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Education improves health, while health improveslearning potential. Education and health comple-ment, enhance and support each other; together,

they serve as the foundation for a better world. To be ableto read, write and calculate has been acknowledged as ahuman right. However, more than 100 million childrenare still deprived of access to primary education andfewer than half of all children worldwide participate inearly childhood programmes.

Gender equality, including in education, is a conditionfor development. Schooling in itself has been a powerfultool to influence health, and its impact is clearly seen inmaternal and child health benefits. Literate women tend tomarry later and are more likely to use family planningmethods. Mothers with primary education tend to takebetter care of their children and are more likely to seekmedical care, such as immunization, than those who lackschooling. The connection between education, health andearning capacity is better understood. Ensuring that oursurroundings are conducive to good health means direct-ing efforts at all levels, within and between all sectors ofsociety. In so doing, we can make healthier choices and laythe foundations for true social and economic development.

Every year, 529,000 girls and women die at childbirth.Over 300 million women worldwide suffer from eithershort- or long-term complications arising from preg-nancy or childbirth, with around 20 million new casesevery year. Most of these deaths and disabilities are pre-ventable. The Millennium Development Goals (MDGs),which are very simple yet powerful, could change theworld. The MDGs have become the yardstick for progressamong Governments and international organizations, tomeasure progress, shift budget priorities and institutereforms to improve human development worldwide. TheUnited Nations is mobilizing its resources with partnersin an unprecedented manner in support of the MDGs,which set the terms of a globalization driven not by theinterests of the strong, but managed in the interests of thepoor. These Goals are attainable, provided countries ofthe North and the South work together. “Health for All”and “Education for All” are expressions of the UN

commitment to health and education. The healthy future of society depends on the health of

today’s children and their mothers, who are guardians ofthat future. Because the MDGs are inseparably linked, theymust be achieved concurrently. Poor diet impairs learningand development. Young people need to be healthy inorder to attend school regularly and take advantage of theopportunities provided by schools. Global partnership inwomen’s health care is therefore a necessity, not a luxury.Unwanted and teen pregnancies are challenging issues forboth industrialized and developing countries. Risks inevery pregnancy and childbirth exist, and lifetime risksdepend on how many times a woman gets pregnant. Inaddition, an unwanted or unplanned pregnancy may takeplace at the wrong time. From a health and social point ofview, it may occur at the least optimal period for themother and child.

Health-promoting schools. If we consider what it takesto create health, the school becomes an ideal setting foraction. Schools can help young people acquire the basicskills needed to create health. These so-called life skillsinclude decision-making, problem-solving, critical-think-ing, communication, self-assessment and coping strate-gies. People with such skills are more likely to adopt ahealthy lifestyle. Each new generation of children faceshealth challenges, but those being dealt with by today’syouth seem particularly daunting. Children at an earlyage are confronted by situations that require decision-making skills for preventive action.

Adolescents find themselves under strong peer pres-sure to engage in highly risky behaviour, which can

have serious implications on their lives. The spread ofHIV/AIDS among adolescents is a more recent but grow-ing phenomenon, while the traditional problem of sexu-ally transmitted diseases (STDs) continues to increase.Some of the most important concepts in the area of repro-ductive and sexual health include: respect for others,especially the opposite sex; self-esteem; the possibilityof family planning and understanding that children areideally born of a conscious decision by loving and

IMPROVING MATERNAL HEALTH THROUGH EDUCATIONSafe Motherhood Is a Necessity

BY RITA LUTHRA

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Ibanda hospital, Uganda, August 2007.A mother holds her child who is suffering from malaria.

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UN CHRONICLE NO. 4, 2007 MILLENNIUM DEVELOPMENT GOALS

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responsible parents; the importance of postponing the firstpregnancy; and the ability to withstand peer pressure.

Just as physical health creates an image of strength and vital-ity, mental health should be associated with strength of the

mind and vitality in human interaction when dealing with thechallenges of everyday life. As witnessed by the extent of men-tal health problems shared by children and adults alike, the“how to” of life is often a rather weak component of humancompetence. Education in life skills enables children to protectand promote their own health and well-being. Teaching meth-ods therefore need to be interactive for learning these skillsrather than just acquiring knowledge. When schools arehealth-promoting, a major improvement is anticipated in themental health status of children and the adults that they willbecome. In those circumstances, “mental health” should lose itsnegative connotation, and the real significance of mental well-being for human societies will be acknowledged.

The road to safe motherhood. Women die in the prime oflife, at a time when they should be experiencing fulfilmentand joy. They have a right to safe motherhood. Midwives andobstetricians have an indispensable role to play in makingmotherhood safe. Maternal mortality is not an academicsubject of numbers and words; it is about people in deep dis-tress. Women should be provided with access to community-based maternity services during pregnancy, as well as duringand after delivery. Immediate and effective professional careduring and after labour and delivery can make a life-and-death difference for mothers and their newborn children.Each and every mother or newborn needs skilled maternaland neonatal care—care that is close to where and how peoplelive and to their birthing culture, but at the same time safeand administered by a skilled professional able to act imme-diately when unpredictable complications occur. The chal-lenge that remains is therefore not technological but strategicand organizational.

The need for an urgent, global coor-dinated response has prompted severalagencies and international organizations tojoin forces and create partnerships formaternal, newborn and child health. Thelow social status of women in some coun-tries, for instance, limits their access to eco-nomic resources and education. This, inturn, limits their ability to make decisionsabout their health and nutrition. Somewomen are denied access to care either

because of cultural practices, such as seclusion, or becausedecision-making is the responsibility of other family mem-bers. Lack of access to and use of essential obstetric servicesis a crucial factor that contributes to high maternal mortality.

Skilled attendants mean successful outcomes. A focus onmaternal and newborn health, including psychosocial

support, should be the centre of policy and action. A strongand vital health workforce is an investment in health for todayand the future. The ultimate goal is to have a workforce thatcan guarantee universal access to health care for all citizens inevery country. Continuing medical education in women’shealth and health care is beneficial to both donor and recipientcountries and can engage public and private stakeholderstowards common goals. Internet classrooms in obstetrics andgynecology have potential to manage knowledge and cancreate an environment in which knowledge flows easily and isreadily available, thus reducing the chasm between what isknown and what is done in health, the so-called “know-dogap”. These continuing medical education initiatives inwomen’s health strengthen and reflect sustained high-levelpolitical involvement and can support the scale-up of pro-grammes within and across sectors. Decisions made in onesphere affect those in the other. v

Rita Luthra is President of the Women’sHealth and Education Center and isEditor-in-Chief of the e-learning publica-tion WomensHealthSection.com, which isdedicated to women’s well-being andhealth care worldwide. She is also a Fellowof the American College of Obstetriciansand Gynecologists since 1986 and hasworked with various international organi-zations, such as UNA-USA, Peace Corpsand the World Health Organization. Dr.Luthra’s main interest is internationalhealth and development.

Yei, Sudan, September 2005.Children study English in school.

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