Women, literacy and health: comparing health and education sectoral approaches in Nepal

Abstract

Functional adult literacy interventions have been regarded for many decades by policy makers as an effective way of imparting health knowledge. Supported by research on the statistical relationships between women’s literacy rates and health indicators, this dominant policy discourse is based on assumptions that non-literate women lack understanding and confidence, and that formal programmes and institutions constitute the main sites of learning. Proposing a broader conceptualisation of literacy as a social practice and of health as connected with social justice, this article draws on policy analysis and the authors’ earlier research in Nepal to re-examine the relationship between gender, literacy and health. By comparing health and literacy approaches used within the education and health sectors and taking account of new and indigenous informal learning practices, the article points to ways of investigating the complex interaction of factors that influence inequalities in gender and health at community level.

Keywords:

• Adult literacy
• health education
• health literacy
• health promotion
• gender equality
• Nepal
• women’s literacy

Acknowledgements

The authors would like to thank Prof. Alan Rogers for his insightful comments on an earlier draft of this article. Section 3 draws in part on analysis conducted for a paper commissioned by UNESCO Institute for Lifelong Learning.

Notes

1. It should also be noted that much of the research in this area is based on adult literacy rates – which do not disaggregate between those women who attended school as children and those who learnt to read and write as adults. See Robinson-Pant (2004) for a detailed critique.

2. An example is Burchfield’s 1996 study in Nepal.

3. We conducted qualitative research on women’s literacy and development in Nepal for our doctoral degrees in the 1990s. See Acharya (1999) and Robinson-Pant (1997).

4. This account draws on Acharya (2004) and Robinson-Pant (2001a).

5. For an historical analysis of the conceptualisation and meanings of ‘functional literacy’ within international literacy policy, see Verhoeven (1994). UNESCO first highlighted this concept in 1965, stating that ‘[r]ather than an end in itself, literacy should be regarded as a way of preparing man for a social, civic and economic role that goes beyond the limits of rudimentary literacy training consisting merely in the teaching of reading and writing’ (cited in Verhoeven 1994, 297).

6. The Nepali calendar (Bikram Sambat, BS) is 56 years ahead of the Gregorian calendar (AD).

7. A review of the impact of women’s literacy at this time noted that: ‘Female functional literacy can plan a key role in nurturing and harnessing this tremendous potential of resources and productivity … the most visible impacts are in the areas of income generation, increased awareness of personal hygiene and sanitation, aspiration for education and confidence building’ (Development Alternatives Nepal 1991, 10).

8. The Population Census (2011) identified 123 languages in Nepal and that Nepali was spoken by 44.64% of the population.

9. See for instance, LeVine et al.’s (2004) study on maternal literacy and health in Nepal.

10. Defined by World Health Organization (2016) as ‘the conditions in which people are born, grow, work, live and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems’.

11. For a more detailed account of this literature, see Robinson-Pant 2016.

12. Referred to as ‘schooled literacy’; see Street (2005).

13. See Stromquist’s (1997, 223) case study of the MOVA literacy programme in Sao Paulo, Brazil where she concludes that ‘the pedagogical, emotional and cultural challenges encountered by literacy teachers are seldom investigated’.

14. Similar to the CHVs discussed in our earlier account of the HEAL programme, FCHVs are women from the same community who facilitate discussion in mothers’ group (formed by the health sector) meetings.

15. Documented in the Interpersonal Communication and Counselling Skill Development Manual for FCHVs, BS 2072/2015; Operational guidelines for gender equality and social inclusion mainstreaming in the health sector 2013 and health sector gender equality and social inclusion strategy, 2009.

16. Rodhighar (Rodhi house) is traditionally a dormitory for teenage girls and boys, and young men and women. It is a temporary establishment in villages for entertainment and socialisation. Under the supervision of adult women and men, singing, dancing and other fun activities take place in Rodhighar.