Published in The Lancet, September 2010
Research findings
Education is rising in every region. Globally, women ages 25 and older have seen an increase in education from 3.5 years to 7.1 years, while men in that age range have seen an increase from 4.7 years to 8.3 years. In six countries – Afghanistan, Burkina Faso, Chad, Mali, Niger, and Yemen –women receive less than one year of schooling.
In developing countries, the progress has been particularly dramatic. Average years of schooling for women of reproductive age (ages 15 to 44) in developing countries increased from 2.2 years in 1970 to 7.2 years in 2009, a tripling of average years of schooling. During that same period, mortality in children under the age of 5 dropped from 16 million to 7.8 million annually. IHME researchers estimate that 51% of that 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.
For young adults ages 25 to 34, who have most recently completed their education, the overall education gap between men and women is narrowing. By 2009, women had greater levels of education than men in 87 countries, including Qatar, Malaysia, and the Philippines. However, in 40 countries, including Afghanistan, Pakistan, and Nepal, the gender gap was larger in 2009 than in 1970.
Most of the countries on pace to meet Millennium Development Goal (MDG) 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.
Analytical approach
Researchers gathered data from 915 censuses and national surveys worldwide to create a time series of education levels for 175 countries. They used a first-differences model to explore the association between child mortality and women’s educational attainment, controlling for income per person and HIV seroprevalence. They then computed estimates of child mortality for every country year between 1970 and 2009.
Research objective
Research long has established a link between education and health, and IHME studies education as one of the social determinants necessary to improve health worldwide. Policymakers have set international targets for raising education levels, including MDG 2, which calls for universal primary education. Despite these goals, progress has suffered from a lack of a comprehensive time series of educational attainment for all countries, which would allow countries to quantify the contribution of improvements in education to reductions in child mortality. IHME launched this study to provide that quantification and, in doing so, contribute to effective decision-making.
Recommendations for future work
Further study is needed to determine the appropriate level of investment to achieve international targets for educational attainment. With most children now graduating from primary school, the researchers suggest that further progress in educational attainment will require increases in secondary school attendance, which could require building new secondary schools and hiring teachers. Those investments, however, should be weighed against the potential benefits and costs of building clinics, hiring health workers, and other direct health interventions.
Citation: Gakidou E, Cowling K, Lozano R, Murray CJL. Increased educational attainment and its effect on child mortality in 175 countries between 1970 and 2009: a systematic analysis. The Lancet. 2010; 376:959–974.
