Educating Girls: Creating a Future of Healthy Nations
Educating Girls: Creating a Future of Gender Equality and Healthy Nations
~Jennifer Dengler, PA-C, MedTreks clinical advisor, and assistant faculty.
Women’s health and reproductive rights are currently a major global health issue. When assessing the overall health of a woman one can gain insight into the health of her children, the family structure, financial status, and nutritional status of the family. Six out of eight of the United Nations Millennium Development Goals can be centered around the health and well-being of women. In many developing nations women have reduced access to health care, are victims of domestic violence and rape, have restricted access to education, hold a limited socioeconomic position, and are a vulnerable population. This, in turn, increases poverty, child mortality and morbidity, hunger, population growth, and subsequently taxes an already stressed economic and environmental system in the developing world.
A major contributor surrounding many of the key issues in global health care is inadequate education. According to UNESCO Institute for Statistics, the number of people unable to read or write continues to fall globally, even with improvements in literacy there are still 757 million adults who are illiterate and ⅔ are female (UNESCO, 2015). The Gender Parity Index (GPI) for Sub-Saharan Africa is 0.76 for adults, which indicates that women aged 15 years and older are approximately 24% more likely to be illiterate compared to men. On a global level, this disparity is only 9% (UNESCO, 2015). These countries have made significant strides in improving literacy, even though they are still showing great disparities. The Sustainable Development Goals will contain a new literacy target for 2030 that “ensure all youth and a substantial portion of adults, both men and women, achieve literacy and numeracy” (UNESCO, 2015). In order to meet these improved literacy goals, countries will need to be able to provide a means of educating the youth, which will include improved academic institutions, transportation, nutrition, and educated teachers. UNICEF has created the Out-of-School Children Initiative, which is a global effort to uncover data and offer policy recommendations and interventions that will allow every child to go to school and learn (UNICEF, 2015). It is noted in the Global Out-of-School Initiative literature that barriers to obtaining education and remaining in school are; child labor, conflict, poverty, disabilities, gender inequality, and language challenges. These obstacles only complicate the lack of institutions and physical means of educating youth.
Education, Health, and Gender Equality
Education allows individuals the ability to gain the skills necessary to live a prosperous, healthy life and empowers them to make informed decisions. Educated individuals are able to better comprehend medical needs and use services effectively, including preventative care and family planning. A woman with six or more years of education is more likely to seek prenatal care, assisted childbirth, and postnatal care; thereby reducing the risk of maternal and child mortality and illness (Center for Global Development [CGD], 2006). When assessing the social determinants of health, literacy and formal education are a major contributor to overall population wellbeing. Literacy allows individuals to acquire health information and navigate health systems (Jacobsen, 2014). This includes, but is not limited to; the ability to read preventative campaigns, follow medical directions, take medications appropriately, and apply for aid and benefits. Furthermore, individuals with a basic education will have the right to continue their education, which in turn will lead to the ability to train medical professionals who will have incentive to provide care in their community. This will increase the economics of medically underserved populations and improve the health of that location allowing more children the right to go to school. Women who are educated will be able to be trained as teachers and birth attendants which will improve safe access to both healthcare and education for women as many women express fear, discrimination by doctors, and lack of confidentiality as concerns for safe access (Paul, 2015). If women have the option to be cared for by a woman they will be more inclined to seek medical care.
As stated by Irina Bokova, UNESCO Director General,
“Investing in the education of young women and men is absolutely essential to HIV prevention and treatment, and to continuing efforts to end all HIV – related stigma and discrimination. This is why, over the last two decades, UNESCO has worked to overcome discrimination and ensure gender – sensitive and age- appropriate education on sexuality and reproductive health , delivered in safe and healthy learning environments that are free from all forms of gender – based violence.”
Challenges in Policy
Creating policy in order to implement change at a national level requires a multilevel approach. The policy needs to ensure that the program is sustainable for future generations, is cost-effective and efficient, is measurable and reproducible for future administration, is research driven and evidenced-based, has transparency, and a systematic approach to achieving stated goals. Implementing global health policies and interventions to meet the millennium development goals requires multi-agency collaboration to provide structure and a guided approach to promoting the goal. Data and research need to be collected to ensure that programs are reaching endpoints or that deficiencies can be remedied before losses become significant and are no longer cost-effective (Jacobsen, 2014). Even with organizations such as The Kaiser Foundation, UNESCO, UNICEF, and major contributions from governments and private sectors, the lack of funding has greatly limited access to services and obstructed progress (Kaiser Family Foundation [KFF], 2015, 2015). Out of all the millennium development goals, the least progress globally has been on maternal health (KFF, 2015). From the aspect of funding as a challenge in creating policy, it is noted that over $1.35 billion has been committed from the United States alone to help with improving maternal and child health (KFF, 2015), so it is critical that funds can be prioritized and appropriately dispersed without fear of mismanagement and corruption. This requires another layer of complexity for the recipient country where the policy is to be instituted and management and disbursement of funds needs to be regulated. The Global Fund had issued a statement in regards to the complexity of providing these services and utilizing a performance-based financing system. It was noted that data measures are critical in ensuring that funds are appropriately managed based on proven outcomes, however, this comes with challenges as well since many budgets have different endpoints and some aspects of healthcare are not able to have data collection (Silverman & Glassman, 2013). In order to provide evaluations and systematic reviews that have supporting evidence of success, the International Initiative for Impact Evaluation has created a grant-making NGO that promotes policy relevant evidence and can be a tool in providing statistics on what works, cost, and development strategies.
Challenges in policy and implementing programs are multifaceted and require a multi-agency team approach to provide the best resources to ensure a sustainable, cost-effective outcome that is able to impact the health of many girls through education and gender equality.
Through improved academia, countries will have an educated workforce and quality laborers, including healthcare providers. Gender equality goals can be accomplished when women and girls are educated and held to similar standards as men and boys, which will increase the economic growth of the nations and decrease poverty and hunger. Women who are educated tend to have smaller families which will also aid in improving hunger and nutrition, decreasing poverty, decrease the demand on environmental resources, and decrease mortality and morbidity. The contributions of education to healthcare, poverty, and gender equality are all intimately connected. Without policy to create change academically and allow more children, especially girls, the opportunity to participate in formal education we as a global community will continue to see a spread of HIV/AIDS and other infectious diseases, increase child mortality, increased poverty and malnutrition, and overall poor quality of life for those individuals. Without nations placing an emphasis on education and gender equality, many of the Millennium Development Goals and Sustainable Development Goals will not be accomplished. As is evident in this blog, a strong focus on women’s rights and education will allow for nations to meet goals associated with eradicating poverty and hunger, reducing child mortality, improving maternal health, providing access to primary education, empowering women, combating HIV/AIDS and other diseases, and ensuring a sustainable environment. Now is the time to see NGOs and governments come together to create a framework and standards which will ensure that women are able to receive the educational opportunities that all individuals have a right too in order to have a sustainable future.