1. Callister, Lynn Clark PhD, RN, FAAN

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In May 2006, I had the opportunity to deliver boxes of children's books from our family and a nonprofit organization, "Shared Books: Kid to Kid," to an orphanage in the rural community of Gatchina in the Russian Federation. Beautiful, curly haired, blonde little 4-year-old Natalia sat on the floor and hugged the book close to her heart. The joy in the faces of the children who received these books was heartwarming; thus this column focuses on literacy in women and children globally.


Many of the world's women and children have little access to written works and are either marginally literate or illiterate. Literacy is defined as "using printed and written information to function in society, to achieve one's goals, and to develop one's knowledge and potential" (National Center for Education Statistics, 2006).


It is estimated that 781 million adults worldwide are illiterate, most of whom are women. Globally, 140 million children are not attending school, with more than 50% of them being girls (UNESCO, 2006). When I had the opportunity to conduct research in Guatemala, most indigenous children not attending school past the second or third grade level were girls. They either sold goods in the marketplace or were kept at home to care for younger siblings so their mothers could be employed outside the home. Their brothers remained in school. In other countries, cultural beliefs keep girls out of school, as does concern about violence against girls and women.


According to the UNESCO Web site, "Literacy is an indispensable means for effective social and economic participation, contribution to human development and poverty reduction." Providing education to girls and women is strongly associated with positive health outcomes for women, children, and families in the developing world, documented in a body of literature over the past three decades. Delayed marriage and first pregnancy, skills to negotiate family planning, lower incidence of HIV/AIDS, use of healthcare during childbearing, increased probability of children's survival, enhanced child care knowledge, better child nutrition, higher immunization rates, and higher rates of education in generations to come are some of the positive results of education.


The United Nations Millennium Development Goals focus on achieving universal primary education and reducing gender inequities. One Healthy People 2010 objective is to improve the health literacy of individuals with inadequate or marginal literacy. The 10-year UNESCO Literacy Initiative for Empowerment will be implemented in 35 countries with a literacy rate of less than 50%, with the first phase started in 2006.


During 2006, 40 orphaned girls in Kenya, Swaziland, Uganda, and Zambia attended school thanks to the Girl Child Education Fund, a new initiative of the International Council of Nurses (ICN) and the Florence Nightingale International Foundation (FNIF). This initiative targets orphaned daughters of healthcare professionals and provides tuition, fees, uniforms, books, and school supplies administered through national nursing associations. (More information about this initiative is available at or


Several countries have launched education enhancement programs with dramatic results. In Egypt, more schools were built, family support for girls' education was encouraged, and financial support was offered to poor families, with a resulting increased enrollment in schools. In Bangladesh, a girls' scholarship program was established that focused on small, rural schools. In 10 years, the number of Bangladeshi girls enrolled in primary school increased significantly. The child-friendly/girl-friendly school program in Cameroon improved the ratio of girls to boys attending school.


An innovative literacy for health program in Guinea, West Africa among Sierra Leonean and Liberian women in refugee camps is described by McGinn and Allen (2006). This Reproductive Health Literacy Project was carried out with the support of international organizations and Columbia University. Content in the literacy classes focused on safe motherhood; family planning; sexually transmitted infections, including HIV/AIDS; and gender-based violence. Not only were these women empowered with increased levels of literacy but also the health of women and their children improved.


Support of such global initiatives is essential on a continuing basis. I applaud the efforts of governmental and nongovernmental organizations, including nurse researchers and clinicians, to make good things happen related to the literacy of women and children.




McGinn, T., & Allen, K. (2006). Improving refugees' reproductive health through literacy in Guinea. Global Public Health, 1, 229-248. [Context Link]


National Center for Education Statistics. (2006). The health literacy of American adults. Retrieved March 24, 2007, from [Context Link]


UNESCO. (2006). Education worldwide. Retrieved March 24, 2007, from[Context Link]