Between 1970 and 2009, the average woman aged 25 and over has seen a doubling of her years in education. For women in poor nations, the increase is more than triple. This increase in education is estimated to be responsible for averting 4.2 million children's deaths globally in 2009. High-income countries also saw big increases in years in education across the board. The findings are reported in an Article in this week's Millennium Development Goals special issue of The Lancet, written by Dr Emmanuela Gakidou, Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, WA, USA, and colleagues.
Between 1970 and 2009, mortality in children under age 5 dropped from 16 million to 7.8 million annually, and IHME researchers estimate that 51% of the reduction can be linked to increased education among women of reproductive age. This means that 4.2 million fewer children died in 2009 because women received more years of schooling.
Using data from 915 censuses and national surveys from 219 countries to produce estimates for 175 countries, the authors estimated that the global mean number of years of education that a person aged 25-years or over had received increased from 4•7 years to 8•3 years for men and from 3•5 years to 7•1 years for women. For women of reproductive age (15 years) in developing countries, the years of schooling increased from 2•2 years to 7•2 years. By 2009, in 87 countries, women (aged 25 years) had higher educational attainment than had men (aged 25 years). However, in 40 countries, including Afghanistan, Pakistan, and Nepal, the gender gap was larger in 2009 than in 1970.
"We know that direct health interventions, such as immunisations, preventive care, and hygiene classes, are crucial to improving health worldwide," said Dr. Emmanuela Gakidou, the lead author of the study and Associate Professor of Global Health at IHME. "What this study shows is that by focusing on education as well, we can increase the impact that we are having on health."
Other interesting findings included that 31 countries had improved the average years of schooling of reproductive-age women by more than three years between 1990 and 2009. This includes several countries in the Middle East: Saudi Arabia, Lebanon, and the United Arab Emirates. In seven of the world's 10 most populous countries, Brazil, China, Japan, Indonesia, Nigeria, Russia, and the United States, women of reproductive age had on average received more than six years of schooling by 2009, meaning they probably completed primary school.
High-income countries also showed steep increases in the years in education for both men and women aged 25 years and over. In western Europe, Norwegian and British women (13•6 years and 13•0 years respectively) had the most years in education, while Portuguese (7•7) and Spanish (9•0) women had the fewest. For men, Norway (13.6) and Switzerland (13•5) were the best performers, with Spain (9•0) and Portugal (7•6) again finishing well adrift. But the runaway success stories in high-income countries were the USA (13•7 years both women and men) and Canada (14•2 years both women and men).
The authors note that most of the countries on pace to meet Millennium Development Goal 4 – reducing the child mortality rate by 66% between 1990 and 2015 – have improved their average years of schooling for reproductive-age women faster than the global average of 1•9 years since 1990. This includes countries such as Thailand, Egypt, Sri Lanka, and Peru. The researchers estimate that economic growth contributed relatively little to reductions in child mortality – accounting for 7•2% of the reduction between 1970 and 2009 – in large part because development has been slow in countries with the highest child mortality rates.
They conclude: "Even though progress on reduction of child mortality has not been at the pace needed to achieve the ambitious goal of reducing child mortality by two-thirds between 1990 and 2015, evidence indicates that reductions in child mortality are occurring, especially in sub-Saharan Africa. The continued expansion of educational attainment even in some of the poorest countries holds out the real prospect that accelerated progress on MDG4 might be possible. The global health community should take advantage of the opportunity presented by more educated cohorts of women of reproductive age to intensify efforts to deliver key services to women, babies, and children.
In a linked Comment, Dr John Cleland, London School of Hygiene and Tropical Medicine, UK, says: "Gakidou and colleagues present good news. The gender gap in schooling is narrowing and has been reversed in several countries. Younger cohorts of women are better educated than older cohorts, which bodes well for future reductions in child mortality. Their findings also identify west African countries, where educational progress has been dismal. These countries' populations are expected to double or even treble by mid-century. The investigators noted that adult education has a powerful influence not only on mortality, but fertility. Unless huge investments in education are made urgently, population pressures might erode prospects of an escape from poverty and food insecurity for these countries.
For Dr Emmanuela Gakidou at the Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA, please contact William Heisel, IHME Communications. T) +1 (206) 897-2886 / + 1 (206) 612-0739 E) wheisel@uw.edu
Dr John Cleland, London School of Hygiene and Tropical Medicine, UK. T) +44 (0) 1458 851266 E) john.cleland@lshtm.ac.uk
For full Article and Comment see: http://press.thelancet.com/womeduc.pdf
NOTE: THE ABOVE LINK IS FOR JOURNALISTS ONLY; IF YOU WISH TO PROVIDE A LINK TO THE FREE ABSTRACT OF THIS PAPER FOR YOUR READERS, PLEASE USE THE FOLLOWING, WHICH WILL GO LIVE AT THE TIME THE EMBARGO LIFTS: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61257-3/abstract
See also linked country by country tables below:
Table 1. Ranking of countries by years of schooling and child mortality.
http://press.thelancet.com/mdgtable1.xls
Table 2. Ranking of 175 countries by educational level in 1970, by educational level in 2009, and by average increase in educational attainment between 1970 and 2009.
http://press.thelancet.com/mdgtable2.xls
Table 3. Ranking of 175 countries by gender gap in education and by the amount of progress made in narrowing the gap.
http://press.thelancet.com/mdgtable3.xls
Table 4. List of countries on track to achieve Millennium Development Goal 4 – a 66% reduction in the child mortality rate between 1990 and 2015 – alongside the level of educational attainment and the gender gap.
http://press.thelancet.com/mdgtable4.xls
Journal
The Lancet