I recently traveled with the leaders of major global health organizations to Malawi to explore ways to enhance global coordination to advance health and education opportunities for all children, especially girls.
Malawi is one of the poorest countries in the world, with high rates of school dropouts, early pregnancies, and child marriages.
We saw that one of Malawi’s biggest challenges is its under-resourced education system, resulting in many schools unable to provide children with a safe and nurturing learning environment. Many children still learn under a tree, and some classrooms are overcrowded with up to 100 students per teacher. Of those Malawian children who complete primary school, only a small number emerge with the basic skills they should have and few transition to secondary education. Girls are much less likely to be educated than boys.
We also visited rural districts where HIV-positive rates are as high as 75 percent. And we learned that the country’s adolescent girls and young women are increasingly susceptible to vaccine-preventable cervical cancer, among many other health threats.
As in many other low-income developing countries, the factors responsible for Malawi’s struggling education performance – extreme poverty, weak governance, inadequate infrastructure, and huge social inequities – are also seriously hampering the ability of its health system to deliver essential services effectively.
Thankfully, Malawi President Mutharika is committed to education and has made it, along with health, a main pillar of his national agenda, including co-convening Education Commission.
More and Better Cross-Sector Collaboration
Broadening and deepening the synergies between education and health was one of the primary objectives for our joint visit to Malawi. Especially since the adoption of the Sustainable Development Goals in 2015 and the landmark 2016 report by the International Commission on Financing Global Education Opportunity, donor and developing countries have created a new momentum to break down the silos that have historically separated the education and health sectors and find new concrete ways to collaborate.
This renewed push for cross-sector collaboration is based on significant evidence that children must learn to be healthy and be healthy to learn. It is not acceptable that children lose between 200 million and 500 million school days each year due to ill health. And abundant research shows that education positively impacts a range of health indicators, including reducing early mortality, improving reproductive health, limiting the spread of disease and promoting healthy lifestyles and general well-being. According to the education commission, every one dollar invested in girls’ schooling in low-income countries provides returns of $6.60. We also know that as mothers become more educated their children are more likely to survive past the age of five, to be immunized, and to attend school. An estimated four million child deaths have been prevented over the past four decades thanks to the global increase in women's education.
Schools, especially in remote areas, can be effective places for health education and health services. Local health professionals and trained teachers, can easily and regularly monitor students’ well-being and deliver proven, simple health assessments and treatments, advice on and supplies for menstrual hygiene, and guidance on nutrition that may otherwise not be available.
Moreover, investments in basic health programs – such as hearing and eyesight screening, malaria control, or provision of micronutrient supplements – improve children’s physical and cognitive development and ability to learn.
Building on Proven Initiatives
The Global Partnership for Education has long helped many developing countries promote more and better school-based health interventions.
In Cambodia, for example, GPE and its partners have supported a government-led school-based initiative that equips teachers to identify and help large numbers of children who were either dropping out of school or never enrolling because of poor vision.
The program was transformative for large numbers of Cambodian children, such as 14-year-old Sier Leap, who for years struggled to see the blackboard in her classroom and fell behind in her learning. Since receiving eye glasses four years ago, she has excelled in her studies and aspires to become a lawyer someday.
Working with ministries of health and ministries of education, we are also offering workshops for integrated school health and nutrition planning in ten African and five Asian countries.
Efforts to combine the power of education and health in countries like Cambodia and Malawi are not new, but we can surely do more. There’s a growing urgency right now to deepen existing cross-sector interventions and create opportunities for new ones. It’s a welcome trend that will continue to unfold in the months and years to come.