Editor’s Choice

• The Healthcare IT market size is expected to be worth around USD 1728 Bn by 2032
• According to a report by UNESCO, countries in South and South-West Asia have the highest number of illiterate adults in the world, estimated at 388 million.
• Approximately 36% of adult Americans possess only basic or below basic health literacy skills.
• Only 12% of Americans are considered proficient in their health literacy skills.
• Health literacy levels in China increased from 6.48% of the population in 2008 to 23.15% in 2020.
• A recent study analyzing global health literacy research from 1995 to 2020 identified the United States, Australia, and the United Kingdom as major contributors to the international collaboration network on health literacy.
• Mental health has been the most active research field in recent years in the context of health literacy.

As of March 2020, around 4.46 million Mexicans over 15 years of age were unable to write or read, approximately 4.74 percent. Mexico State, the federal entity with the highest share of the population, also registered the highest number of literate people with over 12 million.

In the past five decades, the global literacy rate among adults has grown from 67 percent in 1976 to 87.36 percent in 2023. In 1976, males had a literacy rate of 76 percent, compared to a rate of 58 percent among females. This difference of over 17 percent in 1976 has fallen to just seven percent in 2020. Although gaps in literacy rates have fallen across all regions in recent decades, significant disparities remain across much of South Asia and Africa, while the difference is below one percent in Europe and the Americas. Reasons for these differences are rooted in economic and cultural differences across the globe. In poorer societies, families with limited means are often more likely to invest in their sons' education, while their daughters take up a more domestic role. Varieties do exist on national levels, however, and female literacy levels can sometimes exceed the male rate even in impoverished nations, such as Lesotho (where the difference was over 17 percent in 2014); nonetheless, these are exceptions to the norm.

Literacy in India has been increasing as more and more people receive a better education, but it is still far from all-encompassing. In 2023, the degree of literacy in India was about 77 percent, with the majority of literate Indians being men. It is estimated that the global literacy rate for people aged 15 and above is about 86 percent. How to read a literacy rateIn order to identify potential for intellectual and educational progress, the literacy rate of a country covers the level of education and skills acquired by a country’s inhabitants. Literacy is an important indicator of a country’s economic progress and the standard of living – it shows how many people have access to education. However, the standards to measure literacy cannot be universally applied. Measures to identify and define illiterate and literate inhabitants vary from country to country: In some, illiteracy is equated with no schooling at all, for example. Writings on the wallGlobally speaking, more men are able to read and write than women, and this disparity is also reflected in the literacy rate in India – with scarcity of schools and education in rural areas being one factor, and poverty another. Especially in rural areas, women and girls are often not given proper access to formal education, and even if they are, many drop out. Today, India is already being surpassed in this area by other emerging economies, like Brazil, China, and even by most other countries in the Asia-Pacific region. To catch up, India now has to offer more educational programs to its rural population, not only on how to read and write, but also on traditional gender roles and rights.

The highest literacy rates in Nigeria were registered in the southern regions of the country. In the South West, 89 percent of males and 80.6 percent of females were literate as of 2018. Also, the south zones showed the lowest percentage differences between male and female literacy. Female literacy rate in Nigeria is among the highest in West Africa. The highest female literacy rates were registered in Cabo Verde and Ghana, while Nigeria ranked third.

The literacy rate measures the percentage of people aged 15 and above who are able to read and write. In 2019, Pakistan's total literacy rate was around 58 percent, with less than 46.49 percent of women being literate and more than 69.29 percent of men.

Women in Pakistan need education

In Pakistan, women’s education is in dire need of improvement, and so far, the number of illiterate women has not decreased - on the contrary, it has been going up for years. Although education for both genders is not prohibited in Pakistan, women are generally not as well educated as men. But it doesn’t stop there: Pakistan is one of the countries deemed worst for women in general when it comes to quality of life and safety.

Economy and education

Pakistan is a predominantly Muslim country with a low urbanization rate, meaning the majority of its population live in rural areas, where education is traditionally harder to come by than in cities. Pakistan is still a developing country, and typically, most of the inhabitants work in the primary sector, since Pakistan is rich in arable land. However, the tertiary sector generates the lion’s share of GDP. If the country wants to make the leap to being a developed nation, education and equality need to be higher on the list.

The second National Family Health Survey (NFHS-2), conducted in 1998-99, provides information on fertility, mortality, family planning, and important aspects of nutrition, health, and health care. The International Institute for Population Sciences (IIPS) coordinated the survey, which collected information from a nationally representative sample of more than 90,000 ever-married women age 15-49. The NFHS-2 sample covers 99 percent of India's population living in all 26 states. This report is based on the survey data for 25 of the 26 states, however, since data collection in Tripura was delayed due to local problems in the state. IIPS also coordinated the first National Family Health Survey (NFHS-1) in 1992-93. Most of the types of information collected in NFHS-2 were also collected in the earlier survey, making it possible to identify trends over the intervening period of six and one-half years. In addition, the NFHS-2 questionnaire covered a number of new or expanded topics with important policy implications, such as reproductive health, women's autonomy, domestic violence, women's nutrition, anaemia, and salt iodization. The NFHS-2 survey was carried out in two phases. Ten states were surveyed in the first phase which began in November 1998 and the remaining states (except Tripura) were surveyed in the second phase which began in March 1999. The field staff collected information from 91,196 households in these 25 states and interviewed 89,199 eligible women in these households. In addition, the survey collected information on 32,393 children born in the three years preceding the survey. One health investigator on each survey team measured the height and weight of eligible women and children and took blood samples to assess the prevalence of anaemia. SUMMARY OF FINDINGS POPULATION CHARACTERISTICS Three-quarters (73 percent) of the population lives in rural areas. The age distribution is typical of populations that have recently experienced a fertility decline, with relatively low proportions in the younger and older age groups. Thirty-six percent of the population is below age 15, and 5 percent is age 65 and above. The sex ratio is 957 females for every 1,000 males in rural areas but only 928 females for every 1,000 males in urban areas, suggesting that more men than women have migrated to urban areas. The survey provides a variety of demographic and socioeconomic background information. In the country as a whole, 82 percent of household heads are Hindu, 12 percent are Muslim, 3 percent are Christian, and 2 percent are Sikh. Muslims live disproportionately in urban areas, where they comprise 15 percent of household heads. Nineteen percent of household heads belong to scheduled castes, 9 percent belong to scheduled tribes, and 32 percent belong to other backward classes (OBCs). Two-fifths of household heads do not belong to any of these groups. Questions about housing conditions and the standard of living of households indicate some improvements since the time of NFHS-1. Sixty percent of households in India now have electricity and 39 percent have piped drinking water compared with 51 percent and 33 percent, respectively, at the time of NFHS-1. Sixty-four percent of households have no toilet facility compared with 70 percent at the time of NFHS-1. About three-fourths (75 percent) of males and half (51 percent) of females age six and above are literate, an increase of 6-8 percentage points from literacy rates at the time of NFHS-1. The percentage of illiterate males varies from 6-7 percent in Mizoram and Kerala to 37 percent in Bihar and the percentage of illiterate females varies from 11 percent in Mizoram and 15 percent in Kerala to 65 percent in Bihar. Seventy-nine percent of children age 6-14 are attending school, up from 68 percent in NFHS-1. The proportion of children attending school has increased for all ages, particularly for girls, but girls continue to lag behind boys in school attendance. Moreover, the disparity in school attendance by sex grows with increasing age of children. At age 6-10, 85 percent of boys attend school compared with 78 percent of girls. By age 15-17, 58 percent of boys attend school compared with 40 percent of girls. The percentage of girls 6-17 attending school varies from 51 percent in Bihar and 56 percent in Rajasthan to over 90 percent in Himachal Pradesh and Kerala. Women in India tend to marry at an early age. Thirty-four percent of women age 15-19 are already married including 4 percent who are married but gauna has yet to be performed. These proportions are even higher in the rural areas. Older women are more likely than younger women to have married at an early age: 39 percent of women currently age 45-49 married before age 15 compared with 14 percent of women currently age 15-19. Although this indicates that the proportion of women who marry young is declining rapidly, half the women even in the age group 20-24 have married before reaching the legal minimum age of 18 years. On average, women are five years younger than the men they marry. The median age at marriage varies from about 15 years in Madhya Pradesh, Bihar, Uttar Pradesh, Rajasthan, and Andhra Pradesh to 23 years in Goa. As part of an increasing emphasis on gender issues, NFHS-2 asked women about their participation in household decisionmaking. In India, 91 percent of women are involved in decision-making on at least one of four selected topics. A much lower proportion (52 percent), however, are involved in making decisions about their own health care. There are large variations among states in India with regard to women's involvement in household decisionmaking. More than three out of four women are involved in decisions about their own health care in Himachal Pradesh, Meghalaya, and Punjab compared with about two out of five or less in Madhya Pradesh, Orissa, and Rajasthan. Thirty-nine percent of women do work other than housework, and more than two-thirds of these women work for cash. Only 41 percent of women who earn cash can decide independently how to spend the money that they earn. Forty-three percent of working women report that their earnings constitute at least half of total family earnings, including 18 percent who report that the family is entirely dependent on their earnings. Women's work-participation rates vary from 9 percent in Punjab and 13 percent in Haryana to 60-70 percent in Manipur, Nagaland, and Arunachal Pradesh. FERTILITY AND FAMILY PLANNING Fertility continues to decline in India. At current fertility levels, women will have an average of 2.9 children each throughout their childbearing years. The total fertility rate (TFR) is down from 3.4 children per woman at the time of NFHS-1, but is still well above the replacement level of just over two children per woman. There are large variations in fertility among the states in India. Goa and Kerala have attained below replacement level fertility and Karnataka, Himachal Pradesh, Tamil Nadu, and Punjab are at or close to replacement level fertility. By contrast, fertility is 3.3 or more children per woman in Meghalaya, Uttar Pradesh, Rajasthan, Nagaland, Bihar, and Madhya Pradesh. More than one-third to less than half of all births in these latter states are fourth or higher-order births compared with 7-9 percent of births in Kerala, Goa, and Tamil Nadu. Efforts to encourage the trend towards lower fertility might usefully focus on groups within the population that have higher fertility than average. In India, rural women and women from scheduled tribes and scheduled castes have somewhat higher fertility than other women, but fertility is particularly high for illiterate women, poor women, and Muslim women. Another striking feature is the high level of childbearing among young women. More than half of women age 20-49 had their first birth before reaching age 20, and women age 15-19 account for almost one-fifth of total fertility. Studies in India and elsewhere have shown that health and mortality risks increase when women give birth at such young ages?both for the women themselves and for their children. Family planning programmes focusing on women in this age group could make a significant impact on maternal and child health and help to reduce fertility. INFANT AND CHILD MORTALITY NFHS-2 provides estimates of infant and child mortality and examines factors associated with the survival of young children. During the five years preceding the survey, the infant mortality rate was 68 deaths at age 0-11 months per 1,000 live births, substantially lower than 79 per 1,000 in the five years preceding the NFHS-1 survey. The child mortality rate, 29 deaths at age 1-4 years per 1,000 children reaching age one, also declined from the corresponding rate of 33 per 1,000 in NFHS-1. Ninety-five children out of 1,000 born do not live to age five years. Expressed differently, 1 in 15 children die in the first year of life, and 1 in 11 die before reaching age five. Child-survival programmes might usefully focus on specific groups of children with particularly high infant and child mortality rates, such as children who live in rural areas, children whose mothers are illiterate, children belonging to scheduled castes or scheduled tribes, and children from poor households. Infant mortality rates are more than two and one-half times as high for women who did not receive any of the recommended types of maternity related medical care than for mothers who did receive all recommended types of care. HEALTH, HEALTH CARE, AND NUTRITION Promotion of maternal and child health has been one of the most important components of the Family Welfare Programme of the Government of India. One goal is for each pregnant woman to receive at least three antenatal check-ups plus two tetanus toxoid injections and a full course of iron and folic acid supplementation. In India, mothers of 65 percent of the children born in the three years preceding NFHS-2 received at least one antenatal