% of birthsIran, Islamic Rep.: 0.103% of primary-age children, 99% of birthsIceland: 1.82% of primary-age children, 97.4% of birthsItaly: 2.06% of primary-age children, 99.8% of birthsJamaica: 4.34% of primary-age children, 99.7% of birthsJordan: 1.89% of primary-age children, 99.7% of birthsJapan: 0.0684% of primary-age children, 99.8% of birthsKazakhstan: 7.91% of primary-age children, 99.9% of birthsKenya: 32.9% of primary-age children, 70.2% of birthsKyrgyz Republic: 2.96% of primary-age children, 100% of birthsCambodia: 3.69% of primary-age children, 98.7% of birthsKiribati: 8.71% of primary-age children, 91.9% of birthsKorea, Rep.: 0.0557% of primary-age children, 100% of birthsKuwait: 7.47% of primary-age children, 99.9% of birthsLao PDR: 10.4% of primary-age children, 64.4% of birthsLiberia: 38.3% of primary-age children, 84.4% of birthsSt. Lucia: 7.01% of primary-age children, 100% of birthsSri Lanka: 9.14% of primary-age children, 99.5% of birthsLesotho: 32.2% of primary-age children, 86.6% of birthsLithuania: 0.13% of primary-age children, 100% of birthsLatvia: 2.74% of primary-age children, 99.9% of birthsMorocco: 0.471% of primary-age children, 86.6% of birthsMoldova: 0.463% of primary-age children, 99.6% of birthsMadagascar: 3.4% of primary-age children, 45.8% of birthsMaldives: 0.946% of primary-age children, 99.5% of birthsMexico: 0.363% of primary-age children, 96.6% of birthsMarshall Islands: 1.48% of primary-age children, 92.4% of birthsNorth Macedonia: 3.79% of primary-age children, 100% of birthsMali: 34% of primary-age children, 67.3% of birthsMalta: 2.64% of primary-age children, 99.8% of birthsMyanmar: 1.41% of primary-age children, 60.2% of birthsMontenegro: 0.218% of primary-age children, 98.8% of birthsMongolia: 8.56% of primary-age children, 99.3% of birthsMozambique: 1% of primary-age children, 73% of birthsMauritania: 11.3% of primary-age children, 70.4% of birthsMauritius: 0.785% of primary-age children, 99.7% of birthsMalawi: 2.09% of primary-age children, 96.4% of birthsMalaysia: 12% of primary-age children, 99.6% of birthsNamibia: 0.865% of primary-age children, 88.2% of birthsNiger: 40.4% of primary-age children, 43.7% of birthsNigeria: 24.3% of primary-age children, 50.7% of birthsNicaragua: 6.66% of primary-age children, 94.1% of birthsNorway: 1.38% of primary-age children, 99.2% of birthsNepal: 0.762% of primary-age children, 77.2% of birthsNew Zealand: 2.62% of primary-age children, 96.5% of birthsOman: 5.76% of primary-age children, 99.9% of birthsPakistan: 17.9% of primary-age children, 68% of birthsPanama: 7.7% of primary-age children, 95% of birthsPeru: 0.156% of primary-age children, 94.9% of birthsPhilippines: 11.6% of primary-age children, 84.4% of birthsPalau: 1.33% of primary-age children, 97.2% of birthsPapua New Guinea: 4% of primary-age children, 56.4% of birthsPoland: 0.0917% of primary-age children, 99.6% of birthsPortugal: 0.508% of primary-age children, 98.6% of birthsParaguay: 13.3% of primary-age children, 92.2% of birthsWest Bank and Gaza: 9.56% of primary-age children, 99.7% of birthsQatar: 4.62% of primary-age children, 100% of birthsRomania: 15.6% of primary-age children, 93% of birthsRussian Federation: 4.94% of primary-age children, 99.6% of birthsRwanda: 0.97% of primary-age children, 94.2% of birthsSaudi Arabia: 0.527% of primary-age children, 94.8% of birthsSudan: 43.8% of primary-age children, 77.7% of birthsSenegal: 24.5% of primary-age children, 74.5% of birthsSingapore: 0.212% of primary-age children, 99.6% of birthsSolomon Islands: 30.1% of primary-age children, 86.2% of birthsSierra Leone: 0.888% of primary-age children, 86.9% of birthsEl Salvador: 8.66% of primary-age children, 99.9% of birthsSerbia: 3.33% of primary-age children, 99.9% of birthsSao Tome and Principe: 2.88% of primary-age children, 96.8% of birthsSuriname: 16.2% of primary-age children, 98.4% of birthsSlovak Republic: 1.06% of primary-age children, 98% of birthsSlovenia: 1.45% of primary-age children, 99.8% of birthsEswatini: 3.83% of primary-age children, 88.3% of birthsSeychelles: 6.8% of primary-age children, 99.5% of birthsTurks and Caicos Islands: 0.133% of primary-age children, 100% of birthsChad: 24.8% of primary-age children, 47.2% of birthsTogo: 0.639% of primary-age children, 69.4% of birthsThailand: 0.817% of primary-age children, 99.1% of birthsTajikistan: 4.15% of primary-age children, 94.8% of birthsTurkmenistan: 4.31% of primary-age children, 100% of birthsTimor-Leste: 6.88% of primary-age children, 56.7% of birthsTonga: 2.28% of primary-age children, 98.3% of birthsTrinidad and Tobago: 7.16% of primary-age children, 100% of birthsTunisia: 1.09% of primary-age children, 99.5% of birthsTurkiye: 0.603% of primary-age children, 97% of birthsTuvalu: 0.537% of primary-age children, 99.5% of birthsTanzania: 16.4% of primary-age children, 63.5% of birthsUganda: 4.12% of primary-age children, 74.2% of birthsUkraine: 12.9% of primary-age children, 99.9% of birthsUruguay: 0.0355% of primary-age children, 100% of birthsUnited States: 3.98% of primary-age children, 99.1% of birthsUzbekistan: 0.655% of primary-age children, 99% of birthsSt. Vincent and the Grenadines: 0.59% of primary-age children, 98.6% of birthsViet Nam: 1.73% of primary-age children, 96.1% of birthsVanuatu: 2.53% of primary-age children, 89.4% of birthsSamoa: 1.81% of primary-age children, 88.9% of birthsSouth Africa: 6.06% of primary-age children, 96.7% of birthsZambia: 3.51% of primary-age children, 80.4% of birthsZimbabwe: 10.5% of primary-age children, 86% of birthsAZECAFCPVGNQKORMDGMMRNERPNGSDNURY

best-fit line line after adjusting

Four ways to measure the link

MethodrpCountries
Standard (Pearson), not adjusted-0.5386.8e-14167
By rank (Spearman), not adjusted-0.4162.3e-8167
Standard (Pearson), adjusted for national income-0.3341.1e-5167
By rank (Spearman), adjusted for national income-0.1740.025167

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 167 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: +0.204 (a minus sign means it grew).

How solid is it?

Leaving out one country at a time, r ranges from -0.366 (without CPV) to -0.296 (without AGO). 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: AGO (+0.038).

Fragile: this link may not hold up.
  • correlation moves sharply once outliers are trimmed

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.

nr
East Asia & Pacific26-0.00
Europe & Central Asia43-0.31
Latin America & Caribbean30-0.14
Middle East, North Africa, Afghanistan & Pakistan15-0.57
Sub-Saharan Africa44-0.35

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.

nr
Poorest third56-0.32
Middle third55-0.49
Richest third56-0.21

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.

nr
Christians100-0.26
Muslims42-0.50

By last european coloniser

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.

nr
France21-0.08
Never a European colony19-0.22
Spain19-0.56
United Kingdom57-0.21

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 = -0.177 after dropping 28 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.

The link shows up within countries over time (r = -0.329) but mostly disappears in year-to-year changes (r = -0.004). That points to slow trends particular to each country, not the two measures moving together from year to year.

Across countries (adjusted)-0.334for comparison
Within countries-0.434each country vs itself
…and vs the same year elsewhere-0.329q = 0.003 · 124 countries
Year-on-year changes-0.004q = 0.951
Read with care.
  • The association is much weaker in year-on-year changes than in levels, which points to shared country-specific trends.

1,549 country-years (one country in one year), 124 countries, 1990–2022, about 13 years each on average. Share of the variation that happens within countries over time: 15% for Out of school, primary, 22% 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

0.50−0.5-100+10years Skilled birth attendance trails Out of school, primary →lag -10: r = -0.076 (n = 1,525)lag -9: r = -0.079 (n = 1,606)lag -8: r = -0.069 (n = 1,651)lag -7: r = -0.167 (n = 1,656)lag -6: r = -0.136 (n = 1,718)lag -5: r = -0.178 (n = 1,739)lag -4: r = -0.201 (n = 1,724)lag -3: r = -0.227 (n = 1,751)lag -2: r = -0.276 (n = 1,666)lag -1: r = -0.268 (n = 1,604)lag +0: r = -0.329 (n = 1,549)lag +1: r = -0.330 (n = 1,491)lag +2: r = -0.334 (n = 1,408)lag +3: r = -0.339 (n = 1,315)lag +4: r = -0.393 (n = 1,234)lag +5: r = -0.430 (n = 1,146)lag +6: r = -0.385 (n = 1,057)lag +7: r = -0.463 (n = 1,004)lag +8: r = -0.425 (n = 921)lag +9: r = -0.469 (n = 842)lag +10: r = -0.444 (n = 783)

Same year (lag 0): -0.329. 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.

The largest value on this curve (-0.47 at lag +9) is higher than the same-year one by 0.14. That gap is not a finding. It is the largest of 21 closely related estimates, and picking the biggest of many tests always makes it look bigger. That is exactly why nothing on this site is ranked or chosen by lag.

The data


% of primary-age children
% of births		Years
Equatorial Guinea GNQ65.6%68.3%2015, 2011
Sudan SDN43.8%77.7%2019, 2014
Cabo Verde CPV41.8%97.3%2022, 2018
Niger NER40.4%43.7%2024, 2021
Liberia LBR38.3%84.4%2022, 2020
Central African Republic CAF37.9%40.3%2012, 2019
Angola AGO36.8%49.6%2023, 2016
Burkina Faso BFA34.3%79.8%2024, 2015
Mali MLI34%67.3%2023, 2018
Kenya KEN32.9%70.2%2022, 2016
Lesotho LSO32.2%86.6%2024, 2018
Guinea-Bissau GNB30.5%53.8%2010, 2019
Solomon Islands SLB30.1%86.2%2024, 2015
Gabon GAB28.8%89.3%2019, 2012
Honduras HND26.6%94.1%2024, 2019

World Bank, World Development Indicators
World Bank, World Development Indicators

Sources

Out of school, primary

Children out of school (% of primary school age)

UNESCO Institute for Statistics · CC BY 4.0 · updated quarterly

Children of primary-school age not enrolled at any level. Treated as measuring the same thing as gross primary enrolment, which is on the site. They are two ways of asking whether children are in school, so their agreement is not a finding.

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 2010–2025. 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 Out of school, primary and Skilled birth attendance

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

More links with Out of school, primary or Skilled birth attendance