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0976 – 6510(Online), Volume 3, Issue 2, May-August (2012)
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Volume 3, Issue 2, May- August (2012), pp. 65-79
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FEMALE LITERACY & ITS RELEVANCE WITH MATERNAL

AND INFANT MORTALITY RATES
Garima Jain
Ph.D. Scholar IET-Lucknow
Email : gjain18@yahoo.co.in

Dr. Vikram Bisen

Associate Professor IET-Lucknow

ABSTRACT

When a female is educated the next generation is bound to be educated hence

education has many folds impact on the social and economical development of any nation.
Education as such, results in positive externalities. Not only does it have an intrinsic value in
the sense of the joy of learning, reading etc, but it also has instrumental, social and process
roles. Moreover education may spread through interpersonal motivation. When one family
sends their child to school, their neighbor is likely to do so as well. Women’s education too,
often spreads this way, more specifically, through same sex effects. i.e. an educated woman is
far more likely to send her daughter to school than an uneducated woman. Also, she is likely
to maintain better conditions of nutrition and hygiene in her household and thereby improve
her family’s health (Sen 1997).
Literacy is directly related to the status of a woman, her age at marriage, her decision power
and to mention especially capability to access health care services. Literacy not only increases
women’s self-confidence but also makes them more exposed to information and thereby
altering the way others respond to them. Female literacy improves the chances that women
will obtain meaningful employment, reduces their demand for children and improves health-
seeking behavior, makes them aware of Nutritional requirements - all these combined
improve the chances of survival of both - the mother and the baby.
The present paper focuses on the relationship between the female literacy and mortality rates
(IMR and MMR) and establishes an inverse relationship between them.

INTRODUCTION

Not only might women residing in countries with higher female literacy
enjoy greater personal safety and physical integrity, they may also have greater inheritance
rights, ownership rights in land and loans, and labour market rights (Jütting et al., 2008;
Magadi, Madise, & Rodrigues, 2000). Countries with higher female literacy may also devote
more resources to the provisioning of maternal health care services along a range of maternal
health care delivery models, including physicians, nurses, and traditional birth attendants. In
terms of the “inverse equity hypothesis,” the greater range of services available to women in

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countries with higher female literacy may contribute to lower inequalities in use compared to
those found in countries with lower female literacy.
The United Nations Millennium Development Goals have identified improving women’s
access to maternal health care as a key target in reducing maternal mortality in the world.
Individual socio-demographic and national-level environmental factors may affect women’s
use of maternal health care. At the individual level, age, income, education, and urban or rural
residence may all play a role in women’s use of maternal health care services (Gyimah,
Baffour, & Addai, 2006; Magadi, Agwanda, & Obare, 2007; Magadi, Zulu, & Brockenhoff,
2003; Obermeyer & Potter, 1991). Differences between countries along such dimensions as
female literacy rates or levels of economic development may play a pivotal role in women’s
reproductive health, and maternal and infant mortality (Frey & Field, 2000; Obermeyer,1993;
Shen & Williamson, 1997; Shiffman, 2000; Wang, 2007). National female literacy rates are
an important indicator of women’s status and autonomy in society (Frey & Field, 2000;
Magadi, Agwanda & Obare, 2007).
Mortality, which is one of the major structural variables of demography, has continuously
been affecting the population structure, particularly in developing countries like India. Most
of the countries in the world, developed as well as developing, have experienced drastic
improvement in life expectancy. Among various factors responsible for decline in mortality,
economic factors: increase in per capita income, social factors: improvement in nutrition,
housing and clothing, sanitation, water supply, cleanliness, individual hygienic practices and
developments of medical science have played an important role. However, women and
children do not equally enjoy fruits of these developments. Women and children are still the
deprived sector of the society and maternal and infant mortality remain high in spite of a
striking fall in general mortality rate.

CONCEPTS OF MATERNAL AND INFANT MORTALITY

Maternal mortality is a sensitive indicator of health and general socioeconomic development

of a community or of a nation. It is one of the leading causes of death among women in their
reproductive age. In India like most developing countries, women of reproductive ages
constitute a little more than one-fifth of the total population and are exposed repeatedly to the
risk of pregnancy. More maternal deaths occur in India in one week than in all of Europe in
one year. In a single day in India, the total number of casualties due to pregnancy and child
birth-related complications is more than recorded in one month in the entire developed
world.Maternal mortality is difficult to measure (Campbell and Graham 1990). The tenth
revision of the International Classification of Diseases (ICD- 10) defines a maternal death as
the death of a woman while pregnant or within 42 days of termination of pregnancy,
irrespective of the duration and site of the pregnancy, from any cause related to or aggravated
by the pregnancy or its management but not from accidental or incidental causes.
While many health indicators are required to arrive at a comprehensive assessment of the
health status of a population, a particularly sensitive and widely used summary indicator is the
Infant Mortality Rate (Visaria 1985). Infant Mortality refers to death of children in age group
0-1. Infant Mortality Rate (IMR) is the number of infant deaths that occur per thousand live
births in a population in one calendar year. It is one of the universally accepted indicators of
health status of not only infants but also of the whole population and of socio-economic
conditions under which they live.

EDUCATION AS AN INTERVENING VARIABLE IN MATERNAL AND INFANT

MORTALITY DECLINE

It is universally accepted that the higher the female literacy rate, the lower the MMR.
Studying at school /college for a longer period will prevent early marriage and early
motherhood. Educated women will seek proper antenatal and intra-natal supervision. The
female literacy rates in Sri-Lanka and Thailand are over 80 percent and the MMR in these

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International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN
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two countries is 60 per 100,000 only. Although economically, there is not much of difference
between the MMR of these two countries –340 as compared to 60. Kerala, having the highest
female literacy rate in India, has the lowest MMR, compared to Bihar < U.P. and M.P.
Mothers residing in countries with higher literacy rates were more likely to use maternal
health care, after adjusting for national economic development and individual socio-
demographic factors. socio-economic status has been linked to more frequent use of maternal
health clinics (Rabe-Hesketh & Skrondal, 2005).
Although Magadi et al. (2007) found women in high female literacy countries less likely to
make an inadequate number of visits to maternal health care clinics than women in low
female literacy countries.

The reduction of maternal and infant deaths is high priority for the international community,
especially in view of the increased attention on the Millennium Development Goals. Maternal
deaths arise from the risks attributable to pregnancy and childbirth as well as from the poor
quality care from health services.

Ecological analyses have found direct associations between female literacy and national
economic development for outcomes such as maternal and infant mortality in positive
direction (Jütting, Morrisson, Dayton-Johnson & Drechsler, 2008; Wang, 2007).

A number of studies have examined empirical evidences concerning the influence of

demographic and socio-economic factors of child survival (Gandotra et al. 1980; Clealand
and Ginneken et al. 1988; Miller 1983; Das Gupta 1990; Caldwell 1979; Griffith et al. 2001).
All these studies reinforce the existing argument for a greater emphasis on the schooling of
girls to give women themselves and the next generation a greater chance of survival. Several
authors have discussed the mechanism of literacy influence on infant survival (Caldwell 1979,
1986; Cohrane 1980; Hobecraft et al. 1984; United Nations 1985; Ware 1984; Gokhale et al.
2002; Govindasamy and Ramesh 1997). Ruzika and Kanitkar (1 972) found mother’s literacy
to be the most effective single factor determining the level of infant mortality in an urban
setting.

Pooled data from the Demographic and Health Surveys (DHS) of South-Asian countries from
the late 1990s to examine the association between female literacy and antenatal care visits and
found that women in countries with higher female literacy were more likely to start antenatal
care late in their pregnancy, but less likely to make an inadequate number of visits.

Women’s literacy and their use of health facilities go hand in hand. Krishnan (1985)
examined overall death rates in terms of literacy, doctor, hospital and bed population ratio,
per capita income expenditure on medical and health services. He observed that literacy was
the most important factor while health services also had some explanatory power.

A number of cross-section studies for India have explored the impact of female literacy on
maternal and child death. Sharma and Retherford (1999) have used 1991 Census data,
aggregated to district level, for 326 districts. They show that female literacy would have a
significant negative impact on maternal and child deaths.
High maternal and infant deaths can be attributed to low status and low capability of women.
These deaths are preventable if more and more women are literate thereby exposing them to
new ideas. Literacy can make them aware of a range of services from antenatal to nutrition,
personal hygiene, immunisation, birth spacing, maternal skills, breast-feeding and overall
health.

In order to reduce the high maternal mortality in the developing countries, government
should work on the causes which are multiple, inter-related and tiered. The most superficial of

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all the planes are the “ direct and indirect” causes of maternal deaths. The direct causes
account for 7% of maternal deaths and are the following: -
1) Sepsis including septic abortion 20-25%
2) Obstetric hemorrhages 20-22%
3) Eclampsia 5-15%
4) Accidents of labor (e.g. rupture of uterus) 10-30%
The indirect causes account for 25% cases and are due to associated medical diseases that
worsen during pregnancy, the commonest being anemia followed by jaundice and heart
diseases.
The causes mentioned above are only the tip of the iceberg. The underlying causes of
maternal deaths in developing countries, particularly in India are the following.

1) Illiteracy
2) Ineffective health services
3) Inadequate obstetric care
4) Inadequate essential supplies
5) Poor maternal mortality audit
6) Unregulated fertility
7) Infection and infestations
8) Early marriage
9) Poverty
10) Malnutrition
11) Ignorance.

These underlying causes can be effectively managed by a single most strong remedy i.e.
educate the females, as it is shown already in the developed world by reducing their MMR
and IMR to the significant level.

If the food habits and nutrition of girls and especially of pregnant women are properly taken
care of, infant and maternal mortality may be brought down considerably. At the pre-
pregnancy stage as well as during pregnancy, level of nutrition is an important determinant of
complications during pregnancy or
childbirth. Various studies confirm the relatively poor nutritional and health status of young
women and wide ranging gender disparities in feeding practices. Poor nutrition contributes to
poor maternal health and underlies poor pregnancy outcomes in a variety of ways. Literacy is
supposed to make women aware
of nutritional requirements of pregnant women, young girls and infants as well. It is also
possible to change age-old food habits of people through educating them. Maternal health,
nutrition and literacy are important for the survival and well-being of women in their own
right and are key determinants of the health and well-being of infants.

The cause of the high rates of infant mortality, especially neonatal mortality are linked to
untimely pregnancies, low birth weight and unsafe delivery, etc. These are also major causes
of maternal mortality. Dealing with one of the significant causes of infant and maternal deaths
- unsafe deliveries, it is evident from all accounts that literate women are more likely to have
their deliveries in an institution or at least attended by trained practitioners. Literacy definitely
enhances women’s exposure to the modern health sector and the ease and confidence with
which they can deal with this sector. This increased confidence leads to an increased ability to
deal with emergency situations during pregnancy, delivery, infant illness and therefore to
improved women’s survival and infant survival. Literate women are more likely to avail

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themselves of antenatal care, tetanus toxoid injection, iron and folic acid tablets, institutional
in
delivery and complete immunization for the infants.
Reviews suggest that birth intervals have a noticeably larger impact on infant and maternal
mortality than does maternal age, even maternal age at first birth (IIPS 2002). However, this
association
iation is not always found true. Literate women generally delay first childbearing and
complete their family in a shorter span so as to be free to work outside.

A few studies (Jejeebhoy and Kulkami 1989; Mason 1993; Krishnamurthi 1998) have shown
that interspouse
erspouse consultation is an important factor in the process of decision-making
decision making with
regard to family size and the adoption of family planning practices. Srinivasan (1(1995)
995) stressed
the role of schooling in creating greater access to birth control information and more
extensive use and approval of contraceptive technology. Literacy plays a catalytic role in
enhancing female autonomy, in achieving a greater say in decision
decision-making,
making, which in turn
result in decline in the number of unwanted births, repeated
repeated pregnancies and further to infant
and maternal deaths. More recent studies have found that there is a minimum threshold of
education (at least 5-66 years) that must be achieved before there are significant improvements
in female autonomy, particularly in a highly gender stratified society such as India (Jeffery
and Basu 1996; Jejeebhoy 1995).

The influence of female literacy as a major factor affecting child health in India was
examined using data from the second National Family Health Survey between 1998 and 1999,
as well as microlevel data on rural Indian mothers (n=374) and their children (n=281) aged 0–
0
3 years. After considering the collinearity between several independent variables,
comprehensive models were developed for predicting the outcome va variables
riables such as stunting,
underweight, anaemia, and under-five
under five mortality. The major variables that determined these
models were low maternal body mass index (BMI), lack of colostrum, maternal anaemia,
hospitalized deliveries, treatment with Oral Rehydratio
Rehydration
n Solution (ORS), and complete
vaccinations.

Addition of female illiteracy in these regression models improved prediction of outcome

variables significantly. Mean predicted prevalences, after adjusting for these variables were
significantly higher (p<0.01)
1) for the states with high female illiteracy ( median) than for
those with low female illiteracy (44.3%vs. 34.1%for stunting, 45.1%vs. 34.6%for
underweight; 74.0%vs. 60.7%for anemia and 97.4 vs. 63.9 per thousand live births forunder-
forunder
five mortality).

Microlevel
crolevel data also revealed that less
less-educated
educated mothers married at an early age (16.5±2.0
vs. 17.8±2.0 years; p<0.01), had less duration between onset of menarche and first conception
(2.6±1.41 vs. 3.2±1.9 years; p<0.05), delivered first child at an early age age (18.5±1.9
vs.19.4±2.0 years; p<0.01), did not seek antenatal care (48.2%vs. 31.6%; p<0.05), and opted
less for hospital deliveries (47.7%vs. 74.3%; p<0.01) compared to women with education
higher than fourth standard. As these variables are known to be determinants of low birth
weight that increases risk for child undernutrition and mortality, our findings highlight the
possible underlying pathways between female literacy and child health. Improving female
literacy mainly for creating health awareness will
will thus be beneficial for improving health of
rural children in India.

Having a look at the causes of infant deaths makes it evident that among the medical causes
of infant deaths, causes peculiar to infancy and cough are two main factors along with low
coverage
overage of institutional deliveries (26.3 per cent only). Causes peculiar to infant deaths
which contributes to about two--third
third of the total infant deaths include prematurity, respiratory
infection to new born, diarrhoea cord infection including tetanus, congenital
congenital malformation
and birth injury (SRS 1998). Among these too, prematurity contributes more than half of the

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infant deaths (53.5 per cent) which leads to the conclusion that almost one-third of the total
deaths in India occur due to prematurity, cause of which is malnutrition. The report entitled
“Wasting Away: The Crisis of Malnutrition in India” (World Bank 1998) points to
malnutrition as the main factor retarding improvements in human development and hindering
further reduction in infant mortality. Malnutrition is, in many respects, the common
denominator of the disease and deprivation processes that increase infant mortality. The risk
of death from common childhood diseases is doubled for a mildly malnourished child, trebled
for a moderately malnourished child and may be as high as eight times for a severely
malnourished child (Ghosh 1996). For a malnourished child, every infection is a potentially
fatal illness. Several studies and reports have shown a higher rate of malnutrition among girls
compared to boys, which would contribute to higher mortality among the girls (Ghosh 1987).
The cycle goes on. Today’s malnourished girls grow up to be a malnourished mother and she,
in turn, gives birth to a small undernourished baby. And the life of both the mother and baby
are at stake.
Child mortality rates are about five times higher among illiterate mothers compared to
graduates (Registrar General of India 1989). Better child survival among the educated group
may be due to several factors such as better hygiene, improved nutrition and feeding
practices, and timely medical intervention. A study conducted by NIN (Brahman et al. 1988)
showed that, controlling for income, the energy content of the diet of children whose mothers
were literate tended to be better than those whose mothers were illiterate. There are other case
studies showing that maternal education has a significant influence on the nutritional status of
the children (Walker and Ryan 1990).

Results from a nationwide study of 4434 women show that among the children of women
who became literate exclusively by adult education, mortality and risk of malnutrition are
significantly lower than among those women who remained illiterate. Furthermore, when the
infant mortality rates are given approximate time locations, a sharp reduction is found
following the adult education campaign for the adult-education group, but not for the illiterate
or formal-schooling groups. The survival advantage conferred by education was significantly
greater among those with poor access to health services. The results also suggest that the
effect of education in reducing the risk of malnutrition operates independently of its effect on
mortality, and that both are independent of wealth and their parents' decision to educate their
daughters.
A strong association exists between the level of women’s education and use of reproductive-
maternal health services. Literacy improves women’s status, increases age at marriage,
reduces unwanted fertility and improves utilisation of health services (Pebley, Goldman and
Rodriguez 1996) by contributing to women’s self-confidence, improving their maternal skills,
increasing their exposure to information and thereby altering the way others respond to them
(Das Gupta 1990). Illiterate women are more likely to get
married at an early age, to start childbearing at a younger age, to have children too close
together and to prolong child bearing. Female literacy improves the chances that women will
obtain meaningful employment, reduces their demand for children and improves health-
seeking behavior.

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Studies suggests that national policies that are able to address female literacy and women’s
status in India such as programs that cover costs for tuition, school uniforms and textbooks,
may encourage female education and in the long long-run help reduce income-related
related inequalities
in maternal health care use. As such, female literacy at the national level may be associated
with maternal health care use for all women in the country due to the greater maturity of th the
system and the greater resources and autonomy available to all women. We might therefore
anticipate that the benefits of living in a country with higher average female literacy will be
experienced differently by individual women depending on women’s relative household
income.

There have been efforts to correlate female literacy with age at marriage, fertility rates and
child mortality. In rural areas, a higher proportion of married women are illiterates as
compared to urban areas. Further, among illit
illiterates, around two-thirds
thirds of women got married
before reaching the age of 18 years, suggesting a positive correlation between age at marriage
and level of education. Available data also suggest an inverse correlation between a woman’s
level of education andd her fertility.

STATISTICAL RELATIONSHIPS

Table below presents data for IMR, MMR and adult female literacy in major states of India.
As hypothesized, the inverse correlation between (i) female literacy and IMR and (ii) female
literacy and MMR and positive
tive correlation between (iii) IMR and MMR is statistically true.

However, large variations are seen in mortality rates corresponding to more or less similar
levels of female literacy. For example, IMR ranges from 98 in Orissa and Madhya Pradesh to
64 in Gujarat and 53 in West Bengal in the same band of female literacy (50 to 60 per cent).
At the same time, estimates of MMR for some states like Gujarat and Tamil Nadu prima facie
appear to be on the lower side (SRS 1999). Interstate variations are even greater
greater in MMR for
the same band of female literacy. For example, it is as low as 29 in Gujarat, 105 in Haryana,
and 154 in Andhra Pradesh and as high as 498 in Madhya Pradesh and 401 in Assam. It may
be conceived that several factors block some of the postul
postulated
ated pathways of influence and
erode the positive influence of women’s education (Shivakumar 1995). There are no
evidences to show that education leads to favourable shifts in maternal behaviour, since
factors such as age at marriage, child spacing, family size and so on appear to be strongly
influenced by socio-cultural
cultural norms of society (Ware 1984; Cleland 1990). However, it does
not reduce the role of women’s literacy in any way. It only reiterates to focus on other factors
as well which enhance women’s capabilities.
c

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TABLE

Female literacy and mortalities in India:

States Female Literacy
IMR** MMR**
India 54.2 71 408
Andhra Pradesh 51.2 66 154
Assam 56 78 401
Bihar 33.6 67 451
Gujarat 58.6 64 29
Haryana 56.3 69 105
Karnataka 57.5 58 195
Kerala 87.9 16 195
Madhya Pradesh 50.3 97 498
Maharashtra 67.5 49 135
Orissa 51 98 361
Punjab 63.6 54 196
Rajasthan 44.3 83 677
Tamil Naidu 64.6 53 76
Uttar Pradesh 43 85 707
West Bengal 60.2 53 264

Source: * - Census of India, 2001 ** - SRS, Registrar General of India.

120

100

80

60

40

20

Female Literacy IMR**

800
700
600
500
400
300
200
100
0

Female literacy and mortalities in India: Female Literacy

Female literacy and mortalities in India: MMR**

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Table :- Effect of Female literacy on four RCH indicators [According to Census

2011,Govt Of India]
Location Female Infant Fertility rate Maternal Under 5
Literacy Rate Mortality rate (No. of child Mortality rate Mortality
(No. of death / born/woman) (No. of rate (No. of
1,000 live deaths/1,00,000 death /
birth) live birth) 1,000 live
birth)
Year Year Year Year Year
2001 2011 2001 2011 2001 2011 2001 2011 200 2011
1
India 54.20 65.46 63.19 47.57 3.04 2.62 306 230 87 63
Uttar 42.85 59.26 68.45 51.42 3.72 2.81 372 245 91 66
Pradesh

Female Literacy Rate / Infant Female Literacy Rate / Fertility Rate

Mortality Rate

70 70
60 60
50 50
40 Series 40
30 1 Series1
30
20 20
10 10
0
0
1 2 3 4
1 2 3 4
INDIA INDIA

Female Literacy Rate / Meternal

Mortality Rate
Female Literacy Rate / Under 5
Morality Rate
70
60
50 70
40 Series 60
30 1
50
20 40
10 Series1
30
0
20
1 2 3 4 10
0
INDIA
1 2 3 4

INDIA

Female Literacy Rate / Infant Female Literacy Rate / Fertility Rate

Mortality Rate

80 70
70
60
60
50
50
Serie 40
40 Series1
s1 30
30
20 20
10 10
0 0

1 2 3 4 1 2 3 4

UTTAR PRADESH UTTAR PRADESH

Female Literacy Rate / Meternal

Mortality Rate Female Literacy Rate / Under 5 Morality
Rate
70

60
70
50
60
40 Se
rie 50
30 s1
40
20 Series1
30
10
20
0
10

0
1 2 3 4

UTTAR PRADESH 1 2 3 4

UTTAR PRADESH

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Table: Effect of Female literacy on four RCH indicators

Location Female Infant Fertility rate Maternal Mortality Under 5
Literacy Mortality [No. of child rate [No. of Mortality rate
rate (%) rate [No. of born/woman] deaths/1,00,000 live [No. of death
death / 1,000 birth] / 1,000 live
live birth] birth]
Kanpur 76.89 31.27 1.59 150 6
Nagar
Lucknow 73.88 34.57 1.68 156 8
Saharanpur 60.72 48.63 3.15 227 18
Jhansi 56.60 53.45 3.24 235 21
Budaun 40.92 69.35 3.63 339 69
Shrawasti 37.07 72.18 4.02 363 72

There exists a direct correlation between Female Literacy and Infant Mortality.
Female Literacy Rate / Infant Female Literacy Rate / Female Literacy Rate Female Literacy Rate / Infant
Morality Rate Fertility Rate /Maternal Morality Rate Morality Rate
90 90 90
80 90
80 80
70 80
70 70
60 70
60 60
50 60
50 50
40 40 40
50
30 30 30 40 S
e…
20 20 30
20
10 20
10 10
0 10
0 0
0
1 2
1 2 1 2

Kanpur Nagar Kanpur Nagar Kanpur Nagar

1 2

Kanpur Nagar

F emal e Lit er acy R at e /

F emale Li t eracy R at e / Inf ant F emale Lit eracy R at e / Female Literacy Rate /Maternal U nd er 5 M o r al i t y R at e
M o ralit y R at e F ert ilit y R at e Morality Rate 80

80
80 60
80
70
60 60
60 40
40
40 50 Se re
i s
1
20 20
20 Serei s1 Serie s1 40 Series1
0
0 30 0
1 2
20 1 2
1 2

Luckno w 10

Luckno w 0
1 2
Luckno w
Lucknow

F emale Li t eracy R at e / Inf ant F emale Li t er acy R at e / F emal e Li t er acy R at e F emale Lit eracy R at e /
M o rali t y R at e F er t i li t y R at e / M at er nal M o r al it y R at e U nd er 5 M o ralit y R at e
80 80 80
80

60 60 60
60

40 40 40 40

20 Se e
ir 1
s 20 Serie 1
s 20 Serie 1
s 20 Serie s1

0 0 0 0

1 2 1 2 1 2 1 2

Sahar anp ur Sahar anp ur Sahar anp ur Saharanp ur

Female Literacy Rate / Infant Female Literacy Rate / Fertility Female Literacy Rate Female Literacy Rate / Under
Morality Rate Rate /Maternal Morality Rate 5 Morality Rate
60
57
60
56.5
56 60 50
50
55.5 50
55 40 40 40
54.5 30 Series1
54 20 30 30
53.5
53 10
0 20 20
52.5
52 10
51.5 10
1 2
0
0
1 2
1 2

Jhansi Jhansi 1 2

Jhansi Jhansi

Female Literacy Rate / Infant Female Literacy Rate / Fertility Female Literacy Rate /Maternal Female Literacy Rate / Under
Morality Rate Rate Morality Rate 5 Morality Rate
80 45 45 80
40 40
70 70
35 35
60 60
30 30
50 50
25 25
40 20 20 40 S
S S
e e e
30 15 15 30 r
ri ri
e e i
20 10 10 20
5 5
10 10
0 0
0 0

1 2 1 2
1 2 1 2

Badaun Badaun Badaun Badaun

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Female Literacy Rate / Infant Female Literacy Rate / Female Literacy Rate /Maternal Female Literacy Rate / Under
Morality Rate Fertility Rate Morality Rate 5 Morality Rate
40 40 80
80
35 35 70
70
30 60
60 30

25 50
50 25
S 20 S 40 S
40 20
e e e
r ri 30 r
30 i 15 15 e i

20 10 20
10
10 5 10
5
0 0 0
0

1 2 1 2 1 2
1 2

Shrawasti Shrawasti Shrawasti Shrawasti

Effect of Literacy Rate

District FL R.A. GP & LB EA

Kanpur 76.89 84.57 86.11 88.42
Lucknow 73.88 81.26 82.74 84.96
Saharanpur 60.72 66.79 68 69.8
Jhansi 56.6 62.26 63.39 65.09
Budhaun 40.92 4.01 45.83 47.05
Shrawasti 37.07 40.77 41.51 42.63

FL - Female Literacy.
RA - Female Literacy Promotion in Rural Area.
GP & LB - Female Literacy Promotion y Gram Pradhan and Local
Body.
EA - Female Literacy Promotion economic Aspect.

F L / R .A . F L / GP & LB F L / EA

90 90 90

80 80 80

70 70 70

60 60 60

50 50 50
Ser ies1
Ser ies1 Ser ies1 40
40 40
30
30 30
20
20 20
10 10
10
0 0
0
1 2 1 2
1 2

Kanp ur N ag ar Kanp ur N ag ar Kanp ur N ag ar

F L / R .A . F L / GP & LB F L / EA

80 80 80

70 70 70

60 60 60

50 50 50

40 Ser e
i s1 40 40 Ser ies1
Ser e
i s1
30
30 30
20
20 20

10 10
10
0
0 0
1 2
1 2 1 2

Luckno w Luckno w Luckno w

F L / EA F L / GP & LB F L / EA

70 70 70

60 60 60

50 50 50

40 40 40
Ser ies1
Ser ies1 Ser ies1
30 30 30

20 20 20

10
10 10
0
0 0
1 2
1 2 1 2

Sahar anp ur Sahar anp ur Sahar anp ur

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 International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN
0976 – 6510(Online), Volume 3, Issue 2, May-August (2012)

FL / R.A. F L / GP & LB FL / EA
80 70
60
60
60 50
50
40
40
40 30 Ser e
i s1
30
Serie
s1

20
20
20 10
10
0
0
0 1 2

Jhansi
1
Jhansi 2

1 2
Shrawasti

FL / R .A . F L / EA F L / GP & LB

80 45
45
70 40 40

60 35 35

30 30
50
25 25
40 Ser ies1 Ser ies1 Ser ies1
20 20
30
15 15
20
10 10
10 5 5

0 0 0

1 2 1 2 1 2

B ad aun B ad aun B ad aun

FL / R .A . F L / GP & LB F L / EA

80 40
40
70 35
35
60 30 30
50 25 25
40 20 20
Ser ies1 Ser e
i s1 Ser ies1
30 15 15

20 10 10

10 5 5

0 0 0
1 2 1 2 1 2

Shr awast i Shr aw ast i Shr awast i

CONCLUSION

There are a number of factors including economic, social, cultural, biological and medical,
which influence infant and maternal deaths. It is the product of an enormous number of
complex and interrelated forces. However, they are intimately connected with maternal
capabilities. It is a sorry state of affairs that the majority of maternal and infant deaths
occurring in India are preventable and yet consistently remain on unacceptably high levels.
Given the close, strong and direct association of maternal and infant survival to the
capabilities of the mother, it only reflects the lack of seriousness of government and society in
addressing the issues of primary concerns. A large number of studies throwing light on the
mechanisms whereby female literacy is converted to low maternal and infant mortality have
shown almost convincingly that a dramatic universal exists relationship between them.
However, the actual behaviour or attitudes or abilities that work behind them remain an area
of social research.

Female literacy is the one, which may go a long way not only in reducing mortalities but also
indirectly influencing the number of economic, sociocultural, and health conditions related to
the low status of women. Thus, increasing female literacy leads to a win-win situation. India
spends far less on health and education compared to many other countries. Taking cognisance
of the multiple channels through which female education is translated into lower infant and
maternal mortality, its significance hardly needs to be emphasized. It is high time that the

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0976 – 6510(Online), Volume 3, Issue 2, May-August (2012)

government, nongovernment organisations and civil society, all take up a challenge for a
better tomorrow.

REFERENCES

1- Caldwell, John C., 1979, “Education as Factor in Mortality Decline: An Examination of

Nigerian Data”, Population Studies, No. 33.
2- Caldwell, John C. June 1986. “Routes to Low Mortality in Poor Countries”, Population and
Development Review, 12, (2).
3- Campbell, O.M.A. and Graham, W.J. 1990, “Measuring Maternal Mortality and
Morbidity: Levels and Trends”, London School of Hygiene and Tropical Medicine,
London.
4- Cleland, John. 1990, “Maternal Education and Child Survival: Further Evidence and
Explanations” in Caldwell Sally Findley, Pat Caldwell, Gigi Santow, Wendy Cosford,
Jennifer and Daphane Bross- Freeman (eds.), “What We Know About Health Transition:
The Social, Cultural and Behavioural Determinants of Health Transition”, Series No. 2
(Vol. 1), Health Transition Centre, the Australian National University, Canberra.
5- Cleland, J.G. and Ginneken, J.K.V. 1988. “Maternal Education and Child Survival in
Developing Countries: The Search For Pathways of Influence”, Social Science and
Medicine, 27 (12).
6- Cochrane, S.H. 1980. The Socio-economic Determinants of Mortality: The Cross National
Evidence. In Susan H. Cochrane, Donald 0. Hara and Joanne Laslie The Eflects of
Education on Health, World Bank Staff Working Paper No. 405, World Bank,
Washington D.C.
7- Das Gupta, Monica. 1990. Death Clustering Mother’s Education and the Determinants of
Child Mortality in Rural Punjab, India. In Caldwell Sally Findley, Pat Caldwell, Gigi
Santow, Wendy Cosford, Jennifer and Daphane Bross- Freeman(eds.), What We Know
About Health Transition: The Social, Cultural and Behavioural Determinants of Health
Transition, Series No. 2 (Vol. 2). Health Transition Centre, The Australian National
University, Canberra.
8- Frey, R. S., & Field, C. (2000). The determinants of infant mortality in the less developed
countries: cross-national test of five theories. Social Indicators Research, 52, 215-234.
9- Gandotra, M. M., Das, N. and Bhatt, R.V. 1980. Factors Influencing Peri-natal Mortality
in Indian Economy, Demography India, 9 (112).
10- Ghosh. S. 1987. The Female Child in India - A Struggle for Survival, NFI Bulletin, 8 (4).
11- Ghosh, S . 1996. Life Cycle of Maternal Health and Child Health in K. Srinivasan ed.
Population Policy and Reproductive Health, New Delhi: Hindustan Publishing, pp. 236-
43. Gokhale, M. K., Rao, S . S . and Garole, V.R. June 2002. Infant Mortality in India:
Use of Maternal and Child Health Services in Relation to Literacy Status, Journal of
Health, Population and Nutrition, 20 (2).
12- Govindasamy, Pavalavalli and Ramesh, B.M. 1997. Maternal Education and Utilization
of Maternal and Child Health Services in India, National Family Health Survey Subject
Report No. 5, Mumbai International Institute for Population Sciences and Calvarton,
Maryland Macro International.
13- Griffith, P., Lindet, A. and Mathews, L. October 2001. Infant and Child Mortality in
Three Culturally
Contrasting States of India, Journal of Biosocial Science, 33 (4).
14- Hobecraft, J.N., McDonald R.W. and Rutstein, S.O. 1984. Demographic Determinants of
Infant and Early Child Mortality: Comparative Analysis, Population Studies.
15- IIPS 2002. National Family Health Survey-11. 1998-99. International Institute of
Population Studies, Mumbai.
16- Jeffery, R. and Basu, A.M. 1996. Schooling as Contraception?, in R. Jeffery and A.M.
Basu (eds.) Girls Schooling, Women’s Autonomy and Fertility Change in South Asia,
Sage Publiations, New Delhi.

77
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN
0976 – 6510(Online), Volume 3, Issue 2, May-August (2012)

17- Jejeebhoy, S. J. and Kulkarni, S. 1989. Reproductive Motivation: A comparison of Wives

and Husbands in Maharashtra, India, Studies in Family Planning, No. 20.
18- Jejeebhoy, S. J. 1995. Women’s Education, Autonomy and Psychological Behaviour:
Assessing What We Learnt, Paper presented at the Workshop on Status of Women and
Demographic Changes, East-West Centre, Hawaii, U.S.A.
19-Jütting, J., Morrisson, C., Dayton-Johnson, J., & Drechsler, D. (2008). Measuring gender
equality: the OECD gender, institutions, and development data base. Research in Human
Capital and Development, 9(1), 65-86.
20- Krishnamurti. 1998. Causes of Fertility Transition in Tamil Nadu, Paper presented at the
Workshop on South Indian Fertility Decline: A Comparative Perspective, Centre for
Development Studies, Thiruvananthapuram.
21- Mason, K.O. 1993. The Impact of Women’s Position on Demographic Change During the
Course of
Development, in Nora, Federici, K.O. Mason and Solvi Sagner (eds.) Women’s Position
and Demographic Change, Oxford Clarendon Press.
22- Miller, Barbara D. 1983. The Endangered Sex: Neglect of Female Children in Rural
North India, Ithaca, Cornell University Press.
23- Magadi, M. A., Agwanda, A. O., & Obare, F. O. (2007). A comparative analysis of the
use of maternal health services between teenagers and older mothers in south east asia:
evidence from demographic and health surveys (DMH). Social Science & Medicine, 64,
1311-1325.
24- Magadi, M. A., Zulu, E. M., & Brockenhoff. (2003). The inequalities of maternal health
care in urban sub- Saharan African in the 1990s. Population Studies, 57(3),347-366.
Magadi, M. A., Madise, N. J., & Rodrigues, R. N. (2000). Frequency and timing of
antenatal care in Kenya: explaining the variations between women of different
communities. Social Science & Medicine, 51, 551-561.
25- Obermeyer, C. M., & Potter, J. E. (1991). Maternal health care in Jordan: a study of
patterns and determinants Studies in Family Planning, 22(3), 177-187.
26- Obermeyer, C. M. (1993). Culture, maternal health care, and women’s status: a
comparison of Morocco and Tunisia. Studies in Family Planning, 24(6),354-365.
27- Park, K. 2004. Indicators of MCH Care - Infant Mortality Rate, Textbook of Preventive
and Social Medicine.
28- Pebley, A. R., Goldman, N., and Rodriguez, G. 1996. Prenatal and Delivery Care and
Childhood Immunization in Guatemala: Do Family and Community Matter?,
Demography, 33 (2).
29- Ruzika, L.T. and Kanitkar, Tara. 1972. Infant Mortality in an Urban Setting - The Case of
Greater Bombay in K.E. Vaidyanathan’s (eds.) Studies on Morraliry in India, Chennai.
The Gandhigram Institute of Rural Health and Family Planning, Gandhigram.
30- Rabe-Hesketh, S., & Skrondal, A. (2005)Multilevel and longitudinal modeling using
Stata, 159. College Station, Texas: Stata Corp.
31- Shivakumar, A.K. 1995. Women’s Capabilities and Infant Mortality: Lessons from
Manipur, in Das Gupta M, Linclon Chen and Krishnan (eds.) Women’s Health in India,
Oxford University Press, Mumbai.
32- Srinivasan, K. 1995. Regulating Reproduction in India S Population: Efforts and
Recommendations, Sage Publications, New Delhi.
33- SRS. 1998. Registrar General of India, New Delhi.
34- Shen, C., & Williamson, J. B. (1997). Child mortality, women’s status, economic
dependency, and state strength: a cross-national study of less developed countries. Social
Forces, 76(2), 667-694.
35- Shiffman, J. (2000). Can poor countries surmount high maternal mortality? Studies in
Family Planning, 31, 274-289.
36- SRS. 1999. Compendium of India’s Fertility and Mortality Indicators 1971-1997,
Registrar General of India, New Delhi.
37- UNDP. 1990. Human Development Report, New Delhi: Oxford University Press.

78
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN
0976 – 6510(Online), Volume 3, Issue 2, May-August (2012)

38- United Nations. 1985. Socio Economic Differentials in Child Mortality in Developing
Countries,
STESA/SER.A/97, United Nations Publications, New York.
39- Visaria, Leela. 1985. Infant Mortality in India - Level, Trends and Determinants,
Economic and Political Weekly, XX (32).
40- Wang, G. (2007). Testing the impact of gender on reproductive health: an analysis of
developing countries. Journal of Social Science, 44, 507-0524.
41- Ware, Helen. 1984. Effects of Maternal Education, Women’s Roles and Child Care on
Child Mortality, in Henry W. Hosley and Linclon C. Chen (eds.) Child Survival
Strategies, Population and Development Review Supplement Vol. 10.
42-World Bank. 1998. Wasting Away: The Crisis of Malnutrition in India, Report No. 18667,
Health Organisation Regional Office for Southeast Asia, 1994. Multi-Centre Study on
Low Birth Weight and Infant Mortality in India, Nepal and Sri Lanka, Regional Health
Paper, SEARO, No. 25, New Delhi.

79