CHAPTER TWO

EDUCATION, HEALTH AND DEVELOPMENT

1. The Roles of Education and Health

• Education and health are basic objectives of development.

Health
• The World Health Organization (WHO) defines health as “a state of complete
physical, mental, and social well-being and not merely the absence of disease
and infirmity.”
• Health is central to well-being.
• Health is a prerequisite for increases in productivity.
Education
• Education is essential for a satisfying and rewarding life.
• Education plays a key to absorb modern technology and to develop the capacity
for self-sustaining growth and development.
• Successful education relies on adequate health.
Health and education are closely related in economic development.
On one hand, greater health capital may raise the return on investment in education for
several reasons:

 Health is an important factor in school attendance.

 Healthier children are more successful in school and learn more efficiently.
 Deaths of school-age children increase the cost of education per worker.
 Longer life spans raise the return to investments in education.

On the other hand, greater education capital may raise the return to investment in health in
the following ways:

 Many health programs rely on skills learned in schools.

 Schools teach basic personal hygiene and sanitation.
 Education is needed for the formation and training of health personnel.
 Education leads to delayed childbearing, which improves health.
Improving Health and Education: Why Increasing Income is Not Sufficient?
• Health and education levels are much higher in high-income countries.
• The causality runs in both directions:-With higher income, people and
governments can afford to spend more on education and health, and with greater
health and education, higher productivity and incomes are possible. Because of
these relationships, development policy needs to focus on income, health, and
education simultaneously.
• It is assumed that people will spend more on human capital when income is
higher. However, evidences show clearly that even if we were able to raise
incomes without a large improvement in health and education, we could not
count on that income increase being used to adequately invest in children’s
education and health.
• The market will not solve this problem automatically instead the government
dose; The World Health Organization (WHO) concluded, “Ultimate responsibility
for the performance of a country’s health system lies with government.’’
2. Investing in Education and Health: The Human Capital Approach
• Human capital is a term use for education, health, and other human capacities
that can raise productivity when increased.
• A rate of return can be deduced and compared with returns to other investments.
This is done by estimating the present discounted value of the increased income
stream made possible by these investments and then comparing it with their direct
and indirect costs.
• The income gains can be written as follows,

where, E is income with extra education, M is income without extra education, t is

year, i is the discount rate, and the summation is over expected years of working
life.
• The above formula is also applicable for investment on health.
Financial trade-offs in the decision to continue in school
3. Educational Systems and Development
The Political Economy of Educational Supply and Demand:
The Relationship between Employment Opportunities and Educational
Demands
The amount of schooling received by an individual is largely determined by
demand and supply.
Demand side
•The two principal influences on the amount of schooling desired are:
1. a more educated student’s prospects of earning considerably more income through future
modern-sector employment (the family’s private benefits of education)

2. the educational costs, both direct and indirect, that a student or family must bear.
Supply side
• The quantity of school places at the primary, secondary, and university levels is determined largely
by political processes, often unrelated to economic criteria.
Social versus Private Benefits and Costs of Education

In developing countries

• The social costs of education (costs borne by the public) increase rapidly as
students climb the educational ladder.
• The private costs of education (those borne by students themselves) increase more
slowly or may even decline.
• In higher education social cost is higher than private cost because of this
Educational demand becomes increasingly exaggerated at the post-secondary
levels.
Private versus Social Benefits and Costs
Education, Inequality, and Poverty
• In many least developed countries, education increase inequality.
• Because of different reasons the poor are neglected form accessing secondary and
higher education.
• Private cost of education is higher than expected return for the poor family,
so their willingness to attend the class is low.
• As a result of these higher opportunity costs, school attendance, and therefore
school performance, tends to be much lower for children of poor families than for
those from higher-income backgrounds.
This is greatly compounded by the lower quality of schools attended by the poor,
plagued by poor teaching and teacher truancy and inadequate facilities.
4. The Gender Gap: Discrimination in Education and Health
Education and Gender
• The educational gender gap is higher in least developed countries.
Closing the educational gender gap is essential, because
1. The rate of return on women’s education is higher than that of man’s in
developing countries.
2. Increasing women’s education not only increases their productivity in the
workplace but also results in greater labor force participation, later marriage,
lower fertility, and greatly improved child health and nutrition, thus benefiting
the next generation as well.
3. Women’s carry a disproportionate burden of poverty any significant
improvements in their role and status via education can have an important
impact on breaking the vicious circle of poverty and inadequate schooling.
Health and Gender

 Girls also face discrimination in health care in many developing countries.

• Studies show that families are far more likely to take an ill boy than an ill girl to a
health center.
• Women are often denied reproductive rights, whether legally or illegally.
• health spending on men is often substantially higher than that on women.
• In many countries, health care decisions affecting wives are often made by their
husbands.
• Female genital mutilation/cutting (FGM/C) is also health and gender tragedy.
5. Consequences of Gender Bias on Health and Education

• The global cost of failing to educate girls is about $92 billion a year.

• Discrimination against girls is not just inequitable but it is very costly from the
stand point of achieving development.

• Education of girls has been shown to be one of the most cost-effective means of
improving local health standards.

• The bias toward boys helps explain the “missing women” mystery.

• According to evidences, increase family income is not a guaranty to increase the

attainment of women’s in education or health status.
6. Policies on Education and Health

Major Educational Policy Options

•Developing nations are confronted with two basic alternatives in their policy approaches to
problems of education.
1. They can continue automatically to expand formal systems at the fastest possible pace
with perhaps some minor modifications in curricula, teaching methods, and examinations,
while retaining the same institutional labor market structures and educational costing
policies, or
2. They can attempt to reform the overall educational system by modifying the conditions
of demand for and the supply of educational opportunities and by reorienting curricula in
accordance with the real resource needs of the nation.
• Educational systems largely reflect and reproduce rather than alter the economic and social
structures of the societies in which they exist
• Any program or set of policies designed to make education more relevant for
development needs to operate simultaneously on two levels:
1. Modifying the economic and social signals and incentives outside the
educational system
2. Modifying the internal effectiveness and equity of educational systems

• Only by policies designed simultaneously to achieve these two objectives can the
real positive links between education and development be successfully forged.
These policies can be categorized as external and internal to the educational
systems.

Policies Largely External to Educational Systems

• Adjusting Imbalances, Signals, and Incentives
• Modifying Job Rationing by Educational Certification
• Curbing the Brain Drain

Policies Internal to Educational Systems

• Educational Budgets
• Subsidies Education
• Prepare Primary School Curricula in Relation to Rural Needs
• Quotas
Health Systems Policy
• To measure health WHO develop the disability-adjusted life year (DALY).
• In the WHO’s definition, a health system is “all the activities whose primary purpose is to
promote, restore, or maintain health.”
• Health systems include the components of public health departments, hospitals and clinics, and
offices of doctors and paramedics.
•An effective government role in health systems is crucial for at least four important reasons.
1. Health is central to poverty alleviation, because people are often uninformed about health, a
situation compounded by poverty.
2. Households spend too little on health because they may neglect externalities (such as, literally,
contagion problems).
3. The market would invest too little in health infrastructure and research and development and
technology transfer to developing countries due to market failures.
4. Public health programs in developing countries have many proven successes.