Purpose of Blog:

This blog will be documenting my research concerning female literacy and related health improvements. My original project was to collect information and statistics from various sources and databases and create a cum
ulative source documenting the positive effect of female literacy on women and children’s health in developing African countries. Having completed this research paper, I am now maintaining this blog as a place to share my further findings on the subject of female literacy and its effects on health, etc.

Some quick facts:
Female literacy has been shown to have a positive effect on health because “educated women are more likely to be employed and to earn more than less-educated women” (Daniell & Mortensen , 2007, p. 278), “an extra year of girls’ education can reduce infant mortality by 5-10 percent” and “educated mothers are about 50 percent more likely to immunize their children than uneducated m
others are” (Herz & Sperling, , 2004, p. 4).

Daniell, B., & Mortensen, P. (2007). Women and literacy. New York: Taylor & Francis Group.
Herz, B., & Sperling G. (2004). What works in girls’ education? New York: Council on Foreign Relations Inc.

Wednesday, December 3, 2008

The Health Situation in Sudan

I've evaluated a number of countries and their health/literacy situation. I found Sudan's report particularly jarring, and thought I ought to post it on here. For those of you that aren't aware, Sudan is in the midst of internal conflict-genocide in the area of Darfur. Of all the countries I can think of, Sudan is in the most desperate need of everyone's help.


Female Literacy and Health Status

Where South Africa rates a bit higher than the average Sub-Saharan country, Sudan rates significantly lower. Terrorized by internal conflict, Sudan’s rates are, however, not incredibly unusual. Several other countries currently suffer similar tragedies. And of course, Sudan’s schools are not safe from the terror of this in-fighting: “A UNICEF survey in Tawila documents a large number of rape cases, in one case targeting 41 school girls and teachers, and the gang rape of minors by up to 14 men” (Geneva Centre for Democratic Control of Armed Forces, 2007). This kind of disgusting intrusion is, unfortunately, not uncommon. As a result of this and other difficult factors, school enrolment rates don’t run high. Primary enrolment, as a percentage of the total number of children of primary school age is 60, and male/female: 64/56, while secondary enrolment drops to 34/32 (UNFPA, 2006).

Resulting from this the terrible conflict, its horrifying conditions, and a universal lack of significant education, maternal health is suffering immensely. For every 1,000 live births in Sudan, 590 die (UNFPA, 2006). That’s 59% of Sudan’s mothers. Not only is this a tragedy for these young mothers, but undoubtedly their infant children and families are suffering as well. These tragic and unnecessary deaths occur as a result of lack of materials, trained midwives and doctors, necessary instruments and equipment, first aid items, outreach services, among many other lacking necessities (UN, 1999).

Unsurprisingly, HIV is completely rampant in war-torn Sudan. Ravaged by the “systematic rape of black women,” victims have been informed, “I want to dilute your blood” (Grice, 2007). Not only are locals being slaughtered, but a “second wave of genocide” is occurring as women are raped, develop HIV-AIDS, and then cannot “get the drugs to treat the disease.” (Grice). And even those who might be able to obtain treatment often choose not to, as “women and girls in Darfur are so reluctant to report rape that unless serious injuries are sustained they would rather not seek medical help” (UN Office for the Coordination of Humanitarian Affairs, 2008). Naturally, many women never learn of their HIV-infection until it is too late. And infection is becoming worse and worse, especially since Sudan is a country where female genital mutilation, or circumcision, still occurs regularly. This mutilation increases the probability of infection, because of either unsterilized tools during circumcision, or from “being exposed to tearing or injury during sexual intercourse, which leads to bleeding and increases the capacity of transmitting the virus” (United Nations Development Programme, 2005). As a result, 56% of total AIDS cases are women, and 2.6% of the total population is infected with AIDS (CIA, 2003). Of course, this statistic was given nearly 6 years ago, and has undoubtedly risen significantly as systematic rape has sky-rocketed. And certainly these women and children are not benefiting from their lack of education, which could perhaps have saved them from waiting for treatment until it is too late.

Children’s Health Status

Children are fairing slightly better than their mothers, but not by much. There are about 91 deaths per 1,000 live births in Sudan (CIA, 2007). The under-5 mortality rate is worse, with 113 deaths per 1,000 births for both male and female infants (UNFPA, 2006). Only 1% of these infants are breastfed exclusively at 6 months (LAH, 2003). This unnecessary misfortune likely results from either lack of education for these new mothers, or the fact that, as we learned above, many of the mothers are dead.

*UNICEF Benefit Concert*

Hey everyone! Just wanted to give a shout-out and let everyone know that this Saturday, December 6, there will be a benefit concert for UNICEF in the Wilkinson Center at BYU. Tickets cost $6.00, and ALL the proceeds will go to UNICEF! So even if you can't make because you've already planned a hot date, buy a ticket and support one of the most valuable non-profit children's organizations in the world. Tickets are for sale in the Wilk.

See ya there!

Literature Review

I've recently done a review of all literature pertaining to the effects of female literacy on women and children's health. Here I'm going to post a portion of my review!

Literature Review

First, it is important to understand the documented effect of female literacy on public health in general. As I initially considered this project, I was thrilled to discover that there have already been a number of studies documenting of the effects of female literacy on health. These studies were performed in various locations around the world, however I have narrowed my review to several studies relating to Africa specifically. I've highlighted some of the exciting data and conclusions, to make for easy reading:

Literature Review

Barrett and Browne (1996) discuss the methods in which women’s education affects domestic hygiene practices and the use of health care services in a traditional agricultural village of Gambia. This discussion stems from the their survey of village mothers with and without formal education, with at least one child under the age of 5. Their study was given during the village’s rainy season, which is known for causing high morbidity rates. The results demonstrate, most importantly, that the village women with higher education were better able to understand health education messages (Barrett & Browne, 1996).

I was very impressed with the conclusions of Paul Glewwe, a senior economist for The World Bank (1999). After working, studying, and researching in Morocco, he summarized the relevance of female education effects on health in Morocco in three basic benefits. These three effects include: “(1) Formal education directly teaches health knowledge to mothers; (2) Literacy and numeracy skills acquired in school assist future mothers in diagnosing and treating child health problems; and (3) Exposure to modern society from formal schooling makes women more receptive to modern medical treatments” (p. 1). These conclusions aid in demonstrating how female literacy can specifically affect the health of both the educated mother and her children.

Spratt (1992) also discusses the positive impact of female literacy in Morocco, and discusses the great need for more literacy programs and educational institutions. Documented benefits of female literacy include fewer children per mother, fewer children lost to disease, and a greater use of modern health care practices (Spratt).

Another study, by McAllister and Baskett (2006), concludes with even more significant findings. Researchers were distressed by the fact that “approximately 600,000 women between the ages of 15 and 49 die each year” because of complications during pregnancy and childbirth—a figure that may be underestimated by as much as 25% (p. 984). They noted that countries who treated women as equals to men tended to have lower maternal mortality rates, while countries who allow women to be treated as second class citizens had very high maternal mortality rates. Education played a large role in the development of equity, and therefore they decided to further research the association between women’s education and health. Specifically, they performed polynomial regression analysis for 148 countries, and examined the impact of gender-related predictors, including “education, political activity, economic status, and health, and human development predictors [that] examined the relationship between women’s status, human development, and maternal mortality” (p. 983). After analyzing data from the 148 countries, researchers found that the combined enrolment ratio for females had a p-value of 0.004, which was a “significant and moderately powerful [predictor] of maternal mortality rates” (p. 985). Additionally, female education predictors explained about 50% of variance in data. They concluded, “Strategic investment to improve quality of life through female education will have the greatest impact on maternal mortality reduction” (p. 983, emphasis added). Of all the potential effects on maternal mortality, female education had the greatest association with and potential benefits toward maternal mortality rates.

Maternal Mortality Rates

Here's a great picture that really depicts the situation with maternal mortality rates around the world:

WHO Maternal Mortality Rates, 2005

You can see that there is a real problem in Sub-Saharan Africa: at least ten countries have over 1,000 maternal deaths per 100,000 live births!

Tuesday, November 25, 2008

Maternal Health FAQs

Q: Why do so many women still die in pregnancy or childbirth?

A: Every minute, at least one woman dies from complications related to pregnancy or childbirth – that means 529 000 women a year. In addition, for every woman who dies in childbirth, around 20 more suffer injury, infection or disease – approximately 10 million women each year.

Five direct complications account for more than 70% of maternal deaths: haemorrhage (25%), infection (15%), unsafe abortion (13%), eclampsia (very high blood pressure leading to seizures – 12%), and obstructed labour (8%). While these are the main causes of maternal death, unavailable, inaccessible, unaffordable, or poor quality care is fundamentally responsible. They are detrimental to social development and wellbeing, as some one million children are left motherless each year. These children are 10 times more likely to die within two years of their mothers' death.

Women need not die in childbirth. We must give a young woman the information and support she needs to control her reproductive health, help her through a pregnancy, and care for her and her newborn well into childhood. The vast majority of maternal deaths could be prevented if women had access to quality family planning services, skilled care during pregnancy, childbirth and the first month after delivery, or post-abortion care services and where permissible, safe abortion services. 15% of pregnancies and childbirths need emergency obstetric care because of risks that are difficult to predict. A working health system with skilled personnel is key to saving these women's lives.

Source: WHO

Wednesday, November 5, 2008

Three Cups of Tea

I recently read the internationally acclaimed Three Cups of Tea, and was not only thrilled with its relevance to the topic of this blog, but also just the incredible story it presents. I've posted below a copy of the book review I wrote!

Three Cups of Tea: One Man’s Mission to Promote Peace . . . One School at a Time. Greg Mortenson & David Oliver Relin. New York: Penguin Group Inc. 2006. 349 pp.

Three Cups of Tea, though not written especially as an informational book, gives its readers not only exceptional insight into a hero’s life, but also as a map of international grassroots ingenuity. This biographical narrative relates not only Greg Mortenson’s life, but also his development of a non-profit organization that builds girls schools in the Middle East. As the biography explores the unusual beginnings of Greg Mortenson’s “Central Asia Institute,” (CAI), it also gives especial insight into the heart and abilities required to take an unbelievable dream to a full-fledged non-profit literacy program in the heartland of terrorism. For anyone interested in learning how establish an NGO, or even just an incredible story, this book is a must-read.

The book begins by telling of Mortenson’s failure to mount the peaks of Pakistan’s K2. While fighting the downward battle of a failed ascent, Mortenson got lost in a blizzard and barely made it out alive. He recuperated in the Balti mountain village of Korphe, where after a few weeks, he fell in love with the people. Mortenson was amazed by the diligence of the Balti people—especially their children, who studied outside on the winter ground, for lack of a school. Regardless of his empty savings account, Mortenson was so moved by the scenes that he promised to return someday and build the children a school. And so his eventual million-dollar literacy program began with an almost unachievable promise.

The book progresses by going through phases of Mortenson’s life: First, a recap of his childhood in Africa and the pioneering spirit instilled in him by his missionary parents. Then the story of CAI slowly unfolds, describing all of Mortenson’s struggles along the way. This is more or less a ten-year recap, and finishes with the state of the program in 2006, when the book was published.

Some of the most important messages of the book are demonstrated over the course of CAI’s development. Mortenson’s experiences and personal qualities demonstrate some vitally important pointers for anyone interested in international NGO work. The first is that keeping your word is of the utmost importance. Multiple times in Mortenson’s travels, it is because of his unfailing integrity that he gains the absolute trust of the Pakistani and Afghan people. In fact, the trust and legitimacy he gains in a country full of hatred-preaching madrassas (extremist schools created by the Wahhabi, a fundamentalist offshoot of Sunni Islam), is simply miraculous and all due to his unparalleled integrity. Second, his international relation skills, though it is unlikely they would ever be taught in a classroom, worked wonders for him. In the first ten years of his struggle, Mortenson repeatedly jumped into the Muslim culture with both feet. Even the title of the book, Three Cups of Tea, is a reflection of this; In Pakistan, it is traditional for a guest to sit down with his host and share three cups of tea. Although this seeming waste of time first frustrated Mortenson, he quickly learned the importance of embracing the Pakistani culture, and as he accepted and worked with their traditions, he gained a love for the fundamentalist people. As Mortenson first endeavored to embrace the Muslim culture, he even asked a man how to pray. The man was thrilled, and Greg’s new knowledge served him well in every situation—even ones of life and death. His incredible compassion and desire to embrace a hated people served as the unfailing key that opened their hearts to such a large, white, American man. The most unlikely of saviors, Mortenson became beloved of the people he served because of his genuine desire to work with them and understand their ways.

Another profound message from Three Cups of Tea is a demonstration of the true nature of Islam. In our country—where skepticism (to say the least) of the Muslim religion prevails our 9/11 experiences—it is especially important to gain an understanding of what true Islam is. One of the most striking demonstrations of true Islam occurred just after Mortenson learned of the tragedy of 9/11 while working on a project in Afghanistan. The next day, he attended the dedication of a new girls’ school, where he was flooded with an outpouring of remorse and empathy for the people in the “village of New York.” After the ceremony, Mortenson was approached by “Kaurdu’s many widows . . . [who] pressed eggs into the Americans’ hands, begging them to carry these tokens of grief to the faraway sisters they longed to comfort themselves, the widows of New York village” (p. 258). Mortenson commented about this experience, “I wish all the Americans who think ‘Muslim’ is just another way of saying ‘terrorist’ could have been there that day. The true core tenants of Islam are justice, tolerance, and charity” (p.257). Mortenson’s story is full of such examples of what it means to a true follower of Islam, and Three Cups of Tea serves as an eye-opening experience to anyone who thinks Islam is a terrorist-breeding religion.

Finally, Three Cups of Tea is a vibrant, breathing example of the powerful transformation that girls’ education can bring to a nation. In a world where most girls still struggle under oppressive cultural practices and government, Mortenson’s CAI is an excellent example of how to take a step in the right direction. Although the nations of Afghanistan and Pakistan are so war-torn that Mortenson has actually carved some of his schools out of the mountains to shelter his students from shellfire, his students testify of the incredible peace they find in their lives from their education. One student, Jahan, confided, “Before I met you, Dr. Greg [Mortenson], I had no idea what education was. But now I think it is like water. It is important for everything in life” (p. 312). Shortly after 9/11, a man named Bashir pointed out to Mortenson that the true enemy isn’t men like Osama Bin Laden— “The enemy is ignorance” (p. 310). In his great work, Mortenson has chosen to hack at the root of the tree of evil. And through his countless experiences, he concludes, “If you really want to change a culture, to empower women, improve basic hygiene and health care, and fight high rates of infant mortality, the answer is to educate girls” (p. 209).

As inspiring as the book is, it has a couple of flaws. While reading, I found myself wondering how to possibly keep track of the countless foreign names. Although its index proves very useful, the book could really use some kind of name/reference list. Additionally, I found myself constantly wondering how such a specific account of Mortenson’s experiences was written. Are all the quotes really word for word? How did Greg and David Relin make this record? I wished for some kind of explanation about how the book was compiled and written, because that in itself must be a fascinating tale.

Despite these two shortcomings, reading Three Cups of Tea is an experience not to be missed, and would certainly enrich the life of anyone, regardless of their level of interest in the Middle East or NGOs. I would recommend Mortenson’s story to everyone, for it is truly an enriching tale that empowers each of us to step up and make a difference in our world.

Wednesday, October 29, 2008

Ten Facts About Maternal Health

10 Facts on Maternal Health (WHO)

Fact 1

Worldwide, a woman dies every minute due to complications during pregnancy and childbirth - more than 500 000 women per year. In developing countries, pregnancy and childbirth are the second leading causes (after HIV/AIDS) of death among women of reproductive age.

Fact 2

Five main killers cause more than 70% of maternal deaths worldwide: severe bleeding, infections, unsafe abortion, hypertensive disorders (pre-eclampsia and eclampsia) and obstructed labour. Postpartum bleeding can kill even a healthy woman, if unattended, within two hours. Most of these deaths are preventable.

Fact 3

More than 136 million women give birth a year. About 20 million of them experience pregnancy-related illness after childbirth. The list of morbidities is long and diverse, and includes fever, anaemia, fistula, incontinence, infertility and depression. Very often, ill women are stigmatized and ostracized by their husbands, families and communities.

Fact 4

About 14 million girls aged between 15 and 19 give birth each year, accounting for more than 10% of all births. In the developing world, about 90% of the births to adolescents occur in marriage. In many countries, the risk of maternal death is twice as high for an adolescent mother as for other pregnant women.

Fact 5

The state of maternal health mirrors the gap between the rich and the poor. Only 1% of maternal deaths occur in high-income countries. A woman's lifetime risk of dying from complications in childbirth or pregnancy is about one in seven in Niger and one in 48 000 in Ireland. Also, maternal mortality is higher in rural areas and among poorer and less educated communities.

Fact 6

Most maternal deaths can be prevented through skilled care at childbirth and access to emergency obstetric care. In sub-Saharan

Africa, where maternal mortality ratios are the highest, only 40% of women are attended by a trained midwife, nurse or doctor during childbirth.

Fact 7

In developing countries, the percentage of women who have at least four antenatal care visits during pregnancy ranges from less than 10% to more than 90%. Poor women in rural areas especially do not receive the necessary check-ups. They miss the opportunity to get immunization, and treatment for diseases or for prevention of mother-to-child transmission of HIV/AIDS.

Fact 8

About 18 million unsafe abortions are carried out in developing countries every year, resulting in 70 000 maternal deaths. Many of these deaths could be prevented if information on family planning and contraceptives were available and put into practice.

Fact 9

One target of the Millennium Development Goals (MDGs) is to reduce the ratio by three quarters between 1990 and 2015. So far, the progress has been slow. By 2005 the global maternal mortality ratio declined by only 5%, from 430 tmaternal mortalityo 400 maternal deaths per 100 000 live births. There was no progress in sub-Saharan Africa, where the risk of maternal death is the highest.

Fact 10

The main obstacle to progress towards better health for mothers is the lack of skilled care. This is aggravated by a global shortage of qualified health workers. By 2015 another 330 000 midwives are needed to achieve universal coverage of mothers with skilled birth attendance.

Tuesday, October 7, 2008

Trick-or-Treat for UNICEF

UNICEF, the United Nations Childrens Fund, is an incredible advocate for international humanitarian work. Their many literacy programs are contributing to the growing strength of young and feminine voices around the world. This Halloween, they have a creative and catchy program to help our US children raise money to help educate and feed their brothers and sisters around the world! Check it out at http://youth.unicefusa.org/trickortreat/!