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C h a p t e r 3 Girls’ Health and Educational Needs in Urban Environments Varina Tjon-A-Ten, Brad Kerner, Shweta Shukla, and Anne Hochwalt The majority of the world‘s population now live in urban areas. More than one-third (37 percent) of the urban population in developing regions live in slum conditions and struggle with the associated problems of inadequate public services, inadequate social infrastructure, and a lack of education (United Nations 2006, 2008c). According to a United Nations survey, children’s attendance at primary school is higher in urban areas than in rural areas (84 percent attendance vs. 75 percent attendance), yet children from the poorest households, regardless of where they live, have the lowest attendance (65 percent) (United Nations 2008c). Additionally, girls account for 55 percent of the outof -school population (United Nations 2008c). Worldwide, for every 100 boys out of school there are 122 girls out of school (World Bank 2009). In developing countries, one out of five girls does not complete sixth grade and only 43 percent of secondary-school-age girls are in school (UNICEF 2007). These numbers prevail despite important accomplishments of the United Nations Millennium Development Goals focusing on universal primary education (Goal 2) and gender equality (Goal 3). The importance of ensuring that girls not only enter school, but stay enrolled when they reach puberty is an enduring issue, having been of concern in many societies for more than a century. The novelist Jane Austen wrote: “Give a girl an education and introduce her properly into the world, and ten to one but she has the means of settling well, without further expense to anybody” (Austen 1814). A decade ago, former United Nations Secretary Kofi Annan called out: “The first step is for societies to recognize that educating girls is not an option; it is a necessity ” (Annan 2000). 36 Varina Tjon-A-Ten, Brad Kerner, Shweta Shukla, and Anne Hochwalt Improving school attendance for girls can be life changing, especially in developing countries. Educated girls have a positive impact on gender equity, child and maternal health, reduction of birth and mortality rates, and reduction of poverty (Tembon and Fort 2008; Winter and Macina 1999). Keeping girls in school not only enhances their families’ lives and well-being but also contributes to national economic growth (Dollar and Gatti 1999; King and Mason 2001). For example, when a girl in the developing world receives seven or more years of education, she marries four years later, has fewer children, and sees child and maternal mortality decline (Summers 1994). In Africa, children of mothers who receive five years of primary education are 40 percent more likely to live beyond age 5 (Summers 1994). Furthermore, an extra year of primary school can increase a girl’s eventual earnings by 10 to 20 percent, and an extra year of secondary school can increase wages by as much as 15 to 25 percent (Psacharopoulos and Patrinos 2002). Finally, when women and girls earn income, they reinvest 90 percent of it in their families , compared with only 30 to 40 percent for men (U.S. Department of State 2010). Yet it is not just families that benefit from improved female education; nations also experience economic gains. A recent World Bank study of 100 countries revealed that every 1 percent increase in the proportion of women with secondary education boosted a country’s annual per capita income growth rate by 0.3 percentage points (PLAN 2008). It also showed the staggering costs of failing to educate girls to the same standard as boys. Sixty-five low-income, middle-income, and transition countries that did not offer girls the same secondary school opportunities as boys missed out on an annual economic growth of an estimated $92 billion (PLAN 2008). Countries in South and West Asia and sub-Saharan Africa have the worst record on educating girls to the secondary level, costing the sub-Saharan region alone more than $5.2 billion a year due to gender disparity in schools (Dollar and Gatti 1999; PLAN 2008). Barriers to Girls’ School Attendance Many factors interrupt girls’ school attendance and participation. For example, in western and central Africa, drought, food shortages, child labor, HIV/AIDS, and poverty contribute to low school enrollment and high dropout rates that prove to be particularly devastating for girls (United Nations 2008c). In many countries, the lack of birth registration and the lack of control to enforce compliance make providing and enforcing compulsory education (where...


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