What is the best way to empower women and improve health outcomes?
We know that the most effective way out of poverty is to empower women. It works in all contexts; Bangladesh, Uganda, Thailand. Empowering women is a massive short-cut to solving all sorts of social and economic problems. With the new CSR act a few people have been asking me “what is the best bang for my CSR buck”? It seems to me women’s empowerment is the obvious answer – but even then, where do you start?
I have heard people say economic empowerment is key. Maybe, but I don’t think economic empowerment is sufficient. Anecdotally, I know many urban poor women in Bangalore who are the main breadwinners in their household, they work in jobs (often multiple jobs) such as a maid, a nurse or a cook. They bring up their kids almost single-handedly. Their husbands are unemployed, they drink and beat them up. The women have the income that keeps the family on track, but they are not empowered.
I would say a safer bet is education. Something we’ve long known is that education – especially girls’ education - is a hugely important factor in determining health status – way more important than wealth. One year average increase in schooling for a population gives you about 10% lower child mortality rates, whereas a 10% increase in GDP only reduces child mortality by one or two percent.
Vietnam and Yemen have roughly equivalent GDP per capita. Yet Vietnamese women are healthier – they average 6.3 more years in school and are half as likely to die between the ages of fifteen and sixty (from Epic Measures, reviewed here)
But education does not just delay marriage, educated women are also better decision makers, supporting good health through better nutrition, better healthcare choices, and better lifestyles for themselves and their families.
Anyone who has witnessed the poor quality education in rural areas may be surprised at the consistently positive effects of education on health and well being. But they seem to hold through every study and data source.
Where should education investments go? I say there are two strong “open moments” to achieve big health and wellbeing impacts:
Early childhood education: The kindergarten years are where the most important cognitive and physical development happens, and where the most important lessons are learned. It’s also a great leveler – the greatest benefits of early childhood education are for those from low-income background – where it puts them on a more equal footing in terms of school readiness with their wealthier peers.
Girls’ secondary education: Girls staying in school has many benefits (as mentioned above). Even where girls are in school, there are many opportunities to improve the quality of education and also provide additional inputs such as lifeskills education, financial management, iron supplementation of HPV vaccination. I have written about this before, here.
I am very lucky to also work with a groups of schools that serves children from low income households in downtown Bangalore. My work focuses on health education specifically, but it’s also great to know that their health is improving just by being there.