How to Improve Education Quality in South Asia?

south-asia

Last year, the World Bank published Student learning in South Asia : challenges, opportunities, and policy priorities report about the state of education in South Asia. It showed that, despite undeniable achievements, poor education quality is holding back the region and trapping the youth in poverty. The good news is: there are solutions!

south-asia

1. How is the education sector doing in South Asia?

It’s doing much better! For the past decade, most countries have invested a lot in education, and they have achieved impressive results. Today, 89 percent of the children go to school; in 2001, there were only 75 percent. Besides, the literacy rate has skyrocketed, and 80.6 percent of the youth can now read.

Yet, despite this tremendous progress, there is still much to do. Even now, 13 million young South Asians have no access to education at all. For those attending primary school, many will drop out before graduating, and only 58 percent will get a secondary degree. This is below the world’s average by 12 percentage points.

2. Will South Asia reach universal primary education by end-2015?

There are still wide disparities across the region, so it depends on which country we are talking about. For instance, Sri Lanka achieved this goal several decades ago, and India with its 96 percent enrollment rate is well advanced too. On the contrary, Pakistan is lagging much behind, with only 72.1 percent of its children going to school. And in Afghanistan, the situation is even worse!

3. What are the barriers to accessing education?

As elsewhere in the world, poverty and gender discrimination are the number 1 barriers.

South Asia is one of the poorest regions in the world, and this has a huge impact on education. Children from disadvantaged families tend to drop out more often. But, here, the poverty factor is aggravated by the many conflicts and natural disasters that have racked the region since 2000. Schools have been closed or destroyed, and this has prevented the youth from studying at all.

For the girls, the chance to get an education is even lower. Over half of them have to drop out before reaching the last grade of primary school. This is a pity, as educating the girls is one of the keys to overcoming poverty. Indeed, an educated woman is likely to marry at a later age and have fewer, healthier, and better educated children. And since they often get a higher wage, they can contribute to increasing the standard of living of their family.

4. What about learning outcomes?

For the World Bank, this is the greatest challenge South Asia is facing now. The current education system does not give the youth the skills they need to reach their potential, get a good job, and succeed in life. Today, up to one-third of primary school’s students lack basic numeracy and literary skills. And it hardly gets better in secondary schools.

This low learning outcome has not only an impact on the children’s personal development. It also undermines the whole region’s competitiveness, economic growth, and any efforts to reduce poverty.

5. Why is the quality of education so poor?

Clearly, the educational methods are not effective. In South Asia, pupils are asked to rote learn rather than to reason or think for themselves. This is not to say that rote learning is useless. Still, children also need to be taught how to be analytical, solve problems, and write meaningful sentences.

But how could it be otherwise? Teachers have insufficient skills and are hardly trained. What is more, a majority skips class one day in five, and this has pervasive consequences. In general, the teachers’ knowledge and commitment are critical to the students’ learning. But in South Asia, this is even more important. Most children are the first ones in their family to ever go to school, and they cannot rely on their parents to help them.

6. What could these countries do?

For the World Bank, the priority is to invest in early childhood nutrition. It may sound irrelevant, and yet, the impact on learning outcomes would be massive, as malnutrition damages the children’s ability to learn. Another priority is to improve the teachers’ effectiveness. Governments should appoint them based on merit, train them, and reward their performances. This could increase the motivation of the good ones and persuade them to keep teaching.

7. What about ICTs?

Surprisingly the World Bank does not mention them in its report, and yet, ICTs provide incredibly useful tools to educators. There are many examples of successful initiatives. For instance, Shilpa Sayura in Sri Lanka, Deaf Reach in Pakistan, and eVidyaloka in India have helped thousands of rural, disadvantaged, and disabled children break the learning barriers and overcome school failure.

All these projects have proven to be both innovative and efficient, with few resources. So, why not take inspiration from them?

Jaroka is Expanding Healthcare Access in Pakistan with ICT

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For a nation whose healthcare system is chronically underfunded, Pakistan is all too familiar with disaster. In 2005, a magnitude 7.6 earthquake ravaged the country, killing over 79,000 people. In 2010, heavy monsoon rains triggered massive flooding which destroyed almost 2 million homes, yet Pakistan’s health expenditure that year was just 1% of its GDP. There simply aren’t enough medical personnel in Pakistan to meet demand during times of peace, let alone emergency situations. There are some estimates that up 70% of Pakistanis don’t see a doctor in their entire lifetime.

Jaroka Tele-healthcare

The UM Healthcare Trust, a hospital facility located in rural Mardan, has developed an mHealth system intended to connect rural Pakistanis with the both the daily and disaster healthcare that they need. The system, called Jaroka Tele-healthcare, was developed in tandem with Stanford University. Jaroka directly connects healthcare providers at the Mardan facility to specialists in Pakistan’s urban centers, as well as the United States. This connection allows for specialist review of complex cases without forcing the patient to travel.

Jaroka incorporates an Electronic Medical Record (EMR) into the UM Healthcare Trust system. The EMR allows all medical information, including all records, vital signs, prescriptions, and lab reports to be stored and managed online. These records can be readily accessed when consulting a specialist, or by a healthcare worker in the field.

Lady Health Workers

While there are very few trained doctors and nurses in Pakistan, there are over 110,000 Lady Health Workers (LHWs). LHWs are trained to provide preventative and curative health services to their neighbors, while using their peer status to navigate local customs and languages effectively. Utilizing Jaroka’s SMS enabled features, the LHWs can add new patients to the system, update disease records, search for patients via unique ID’s, retrieve patient history, and access a dictionary of terms. Prior to Jaroka, these capabilities were restricted to the hospital.

Quality care provided by LHWs reduces one of the largest barriers in the Pakistani healthcare system: cost. There is no national health insurance in Pakistan, and 78% of the population pay for their own medical expenses. With over half of Pakistan’s population living under the poverty line, low cost (or free) care provided by LHWs is the only option available. The tools Jaroka provides, used in combination with LHWs peer status, allow them to be efficient intermediaries between the community and the traditional healthcare system.

These intermediaries are even more critical during times of disaster, when the disconnect between hospitals and rural Pakistanis is magnified. One of Jaroka’s key features is a GIS mapping system which allows doctors to track the spread and incidence of diseases in real time. The disease data is received from LHWs in the field who send SMS updates for patients into the Jaroka Electronic Medical Record. From there it is uploaded into a Google Map, allowing real-time tracking. In a disaster scenario, this tool allows doctors to direct resources to areas with the most critical demand.

The Future

The value of Jaroka’s regional disease monitoring capability carries directly over into daily healthcare practice. Pakistan is currently battling a Polio crisis, and ranks fifth in the world for Tuberculosis disease burden. Jaroka provides the UM Health System with the capability to monitor disease trends in the Mardan region, and allocate resources to prevent outbreaks from turning into epidemics.

While Jaroka is currently only deployed in Pakistan’s rural Mardan region, the UM Healthcare Trust is working with the National Rural Development Program to extend mHealth platform throughout the Punjab province. To date, over 200,000 people have received care through Jaroka and the UM Healthcare Trust system.

The UM Healthcare Trust publishes their regional disease trends monthly via Twitter (@Jaroka).