Objective Numerous studies have documented an inverse association between years of schooling attained, particularly by women, and reduced maternal, infant and child mortality. However, if factors affecting educational attainment — many of which are unobservable, e.g. motivation and genetic endowment — also affect the likelihood of engaging in behaviours that enhance health, then assumed effects of schooling will be inflated in analyses that do not address this endogeneity. This systematic review assesses evidence for a causal link between education and maternal and child health in low and middle‐income countries. Methods Eligible studies controlled for observable and unobservable factors affecting both education and health. Reported effects were converted into partial correlations. When possible, we also conducted meta‐analyses to estimate mean effects by outcome. Results Of 4952 papers identified, 16 met the inclusion criteria. The 15 child health papers examined neonatal, infant and child mortality, stunting and wasting. Significant effects of education on infant and child health were observed for 30 of 33 models that did not account for endogeneity. In contrast, only 18 of 46 effects were significant in models that addressed endogeneity. Notably, for only one outcome —child mortality measured dichotomously —was the effect of maternal educational attainment significant in a meta‐analysis. The one maternal morbidity paper found significant effects for the two preventable outcomes considered. Conclusion While we find evidence for a causal link between education and health, effects are weaker in models that address endogeneity compared to naïve models that do not account for unobservable factors affecting both education and health. Advances in women's educational outcomes have undoubtedly played a role in improving health in many settings; however, the effect is not as strong as some researchers and advocates have claimed.

Background Despite strong theoretical grounding, important gaps in knowledge remain regarding the degree to which there is a causal relationship between education and sexual and reproductive health, as many claims have been made based on associations alone. Understanding the extent to which these relationships are causal is important both to inform investments in education and health, as well as to understand the mechanisms underlying these relationships. Methods We conducted a systematic review of the evidence for a causal link between education and sexual and reproductive health (SRH) in low and middle-income countries. Education indicators included exposure to formal schooling and learning. SRH outcomes included: age at first sex, age at first marriage, age at first pregnancy/birth, contraceptive use, fertility, and HIV status and other sexually transmitted infections. When possible, we also conducted meta-analyses to estimate mean effects by outcome, and to understand sources of variation between studies. Results We identified 35 papers that met our inclusion criteria. Although many of the studies report evidence of a causal relationship between education and one or more SRH outcomes, estimated effects are often small in magnitude. Our meta-analyses reveal mostly null mean effects, with the exception of small effects of increased grade attainment on lower fertility and HIV positive status. We also found inconsistent evidence supporting mechanisms linking education and SRH. Conclusions This review demonstrates that, although investments in schooling may have positive ripple effects for sexual and reproductive health in some circumstances, those effects may not be as large or consistent as expected. Further, our understanding of the circumstances in which schooling is most likely to improve SRH remains somewhat limited. An accurate picture of whether and when improvements in education lead to better health outcomes is essential for the achievement of global development goals.

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Background Gender disparities in education continue to undermine girls' opportunities, despite enormous strides in recent years to improve primary enrolment and attainment for girls in low‐ and middle‐income countries (LMICs). At the regional, country and subnational levels gender gaps remain, with girls in many settings less likely to complete primary school, less likely to complete secondary, and often less likely to be literate than boys. The academic and policy literatures on the topic of gender‐related barriers to girls' education are both extensive. However, there remain gaps in knowledge regarding which interventions are most likely to work in contexts with different combinations of barriers. Objectives This systematic review identified and assessed the strength of the evidence of interventions and exposures addressing gender‐related barriers to schooling for girls in LMICs. Search Methods The AEA RCT Registry, Africa Bibliography, African Education Research Database, African Journals Online, DEC USAID, Dissertation Abstracts, EconLit, ELDIS, Evidence Hub, Global Index Medicus, IDEAS‐Repec, Intl Clinical Trials Registry, NBER, OpenGrey, Open Knowledge Repository, POPLINE, PsychINFO, PubMed, Research for Development Outputs, ScienceDirect, Sociological Abstracts, Web of Science, as well as relevant organization websites were searched electronically in March and April of 2019. Further searches were conducted through review of bibliographies as well as through inquiries to authors of included studies, relevant researchers and relevant organizations, and completed in March 2020. Selection Criteria We included randomized controlled trials as well as quasi‐experimental studies that used quantitative models that attempted to control for endogeneity. Manuscripts could be either published, peer‐reviewed articles or grey literature such as working papers, reports and dissertations. Studies must have been published on or after 2000, employed an intervention or exposure that attempted to address a gender‐related barrier to schooling, analyzed the effects of the intervention/exposure on at least one of our primary outcomes of interest, and utilized data from LMICs to be included. Data Collection and Analysis A team of reviewers was grouped into pairs to independently screen articles for relevance, extract data and assess risk of bias for each included study. A third reviewer assisted in resolving any disputes. Risk of bias was assessed either through the RoB 2 tool for experimental studies or the ROBINS‐I tool for quasi‐experimental studies. Due to the heterogeneity of study characteristics and reported outcome measures between studies, we applied the GRADE (Grading of Recommendation, Assessment, Development and Evaluation) approach adapted for situations where a meta‐analysis is not possible to synthesize the research. Results Interventions rated as effective exist for three gender‐related barriers: inability to afford tuition and fees, lack of adequate food, and insufficient academic support. Promising inter...

This paper presents results from a three-arm randomized controlled trial in Zambia with a sample of nearly 1200 adolescent girls enrolled in Grade 7. Selected primary schools (N=36) were randomly assigned within each of three districts to one of three arms: 1) e-readers, which girls could take home, provided within a safe space group platform plus community engagement activities; 2) safe space groups plus community engagement activities; and 3) control. The intent-to-treat estimates indicate that girls in the e-reader arm scored significantly better on two basic literacy assessments as well as non-verbal reasoning compared with girls in the control arm.