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Maternal education and the multidimensionality of child health outcomes in India
- Kriti Vikram, Reeve Vanneman
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- Journal:
- Journal of Biosocial Science / Volume 52 / Issue 1 / January 2020
- Published online by Cambridge University Press:
- 21 May 2019, pp. 57-77
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- Article
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Maternal education plays a central role in children’s health, but there has been little research comparing the role of maternal education across health outcomes. It is important to distinguish child health outcomes from medical care outcomes. Health outcomes such as short-term morbidity and stunting are multifactorial in origin and determined by a range of factors not necessarily under a mother’s control. Mother’s education, given the necessary structural factors such as medical centres, is likely to lead to increased access to, and uptake of, medical services. Using data from the 2004–05 India Human Development Survey, eight separate logistic regressions were carried out on 11,026 women of reproductive age and their last-born child under five years of age. The results showed that maternal education had the strongest association with medical care, immunization (except polio) and iron supplementation for pregnant mothers, moderate association with underweight and weak association with short-term diseases and stunting. In addition, the study investigated whether maternal education impacts child health and medical care outcomes through the intervening roles of empowerment and human, social and cultural capital. These intervening linkages were found to be missing for short-term diseases and stunting, bolstering the argument that the influence of maternal education is limited for these outcomes.
2 - The right to health: illusion or possibility?
- Edited by Paul Bywaters, Coventry University, Eileen McLeod, University of Warwick, Lindsey Napier, The University of Sydney
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- Book:
- Social Work and Global Health Inequalities
- Published by:
- Bristol University Press
- Published online:
- 15 July 2022
- Print publication:
- 16 September 2009, pp 23-36
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Summary
Introduction
The World Health Organization's (WHO’s) constitution defines health as ‘a state of complete physical, mental and social well being and not merely the absence of disease or infirmity’ (WHO, 1948, p 1). This may be widely accepted as an ideal, but in practice health continues to be perceived differentially by policy makers, health care providers, civil society groups and the general populace. One thing is certain: the evidence that health cannot be achieved through only biological and technological interventions is overwhelming.
Thirty years ago, there was a ‘revolution in thinking’ about health and health care at the International Conference on Primary Health Care at Alma Ata (WHO, 2008, p 747). The conference asserted that primary health care was the preferred strategy for global health policy, underpinned by core values. The Alma Ata Declaration (WHO, 1978) reaffirmed that health is a fundamental human right and proclaimed that the gross inequalities in health status between and within developed and developing countries were politically, socially and economically unacceptable. Governments who signed the Declaration committed themselves to making appropriate investments in economic and social development, and in health systems, to ensure ‘Health for All’ their citizens, including the poor; to provide access to affordable health care; and to community ownership of the organisation of health services. The resultant ‘Global Strategy of Health for All by the Year 2000’ determined that ‘all people in all countries should have at least such a level of health that they are capable of working productively and of participating actively in the social life of the community in which they live’ (WHO, 1981, p 15).
However, this vision was rapidly undermined by the International Monetary Fund's promotion of its ‘structural adjustment’ approach to economic development, supported by the World Bank, and was replaced with a ‘selective primary health care’ approach (Walsh and Warren, 1979) which focused on vertical single issue interventions (WHO, 2008). It has been argued that ‘Health for All’, based in primary health care, was not really given a chance, although countries like Mozambique, Cuba and Nicaragua demonstrated that the principles of equity and justice on which ‘Health for All’ was based could work (Magnussen et al, 2004).