Famine, drought, and war—often affecting civilian populations—have devastated many countries in Africa. Following such emergencies, most deaths in affected populations occurred among children under five years of age. Gebre-Egziabher Kiros, a Population Council Berelson Fellow, and Dennis P. Hogan, a Brown University professor, recently evaluated the role of parental education in the ability of children to survive such circumstances.
Influence of education
Limited information exists on mechanisms by which parental education might improve child survival. Social scientists have speculated that higher levels of education lead to increased income, which in turn decreases malnutrition. Educated mothers may be more likely to implement simple health-promoting practices, such as increasing cleanliness or using health services. Educated fathers may boost their children’s chances of survival through their greater affluence and knowledge.
Kiros and Hogan focused on the Tigrai region of northern Ethiopia, where only 28 percent of males and 14 percent of females can read and write. Tigrai was heavily affected by the decades of civil war and famine that occurred in Ethiopia between 1973 and 1991. About 85 percent of people in the region engage in agriculture. All economic activities proceed at subsistence level and are thus acutely sensitive to seasonal variations and rainfall shortages. Only 23 percent of the population receives clean water. The terrain is mountainous and rugged, leaving the region largely inaccessible to outsiders. During the civil war, the government targeted Tigrai and other regions, restricting food aid in response to famine to subjugate the population as a part of its counter-insurgency efforts.
Fathers' influence
The researchers examined data from the 1994 Housing and Population Census of Ethiopia, which sampled 20 percent of all households in Tigrai. The sample comprised 144,090 households with 414,445 children; these households experienced 87,025 child deaths between 1979 and 1994.
The investigators found that both mothers’ and fathers’ education are strongly associated with child survival. Child mortality is highest among children born to illiterate parents; it decreases as mothers’ and fathers’ education increases. The researchers found average child mortality levels between 1979 and 1994 of 200 and 156 per 1,000 live births for illiterate and literate mothers, respectively. Mortality among the children of illiterate fathers was 201 per 1,000 births, declining to 178 per 1,000 births when fathers had a primary education. The investigators were most intrigued, however, by death rates among the children of fathers with more than a primary education. The mortality rates for these children dropped to only 114 per 1,000 births. (Very few mothers had more than a primary education.)
“There is an established belief that a mother’s education is more important than a father’s education when it comes to children’s health because mothers are more involved in childcare and spend more time with the children, says Kiros. We did confirm that a mother's education is important. The data we analyzed, however, further suggest that in this setting a father's education can be extremely important, especially during emergencies. Unfortunately, if a crisis is prolonged, the benefits of both mothers' and fathers' education diminishes.
The researchers also found that in the communities most heavily affected by war, the influence of parental education was negligible except when the father had more than a primary education.
"Expanding educational opportunities for boys and girls would be a concrete policy change that governments could make that would ultimately help reduce child mortality during famine, drought, and war in the future," states Hogan.
Source
Kiros, Gebre-Egziabher and Dennis P. Hogan. 2001. “War, famine and excess child mortality in Africa: The role of parental education,” International Journal of Epidemiology 30: 447–455.
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