Chata Male

Economic impacts of child marriage: global synthesis report.

Background As the number of deaths among children younger than 5 years of age continues to decline globally through programs to address the health of older infants, neonatal mortality is becoming an increasingly large proportion of under–5 deaths. Lack of access to safe delivery care, emergency obstetric care and postnatal care continue to be challenges for reducing neonatal mortality. This article reviews the available evidence regarding the effectiveness of community–based primary health care (CBPHC) and common components of programs aiming to improve health during the first 28 days of life. Methods A database comprising evidence of the effectiveness of projects, programs and field research studies (referred to collectively as projects) in improving maternal, neonatal and child health through CBPHC has been assembled and described elsewhere in this series. From this larger database (N = 548), a subset was created from assessments specifically relating to newborn health (N = 93). Assessments were excluded if the primary project beneficiaries were more than 28 days of age, or if the assessment did not identify one of the following outcomes related to neonatal health: changes in knowledge about newborn illness, care seeking for newborn illness, utilization of postnatal care, nutritional status of neonates, neonatal morbidity, or neonatal mortality. Descriptive analyses were conducted based on study type and outcome variables. An equity assessment was also conducted on the articles included in the neonatal subset. Results There is strong evidence that CBPHC can be effective in improving neonatal health, and we present information about the common characteristics shared by effective programs. For projects that reported on health outcomes, twice as many reported an improvement in neonatal health as did those that reported no effect; only one study demonstrated a negative effect. Of those with the strongest experimental study design, almost three–quarters reported beneficial neonatal health outcomes. Many of the neonatal projects assessed in our database utilized community health workers (CHWs), home visits, and participatory women’s groups. Several of the interventions used in these projects focused on health education (recognition of danger signs), and promotion of and support for exclusive breastfeeding (sometimes, but not always, including early breastfeeding). Almost all of the assessments that included a measurable equity component showed that CBPHC produced neonatal health benefits that favored the poorest segment of the project population. However, the studies were quite biased in geographic scope, with more than half conducted in South Asia, and many were pilot studies, rather than projects at scale. Conclusions CBPHC can be effectively employed to improve neonatal health in high–mortality, resource–constrained settings. CBPHC is especially important for education and support for pregnant and postpartum mothers and for establishing community–facility linkages to facilitate referrals for obstetrical emergencies; however, the latter will only produce better health outcomes if facilities offer timely, high–quality care. Further research on this topic is needed in Africa and Latin America, as well as in urban and peri–urban areas. Additionally, more assessments are needed of integrated packages of neonatal interventions and of programs at scale.

Girls’ Education and Child Marriage in West and Central Africa: Trends, Impacts, Costs, and Solutions*

Abstract Within the context of women’s lack of empowerment, the issues of child marriage and low educational attainment for girls are prominent, especially in West and Central Africa. Using survey data for 21 of the 25 countries in West and Central Africa, this article analyzes trends over time in educational attainment for girls and child marriage. Over the last two and a half decades, not accounting for differences in population sizes between countries, according to the latest DHS and MICS surveys available in each country, completion rates increased on average by 24 points, 14 points, and 8 points at the primary, lower secondary, and upper secondary levels, respectively. The prevalence of child marriage decreased by about 8 points over that period. Clearly, progress at the secondary level has been weaker than at the primary level, probably in part due to the persistence of high rates of child marriage in many countries. The article suggests that ending child marriage should improve girls’ educational attainment, and conversely, improving girls’ educational attainment should help reduce child marriage. This, in turn, could have major impacts toward contributing to empowering women more broadly. A review of impact evaluations for pilot interventions suggests how ending child marriage and improving educational attainment for girls could be done, with potentially large economic benefits not only for girls and their future household, but also for the region as a whole.

Child Marriage, Early Childbearing, Low Educational Attainment for Girls, and Their Impacts in Uganda

The proportions of girls marrying or having children before the age of 18 have been declining in Uganda according to data from the latest publicly available Demographic and Health Survey (DHS) implemented in 2011. Yet despite progress, more than one third of girls still marry as children, and close to three in ten girls have their first child before turning 18. Similarly, despite substantial efforts to improve educational attainment, only one in four girls completes lower secondary school, and an even smaller proportion completes upper secondary school. The government of Uganda has adopted a national strategy to end child marriage and teenage pregnancies. Improving girls’ education is also a priority of the government. Unfortunately, the cultural, economic, and social conditions that have historically contributed to child marriage, early childbearing, and low educational attainment for girls remain strong. More needs to be done to accelerate progress. To inspire greater investments in adolescent girls, this note analyses the economic and social impacts of these issues in Uganda. The note also suggests potential options for investments.

Egypt Note: Selected Issues and Options for the Education Sector

This note provides a diagnostic of issues faced by the pre-tertiary education sector in the areas of schooling, learning, education and labor market earnings, and education spending.Acknowledging the Ministry of Education and Technical Education (MOETE) strategy for the sector and the Vision 2030, the note also discusses challenges in six areas: (1) Early childhood education; (2) Teacher policies; (3) Student assessment; (4) TVET/skills development; (5) School autonomy/accountability; and (6) curriculum, ICT, and materials.