Children in developing
countries are healthier and more likely to survive past the age of five
when their mothers can read and write. Experts In public health accepted this
idea decades ago, but until now no one has been able to show that a woman's
ability to read in Itself Improves her children’s chances of survival.
Most literate women learnt to
read In primary school, and the fact that a woman has had an education may
simply indicate her family’s wealth or that It values Its children more
highly. Now a long-term study carried out In Nicaragua has eliminated these
factors by showing that teaching reading to poor adult women, who would
otherwise have remained Illiterate, has a direct effect on their children’s
health and survival.
In 1979, the government of
Nicaragua established a number of social programmes, including a National
Literacy Crusade. By 1985, about 300,000 Illiterate adults from all over
the country, many of whom had never attended primary school, had learnt how
to read, write and use numbers.
During this period,
researchers from the Liverpool School of Tropical Medicine, the Central
American Institute of Health In Nicaragua, the National Autonomous University
of Nicaragua and the Costa Rican Institute of Health Interviewed nearly
3,000 women, some of whom had learnt to read as children, some during the
literacy crusade and some who had never learnt at all. The women were asked
how many children they had given birth to and how many of them had died In
Infancy. The research teams also examined the surviving children to find
out how well-nourished they were.
The Investigators' findings
were striking. In the late 1970s, the infant mortality rate for the children
of Illiterate mothers was around 110 deaths per thousand live births. At
this point In their lives, those mothers who later went on to learn to read
had a similar level Of child mortality (105/1000). For women educated in
primary school, however, the Infant mortality rate was significantly lower,
at 80 per thousand.
In 1985, after the National
Literacy Crusade had ended, the infant mortality figures for those who
remained illiterate and for those educated In primary school remained more
or less unchanged. For those women who learnt to read through the campaign,
the infant mortality rate was 84 per thousand, an impressive 21 points
lower than for those women who were still Illiterate. The children of the
newly-literate mothers were also better nourished than those of women who
could not read.
Why are the children of
literate mothers better off? According to Peter Sandiford of the Liverpool
School of Tropical Medicine, no one Knows for certain. Child health was not
on the curriculum during the women’s lessons, so fie and his colleagues are
looking at other factors. They are working with the same group of 3,000
women, to try to find out whether reading mothers make better use of
hospitals and clinics, opt for smaller families, exert more control at
home, learn modern childcare techniques more quickly, or whether they
merely have more respect for themselves and their children.
The Nicaraguan study may have
important implications for governments and aid agencies that need to know
where to direct their resources. Sandiford says that there is increasing
evidence that female education, at any age, is "an important health
intervention in its own right’. The results of the study lend support to
the World Bank's recommendation that education budgets in developing countries
should be increased, not just to help their economies, but also to improve
child health.
'We’ve known for a long time
that maternal education is important,’ says John Cleland of the London
School of Hygiene and Tropical Medicine. ‘But we thought that even if we
started educating girls today, we'd have to wait a generation for the pay
off. The Nicaraguan study suggests we may be able to bypass that.'
Cleland warns that the
Nicaraguan crusade was special in many ways, and similar campaigns
elsewhere might not work as well. It is notoriously difficult to teach
adults skills that do not have an immediate impact on their everyday lives,
and many literacy campaigns in other countries have been much less
successful. 'The crusade was part of a larger effort to bring a better life
to the people,’ says Cleland. Replicating these conditions in other
countries will be a major challenge for development workers.
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