Children in developing countries are healthier and more likely to survive past the age of five when their mothers can read and write. Experts in public health accepted this idea decades ago, but until now no one has been able to show that a woman's ability to read in itself improves her children's chances of survival.

公共健康专家们在几十年以前就早已认同的观点是：发展中国家的孩子，当其母亲有读写能力时，他们会更加健康，更有可能活到5岁以上。但是一直到现在，还没有人能够证明女性的读写能力本身提高了孩子的存活几率。

大多数有文化的妇女是在小学阶段学会识字的，并且此类妇女受过教育的事实可能仅仅表明她们成长在富有的家庭，或她们的家庭更加重视孩子。如今在尼加拉瓜开展的一个长期研究排除这些因素。研究表明：教会成年贫穷妇女识字(否则她们依然处于文盲状态)，会直接影响她们孩子的健康和存活率。

Most literate women learnt to read in primary school, and the fact that a woman has had an education may simply indicate her family's wealth or that it values its children more highly. Now a long-term study carried out in Nicaragua has eliminated these factors by showing that teaching reading to poor adult women, who would other wise have remained illiterate, has a direct effect on their children's health and survival.

1979年，尼加拉瓜政府设立了很多社会项目，包含“全国扫盲运动”。到1985年，大约30万来自全国各地的成人文盲(其巾很多人从未上过小学)已经学会了读写和算术。

在这期间，来自于利物浦热带医学院、尼加拉瓜的中美健康研究所、尼加拉瓜国家自治大学和哥斯迭黎加健康研究所的研究员们采访了近3 000名妇女，其中有些妇女在孩提时学过识字；有些妇女在扫盲运动中学过识字；有些妇女从来没学过识字。研究员询问的问题是：已生育了几个孩子，其中有多少孩子夭折，研究队伍也调查了幸存的孩子们的营养情况。

In 1979, the government of Nicaragua established a number of social programmes, including a National Literacy Crusade. By 1985, about 300,000 illiterate adults from all over the country, many of whom had never attended primary school, had learnt how to read, write and use numbers.

研究局的发现让人吃惊。在20世纪70年代末，文盲母亲的罂儿死亡率大约为110／1 000，此数值与后来学习识字的母亲的婴儿死亡率(105／1 000)相近。然而，至于在小学受过教育的母帝，其婴儿的死亡率明显更低一些，为80／1 000。

1985年，“全国扫盲运动”结束之后，依然是文盲的母亲和上过小学的母亲的婴儿死亡率几乎保持不变。对于那些通过扫盲运动学会识字的母亲，其婴儿死亡率是84／1 000，比依然是文盲的母亲的婴儿死亡率低了令人印象深刻的21个点；对于刚学会识字的母亲，其孩子的营养状况也比文盲母亲的孩子好一些。

During this period, researchers from the Liverpool School of Tropical Medicine, the Central American Institute of Health in Nicaragua, the National Autonomous University of Nicaragua and the Costa Rican Institute of Health interviewed nearly 3,000 women, some of whom had learnt to read as children, some during the literacy crusade and some who had never learnt at all. The women were asked how many children they had given birth to and how many of them had died in infancy. The research teams also examined the surviving children to find out how well-nourished they were.

有文化的母亲的孩子为什么情况更好?利物浦热带医学院的Peter Sandiford认为，没有人确切地知道答案。因为妇女课程中没有孩子保健方面的知识，于是Peter和他的同事们正在探讨其他的因素，他们和同样这批参加扫盲运动的3 000名妇女合作，试图查明的问题为：是否有文化的女性会更好地利用医院和诊所，选择较小型的家庭，在家中有更大控制权，能够更快学会现代儿童保育技能或她们是否仅仅是更加尊重自己和孩子。

尼加拉瓜的研究对政府和资助机构有重大的潜在意义。因为这些机构需要知道如何分配自己的资源。Sandiford说，有越来越多的证据表明对任何年龄段的女性进行教育就其自身来讲，是“影响健康的重要因素”。此研究结果支持了世界银行的建议——对发展中国家的教育预算应该增加，不仅要提高它们的经济，而且还要促进这些国家的儿童健康。

The investigators' findings were striking. In the late 1970s, the infant mortality rate for the children of illiterate mothers was around 110 deaths per thousand live births. At this point in their lives, those mothers who later went on to learn to read had a similar level of child mortality (105/1000). For women educated in primary school, however, the infant mortality rate was significantly lower, at 80 per thousand.

伦敦卫生和热带医学院的John Cleland说，“我们早巳知道女性教育是重要的，但是，我们过去一直认为，即使今天开始教育女孩子，其教育的效果必须要等上一代人的时间才能看到。尼加拉瓜的研究表明我们也许能忽略这一忧虑。”

Cletand告诫：尼加拉瓜的扫盲运动在很多方面具有特殊性，其他地方的相似运动可能也未必有效。教会成年人对他们的日常生活没有直接影响的技能是非常困难的事情，所以很多国家的扫盲运动不是那么成功。“扫盲运动只是提高人们生活的努力中的一部分，”Cleland说。对于致力于发展的工作人员来说，在其他国家复制这些条件是一个主要的挑战。

In 1985, after the National Literacy Crusade had ended, the infant mortality figures for those who remained illiterate and for those educated in primary school remained more or less unchanged. For those women who learnt to read through the campaign, the infant mortality rate was 84 per thousand, an impressive 21 points lower than for those women who were still illiterate. The children of the newly-literate mothers were also better nourished than those of women who could not read.

Why are the children of literate mothers better off? According to Peter Sandiford of the Liverpool School of Tropical Medicine, no one knows for certain. Child health was not on the curriculum during the women's lessons, so he and his colleagues are looking at other factors. They are working with the same group of 3,000 women, to try to find out whether reading mothers make better use of hospitals and clinics, opt for smaller families, exert more control at home, learn modern childcare techniques more quickly, or whether they merely have more respect for themselves and their children.

The Nicaraguan study may have important implications for governments and aid agencies that need to know where to direct their resources. Sandiford says that there is increasing evidence that female education, at any age, is 'an important health intervention in its own right'. The results of the study lend support to the World Bank's recommendation that education budgets in developing countries should be increased, not just to help their economies, but also to improve child health.

'We've known for a long time that maternal education is important,' says John Cleland of the London School of Hygiene and Tropical Medicine. 'But we thought that even if we started educating girls today, we'd have to wait a generation for the pay-off. The Nicaraguan study suggests we may be able to bypass that.'

Cleland warns that the Nicaraguan crusade was special in many ways, and similar campaigns elsewhere might not work as well. It is notoriously difficult to teach adults skills that do not have an immediate impact on their everyday lives, and many literacy campaigns in other countries have been much less successful. 'The crusade was part of a larger effort to bring a better life to the people,' says Cleland. Replicating these conditions in other countries will be a major challenge for development workers.