After reading this chapter, students should be able to:
- Identify and define important indicators of health and education
- Describe, using these indicators, the situation of LDCs in comparison to wealthier countries
- Explain reasons why LDCs face challenges in improving health and education
- Explain the factors that have allowed the LDCs to make improvements in the areas of health and education over the last fifty years
It is important to not view economic development or increasing GDP as an end in itself. Many scholars contend that human development should be the goal of economic development. Poverty is one obstacle to people developing the ability to use their freedoms. Two of the biggest obstacles to human development are those presented by ill health and lack of appropriate education. While good health and good education are also valued for their own sake, they also provide a means for better economic productivity for both the individual and for society. This chapter examines those issues from two comparative perspectives: cross-national comparisons with more developed countries and comparisons of trends within LDCs themselves.
Two health indicators are examined: life expectancy and child mortality. Life expectancy is a measure of how long a person can expect to live based on current mortality risks in that society. Life expectancy in the more developed countries is generally over seventy years, while in the less developed world, although a few countries may be notably higher, they can range from the fifties to sixties.
Child mortality measures the proportion of children who die before the age of five while infant mortality measures the proportion of children who die before their first birthday. They are expressed as the number of deaths that occur for every 1,000 live births. In the less developed world these rates are often ten times higher than in the more developed countries. It is also noted that there are both regional disparities among areas of the global south (with Latin America having better rates and sub-Saharan Africa having the worst rates) as well as within each nation (where rural areas, often poorer and distant from medical clinics suffer from worse mortality rates than urban areas).
Another health indicator is malnutrition, where the body does not receive enough nutrients. Some malnourished people actually consume large quantities of food, but the food may lack certain nutrients essential for human development. Malnutrition, even when it does not lead to death, can have significant impacts upon cognitive functioning, physical development of the body and may leave individuals susceptible to diseases and infections.
The LDCs also have high infectious disease rates. Infectious diseases, which can be transmitted from one person to another (either directly or through a vector), include malaria, tuberculosis, cholera, influenza and AIDS. Some of these diseases are directly related to the lack of safe water and sanitation. Few people in the global south have access to clean, treated water; the vast majority of people in the global south defecate outdoors or into pits or public sewers that release untreated sewage into the environment, further endangering fresh water supplies. Compounding the disease situation in LDCs is the fact that many tropical LDCs face tropical disease risks that are unknown or minimal in most developed countries. Malaria is an example of such a disease.
Compared to more developed countries, LDCs spend less on less on their public health care sectors. They also often have few trained and certified professionals and clinics, especially in the rural areas. Because education and communication are often also weak in LDCs, it is difficult to inform citizens of health risks or good health practices. Immunization rates are frequently much lower than in the more developed world, often because parents do not understand the need for having healthy children treated.
Despite the fact that the health situation in LDCs compares poorly with that in the more developed world, when compared to the past, the picture is quite positive. Life Expectancy, child mortality rates and infant mortality rates have all significantly improved in almost all LDCs since 1960. Part of the reason for this improvement is that the cost of improving health care has declined: scientific and technological improvements related to water and sanitation has become dramatically cheaper. Awareness-raising campaigns have also become cheaper and more effective.
Education is significant not only because of the job market skills it brings but because it creates informed and empowered citizens. Educational indicators can measure quantity and quality of education. Enrollment ratios can measure which percentage of the school age population attends school at the primary and secondary levels. LDCs tend to have significantly lower secondary enrollment rations than high income countries. Some LDC regions such as East Asia, the Middle East and Latin America have high primary enrollment ratios but sub-Saharan Africa and South Asia lag considerable behind in this area. Quantity of education can also be measured by mean years of schooling.
Literacy rates are one basic way of measuring achievement. While literacy is a minimal expectation for education, when one measures the adult literacy, in some regions less than two-thirds of the population are minimally literate, meaning 900 million people worldwide are illiterate. Another measure of educational quality is the pupil-teacher ratio. Generally, students in smaller classes tend to get better instruction. In the more developed countries this ratio is about 12:1 or 14:1; in less developed countries it can be in the 40:1 area or worse.
There are a variety of explanations for why educational outcomes are poor in LDCs. The most obvious is poor funding of education. Funding for education in wealthier countries is sometimes twenty times as much as what poor countries spend on education. This means fewer schools, teachers and materials for students. Further, many instructors do not get adequate training for their position and tend to employ less effective methods of instruction like rote teaching. A third factor is that parental decisions often affect children’s education in negative ways. Sometimes decisions are made based on financial necessity such as the inability to pay school fees or the need for children to earn money or work to support the family.
Much like the situation related to health, when one analyzes current educational trends in LDCs, the picture is more positive. Enrollment ratios mean years of schooling and various quality measures have experienced significant improvement between 1970 and 2010. One reason is improved funding from LDC governments as well as efforts by governments to better inform parents and to provide incentives for parents to keep their children in school.
India is used a case study that reinforces the point that while LDCs still lag behind wealthier countries in health and education, significant improvements have been achieved.