United States (KaiserHealth) – In the heated debate over to what extent religiously affiliated employers should be required to provide free contraception for workers, no one has talked much about what methods are available to women who want to prevent pregnancy and how their choices might change if cost were removed from the equation. But it’s an important subject.

With prices ranging from about $1 for a condom to more than $800 for an intrauterine device (IUD), some of these women, maybe a lot of them, might switch methods if they could afford to.

That’s exactly what many women’s health advocates hope. Long-acting methods such as the IUD and the hormonal implant are nearly 100 percent effective, require no effort after insertion and protect against pregnancy for up to 10 years. (In contrast, birth control pills are about 92 percent effective, and many other common methods are even less reliable in everyday use.)

Some women worry that having a device inserted in the uterus or under the skin is riskier than methods such as a pill, a patch or a vaginal ring that they can discontinue at will.

But experts such as Adam Sonfield, a senior public policy associate at the Guttmacher Institute, a nonprofit research center on reproductive policy, point out that IUDs and implants “eliminate the possibility of inconsistent use.”

They’re also among the most cost-effective methods available in the United States, according to research by James Trussel, a professor of economics and public affairs at Princeton University. Among other things, Trussell factored in the cost of particular methods, their effectiveness at preventing pregnancy, and the costs of unintended pregnancy or other events during a five-year period. IUDs and vasectomies were found to be the most cost-effective. Implants were somewhat less cost-effective but still a better bet than oral contraceptives, the patch, the vaginal ring or injectable contraceptives, among others.

These longer-acting methods, however, carry a hefty upfront price tag of between $500 and $1,000 for the device itself and its insertion. Meanwhile, insurance coverage is uncertain. Although the vast majority of employer health plans cover contraception, they don’t necessarily cover all methods and they generally don’t cover them for free. A 2004 study found that 40 percent of companies covered IUDs.

“For most plans, the devices aren’t considered part of the drug formulary, so you might have coinsurance of some amount like 20 percent,” Sonfield says.

Health Care Reform

Under the new health care law, starting this August, new employer health plans or those that change their benefits substantially will be required to cover all FDA-approved contraception methods and related counseling without co-pays. Catholic bishops and others strenuously objected to imposing this requirement on employers who objected to contraception on religious grounds. The Obama administration last week offered a compromise that would allow women who work for religious organizations to obtain contraception directly from an insurer — still without co-pays. But the debate continues.

Although eliminating cost concerns may help encourage the use of longer-acting methods, that’s only half the battle. Educating women and providers is also critical, say experts. Many people still associate IUDs with the Dalkon Shield, a device marketed in the early’70s that led to severe infections, infertility and death, resulting in hundreds of millions of dollars in legal

claims.

“The Dalkon Shield put a chill on IUDs for the next four decades,” says Eve Espey, a professor of obstetrics and gynecology at the University of New Mexico.

Only 5.5 percent of women practicing birth control used an IUD in 2006-2008. An even smaller percentage used hormonal implants, which received FDA approval in 2006. In contrast, 28 percent of women used birth control pills.

The longer-acting methods currently approved by the FDA are considered safe and effective. They include two IUDs, Mirena and ParaGard. These small T-shaped devices are inserted into the uterus and release hormones or small amounts of copper to prevent fertilization for five or 10 years, respectively. Implanon is a matchstick-sized hormonal implant that, once inserted under the skin of the upper arm, prevents pregnancy for three years.

Education Effort

The Contraceptive Choice Project is testing the idea that by educating women about longer acting methods and removing cost barriers, more will decide to use them and fewer will become accidentally pregnant.

In 2007, researchers at Washington University in St. Louis began to enroll 10,000 women in that region, offering them free contraceptives of any type for three years and focusing on educating them about longer-acting methods.

Seventy-five percent chose IUDs or implants, a much higher proportion than the 5.5 percent in the general population. After a year, 86 percent of those using IUDs or implants decided to continue with the longer acting method; only 55 percent of the women who were taking birth control pills continued with that method, according to preliminary figures from the researchers.

“Women should be able to control their reproductive lives,” says Jeffrey Peipert, principal investigator for the project who is vice chair for clinical research in the department of ob/gyn at the Washington University School of Medicine. “But with our current system, so many people are uninsured or unable to pay for their birth control.”

Happy With Her Choice

Lydia and Drew Huston have three children and don’t want any more. When Lydia, now 44, heard about the research project at the university near their home in Florissant, Mo., she signed up. Three years of free contraceptives sounded like a good deal.

Until she enrolled in the study, Huston had been getting hormonal Depo-Provera shots every three months to prevent pregnancy. Her co-pay was $20 each time. Although it was better than having to take a pill every day, getting to the doctor even once every three months was tough given her family commitments and her job working in development at a nonprofit organization.

Before meeting with the university researchers, Huston never understood the longer-acting options that were available. “They gave me this array of information,” she says. “It was so empowering.” After discussing the methods, Huston decided on a hormonal implant, which would last for three years. It was an easy transition from the injections she’d been receiving earlier.

Huston is happy with her choice. “Knowing what I know now, if I had to pay for a longer-acting method I would.”

That’s a choice many women like Huston soon won’t have to make.

Please send questions or ideas for future topics for the Insuring Your Health column to questions@kaiserhealthnews.org.

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SaanaSana’a, Yemen (IRIN) – Aid workers hope “shocking” new malnutrition figures from a survey conducted in western Yemen will help highlight the serious humanitarian situation in the country and prompt donors to act immediately.

Until now, aid workers say some donors have been unconvinced of the extent of the problem because of a perceived lack of evidence.

“It’s been a challenge,” one Yemen-based aid worker told IRIN. “Every time we sit down with donors, they say ‘Where are the figures? Where is the data?’”

Geert Cappelaere, head of the UN Children’s Fund (UNICEF) in Yemen, said donors have asked him for more evidence that malnutrition was such a priority.

“That kind of question – each and every time – kills something in me. Why do you want children to die first before you’re going to give any credibility to a disaster looming here in Yemen?”

Results

Yemen’s Ministry of Public Health and Population, with the support of UNICEF, surveyed 3,104 households in Hudeidah Governorate in October and collected data on 4,668 children under five.

The survey found a global acute malnutrition (GAM) rate of 31.7 percent – meaning nearly one third of children surveyed suffered from either moderate or severe acute malnutrition – of which nearly 10 percent were severe cases. These figures are more than double the internationally recognized emergency threshold of 15 percent. The survey also found that nearly 60 percent of children were underweight and 54.5 percent stunted, meaning their height was too low for their age, a sign of longer-term malnutrition.

These results are consistent with recent surveys conducted in other parts of the country.

In the southern Abyan Governorate, a battleground in ongoing fighting between government troops and al-Qaeda affiliated militants, a UNICEF survey in September found a GAM rate of 18.6 percent, of which 3.9 percent were severe cases. In the northern Hajjah Governorate, a government survey in June found a GAM rate of 31.4 percent, of which 9.1 percent were severe cases. Nearly half of the children surveyed in Hajjah were underweight and 43.6 percent were stunted.

“Wherever we go, wherever we survey, wherever we assess, we come to the same conclusions,” Cappelaere told IRIN. “The levels of acute malnutrition in Yemen are incredibly high.”

Yemeni Minister of Health Ahmed Al-ansi says half a million children suffer from acute malnutrition across the country. Hundreds of thousands of farmers are at risk of losing their livelihoods because of floods and drought, he added. According to the NGO Oxfam, many Yemenis live off tea and bread.

The UN says some seven million people (a third of the population) are food insecure, meaning they go to bed hungry or do not know where their next meal is coming from. This number is expected to rise significantly when the World Food Programme carries out a new national Comprehensive Food Security Survey in January. Aid workers expect the humanitarian situation in Yemen to continue getting worse next year.

The mortality formula

While malnutrition rates in parts of Yemen are comparable to those in parts of Somalia, they have not yet resulted in the same mortality rates, only because – until recently – Yemen had a functioning, if imperfect, primary health care system, including vaccination.

But in the past 10 months, during which anti-government demonstrations led to a violent crackdown and a political crisis, some areas have seen up to 40 percent fewer children immunized, UNICEF’s Cappelaere said.

Combine the high rates of malnutrition, the low levels of vaccination and sporadic outbreaks of diseases like measles, and “a disaster may be around the corner.”

The Hudeidah survey found that three in every four children suffered from diarrhoea, acute respiratory infections or fever in the two weeks preceding the survey; and 2.5 percent of mothers reported symptoms of measles in their children in the past three months. The survey found measles vaccination coverage of 74 percent in Hudeidah, well below the 90 percent coverage rate needed to prevent an outbreak.

“Why is it that the international community gets mobilized primarily when it sees the dramatic outcome of a situation or a crisis that we could have seen coming for many, many years?” Cappelaere asked. “This is not a blaming and shaming [exercise], but this is a collective question we need to ask ourselves.”

The UN has appealed for US$154 million for food and agricultural programmes and $70 million for nutritional programmes, the largest sectoral demands amid an overall appeal of $447 million for Yemen in 2012.

Government capacity

Government officials admit dealing with the dramatic levels of malnutrition will be a challenge for the interim Yemeni cabinet which emerged after a peace deal signed in late November pulled the country back from the brink of civil war.

The cash-strapped government is charged with organizing presidential elections by February 2012, while trying to maintain stability. Pro-democracy protesters, and an armed opposition, had been clashing with government forces on and off since February 2011. The peace deal has brought some calm to the capital Sana’a and the second city Taiz, but rebels, separatists and al-Qaeda affiliated-militants are still opposing the government in different parts of the country.

Majid Al Jonaid, deputy minister of health, said one of the government’s priorities is to address issues affecting the daily life of Yemenis, including malnutrition. The government plans to open clinics and run education campaigns, as part of a multi-sectoral national government strategy on malnutrition approved by the cabinet last year, before the latest crisis.

But “it depends mainly on the availability of resources and the overall situation,” he told IRIN. “We will start our work with the hampered resources that we have.”

Still, Al Jonaid said he was concerned malnutrition may not get the attention it deserves amid competing government priorities and big constraints. For example, the Ministry of Health was virtually shut down for weeks because of insecurity in and around the building.

Cappelaere said it was unrealistic to expect the government to take over much of the international community’s humanitarian work in the next year.

Long-term effects

The economic situation in the country has been set back 5-10 years by the events of this year and Yemen will continue having substantial humanitarian needs for 3-5 years, according to the UN humanitarian coordinator in Yemen, Jens Toyberg-Frandzen. Cappelare said the country will probably continue needing some form of assistance for two to three decades.

Addressing malnutrition is a complex task, as the problem relates to poverty, lack of education, bad sanitation, and cultural practices, like chewing khat and resisting exclusive breastfeeding. In Hudeidah, only 9 percent of infants under six months were exclusively fed breast milk.

The Ministry of Health report from the nutrition survey recommended establishing out-patient therapeutic programmes in community health facilities and considering “radical strategies” like blanket, rather than targeted, distribution of supplementary food.

Investments in lifesaving humanitarian assistance, as well as longer-term development work, are required immediately, Cappelaere said, to prevent both high mortality rates and longer-term effects of chronic malnutrition, like retardation in cognitive development, which will affect the country’s ability to move forward.

“Yemen is entering a new phase in its history,” said Pete Manfield, deputy head of the UN Office for the Coordination of Humanitarian Affairs (OCHA) in Yemen, “but it’s critical that humanitarian needs are met in 2012, not only to prevent the loss of life, but also to support the stabilization of the country.”

“We appeal not to let Yemen become another catastrophe,” Toyberg-Frandzen added.

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Kinshasa, Dr Congo (IRIN) – Urban farming in the Democratic Republic of Congo (DRC) is providing a livelihood for thousands of city dwellers, with vegetables bringing in good money for small growers and helping to alleviate high levels of malnutrition nationally, agricultural officials say.

The demand for vegetables and the high prices they command in DRC cities – up to US$4 per kilo – has pushed many jobless residents into becoming small-scale growers.

Most of the green spaces along the roadsides of the capital, Kinshasa, have been transformed into small farms. City farmers now grow 122 percent more produce than they did five years ago, according to the UN Food and Agriculture Organization (FAO). The FAO is supporting gardeners in five main DRC cities with a $10.4 million urban horticulture project to increase their productivity and improve their farming skills.

“The program, started as a response to mass urban migration following a five-year conflict in the eastern DRC, now assists local urban growers to produce 330,000 tons of vegetables annually,” FAO said in a statement. “In addition to food, the program has also helped provide employment and income for 16,000 small-scale market gardeners.”

Sebastien Mbuku, previously a school teacher in Kinshasa, said teaching only paid the bills for one week of the month. Unable to make ends meet, he turned to farming amaranth – a leaf vegetable – and spinach on 16 square meters of land.

Mbuku said he can now afford to put meat on the table to feed his wife and five children, and cover school fees. “Working as a small vegetable grower has become like any other respected job,” Mbuku said.

Reduced malnutrition?

The urban farmers sell 90 percent of what they produce in urban markets and supermarkets, according to FAO, helping to feed a swelling city population as Congolese leave the countryside in search of security.

“When production has doubled or tripled we can confidently says it’s had an impact on reducing malnutrition, as vegetables are available more cheaply on the market and people can eat them more frequently,” said Ndiaga Gueye, FAO’s country director in the DRC.

Although the project has contributed to improving nutrition in urban areas, Gueye said there was still a lot of work to be done. “No one can sell the illusion that our project has eradicated malnutrition,” he said.

A 2009 survey by Programme National de Nutrition, the UN World Food Programme (WFP) and the UN Children’s Fund (UNICEF) showed alarmingly high levels of wasting among urban and rural children.

According to a Multiple Indicator Survey published by agencies in September 2010, 24 percent of children in the DRC under five are underweight; 43 percent are stunted; and 9 percent are wasted.

Micro-finance

The burgeoning incomes of small vegetable growers, who sometimes earn 200 or 300 percent profits, have made them more attractive to micro-finance institutions like the DRC-based FINCA, which supports small-scale credit loans.

FINCA said 99.9 percent of the credit they have given to vegetable growers has been paid back in full and on time.

“At first I doubted the ability of vegetable growers to pay back credit,” said Dick Mabiala, a credit agent at FINCA. “But I changed my mind when a lady growing fruit and vegetables took a $300 credit and came back to deposit $1,000 worth of profits into her account. The woman was only using two hectares of land for her enterprise.”

Farmers have seen their incomes increase dramatically. In Kinshasa and in the town of Lubumbashi, the average annual income of each farmer increased from around $500 in 2004 to $2,000 in 2010. In Likasi town, it rose from $700 to $3,500. There have been similar increases in other cities, according to the FAO statement.

Mabiala knew of vegetable growers who put themselves through college with the income they got farming. But after their studies, it was back to the land.

“After ending university studies they tell you they cannot look for an office job just for the prestige of wearing a clean shirt and tie, when they could be making $600-800,” he said.

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CAPE TOWN, South Africa (IRIN) – Instead of providing much needed opportunities, South Africa’s ailing education system is keeping children from poor households at the back of the job queue and locking families into poverty for another generation.

By the age of eight, school children from the most affluent 20 percent of South Africa’s population are already significantly out-performing children from poorer backgrounds, according to new research by the Social Policy Research Group at Stellenbosch University.

The study, “Low Quality Education as Poverty Trap”, found that the schooling available to children in poor communities is reinforcing rather than challenging the racial and economic inequities created by South Africa’s apartheid-era policies.

Using newly available data sets, including those linking information on income with numeracy skills, the report analyzed how low-quality tuition in the post-apartheid education system is perpetuating “exclusion and marginalization”.

The government allocated R190 billion (US$28 billion) or 21 percent of its 2011/12 budget to education, but 80 percent is spent on personnel and the remainder is not enough to supply thousands of schools in mainly poor areas with basic requirements like electricity and textbooks.

Yet the top 20 percent of state schools – which largely correspond to historically white schools and charge fees to compensate for insufficient public funding – enjoy adequate facilities and attract the best teachers.

South Africa’s status as one of the wealthiest countries on the continent has not helped its educational performance – the poorest 25 percent of students ranked-th out of 15 sub-Saharan countries in reading performance, and 12th for mathematics, according to the Southern and Eastern African Consortium for Monitoring Education Quality surveys of 2000 and 2007.

“When seen in regional context, South Africa grossly under-performs, given that it has more qualified teachers, lower pupil-to-teacher-ratios and better access to resources,” the report on the study noted.

Nomusa Cembi, spokesperson for the South African Democratic Teachers’ Union (SADTU), whose nearly 250,000 members make it the country’s largest public sector union, said many teachers had received an inferior education as a result of apartheid’s “Bantu” education system, which was deliberately designed to disadvantage black learners and only ended in’94 when a new democratic government came into power.

There are a host of other problems besetting schools in poor areas. According to Yoliswa Dwane, spokesperson for the education advocacy group, Equal Education, over 2,000 schools had no piped water supply, 3,600 lacked electricity, and over 90 percent were without libraries or a functioning laboratory.

SADTU and other teachers’ unions have opposed national calls for education to become an essential service, which would prevent strike action. In August 2010 a teachers’ strike closed schools across the country for three weeks, contributing to a public perception that SADTU and some of its members did not have learners’ interests at heart.

“The focus needs to be on teachers’ development,” said Cembi. “We’ve had changes in the curriculum since the new [post-apartheid] era, but we find not much focus on training teachers.”

Many teacher training colleges were closed in the late’90s after new legislation required them to merge with existing higher education institutions. Plans to transform the training colleges into university-level institutions have not materialized, leaving thousands of teachers without any specialized training.

In recent years, SADTU has called for the reopening of training colleges because the shortage of teachers has meant that some schools in poor and rural areas have had to hire individuals who do not meet the official requirement of holding a teaching diploma.

According to the report, insufficient teacher knowledge is a problem, with many teachers scoring poorly in basic reading and mathematics tests.

A large number of changes to the national curriculum, beginning with the’97 adoption of Outcomes Based Education, many subsequent adjustments, and the final decision -announced in 2010 – to scrap it, have further stressed an already failing system.

Equal Education’s Dwane said the debate needed to move past “blaming teachers” and towards how to achieve a “serious commitment to a national education programme that would spell out what needs to be done over the next 20-30 years”.

Such a plan would have to include an assessment of existing teacher knowledge, followed by a national teacher training programme, but Dwane stressed the need to consider factors beyond teacher knowledge, including teacher motivation, and a lack of community and parental involvement.

Her view was backed up by the Stellenbosch study, which identified the lack of regular and meaningful student assessments and feedback to parents as another major weakness in the education system.

“For the parents to know how their child is performing, and by proxy to know how the teachers are performing, is very helpful,” said Ronelle Burger, one of the study’s lead researchers. “Very few top-down measures can be as effective as getting the people who are affected to act to correct the problems.”

The researchers found that the job prospects of school leavers were determined not only by the number of years of education attained, but the quality of that education.

“The labour market is at the heart of inequality, and central to labour market inequality is the quality of education,” they concluded. “Policies that address inequality by intervening in the labour market will have limited success as long as the considerable pre-labour market inequalities in the form of differential school quality persist.”

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CAPE TOWN, South Africa (IRIN) – Instead of providing much needed opportunities, South Africa’s ailing education system is keeping children from poor households at the back of the job queue and locking families into poverty for another generation.

By the age of eight, school children from the most affluent 20 percent of South Africa’s population are already significantly out-performing children from poorer backgrounds, according to new research by the Social Policy Research Group at Stellenbosch University.

The study, “Low Quality Education as Poverty Trap”, found that the schooling available to children in poor communities is reinforcing rather than challenging the racial and economic inequities created by South Africa’s apartheid-era policies.

Using newly available data sets, including those linking information on income with numeracy skills, the report analyzed how low-quality tuition in the post-apartheid education system is perpetuating “exclusion and marginalization”.

The government allocated R190 billion (US$28 billion) or 21 percent of its 2011/12 budget to education, but 80 percent is spent on personnel and the remainder is not enough to supply thousands of schools in mainly poor areas with basic requirements like electricity and textbooks.

Yet the top 20 percent of state schools – which largely correspond to historically white schools and charge fees to compensate for insufficient public funding – enjoy adequate facilities and attract the best teachers.

South Africa’s status as one of the wealthiest countries on the continent has not helped its educational performance – the poorest 25 percent of students ranked-th out of 15 sub-Saharan countries in reading performance, and 12th for mathematics, according to the Southern and Eastern African Consortium for Monitoring Education Quality surveys of 2000 and 2007.

“When seen in regional context, South Africa grossly under-performs, given that it has more qualified teachers, lower pupil-to-teacher-ratios and better access to resources,” the report on the study noted.

Nomusa Cembi, spokesperson for the South African Democratic Teachers’ Union (SADTU), whose nearly 250,000 members make it the country’s largest public sector union, said many teachers had received an inferior education as a result of apartheid’s “Bantu” education system, which was deliberately designed to disadvantage black learners and only ended in’94 when a new democratic government came into power.

There are a host of other problems besetting schools in poor areas. According to Yoliswa Dwane, spokesperson for the education advocacy group, Equal Education, over 2,000 schools had no piped water supply, 3,600 lacked electricity, and over 90 percent were without libraries or a functioning laboratory.

SADTU and other teachers’ unions have opposed national calls for education to become an essential service, which would prevent strike action. In August 2010 a teachers’ strike closed schools across the country for three weeks, contributing to a public perception that SADTU and some of its members did not have learners’ interests at heart.

“The focus needs to be on teachers’ development,” said Cembi. “We’ve had changes in the curriculum since the new [post-apartheid] era, but we find not much focus on training teachers.”

Many teacher training colleges were closed in the late’90s after new legislation required them to merge with existing higher education institutions. Plans to transform the training colleges into university-level institutions have not materialized, leaving thousands of teachers without any specialized training.

In recent years, SADTU has called for the reopening of training colleges because the shortage of teachers has meant that some schools in poor and rural areas have had to hire individuals who do not meet the official requirement of holding a teaching diploma.

According to the report, insufficient teacher knowledge is a problem, with many teachers scoring poorly in basic reading and mathematics tests.

A large number of changes to the national curriculum, beginning with the’97 adoption of Outcomes Based Education, many subsequent adjustments, and the final decision -announced in 2010 – to scrap it, have further stressed an already failing system.

Equal Education’s Dwane said the debate needed to move past “blaming teachers” and towards how to achieve a “serious commitment to a national education programme that would spell out what needs to be done over the next 20-30 years”.

Such a plan would have to include an assessment of existing teacher knowledge, followed by a national teacher training programme, but Dwane stressed the need to consider factors beyond teacher knowledge, including teacher motivation, and a lack of community and parental involvement.

Her view was backed up by the Stellenbosch study, which identified the lack of regular and meaningful student assessments and feedback to parents as another major weakness in the education system.

“For the parents to know how their child is performing, and by proxy to know how the teachers are performing, is very helpful,” said Ronelle Burger, one of the study’s lead researchers. “Very few top-down measures can be as effective as getting the people who are affected to act to correct the problems.”

The researchers found that the job prospects of school leavers were determined not only by the number of years of education attained, but the quality of that education.

“The labour market is at the heart of inequality, and central to labour market inequality is the quality of education,” they concluded. “Policies that address inequality by intervening in the labour market will have limited success as long as the considerable pre-labour market inequalities in the form of differential school quality persist.”

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North Yorkshire, England, United Kingdom (AHN) – British Prime Minister David Cameron criticized Oxford University Monday for its alleged racially discriminatory admission policies. Cameron claimed the educational institution admitted only one black student in the last academic year.

The prime minister also hit other elite institutions for discriminating against high school graduates of state schools.

However, senior Oxford officials denied Cameron’s allegation. They said Oxford admitted 42 black students last year – 27 were black Africans, one was a black Caribbean and 14 of mixed race. The sole black student that Cameron referred to was the one from the Caribbean.

The university explained only 452 black students across Britain met the A-level results required by Oxford’s tough minimum entry standards for the 2009-10 academic year.

The Conservative chairman of the Commons Education Select Committee, Graham Stuart, said the reason behind the low acceptance rate by elite universities in Britain of minority group members is the lack of good education at the basic level. He said the problem could not be solved by forcing universities with higher benchmarks to lower the bar, but by improving the standards of state education.

Of 16,591 students enrolled last year at Oxford who disclosed their ethnicity, 12,671 or 76 percent were white, 1,477 (9 percent) were Asian, 1,098 (7 percent) were Chinese, 254 (1.5 percent) were of other ethnicities and 253 (1.5 percent) were black.

Downing Street eventually admitted Cameron was not precise in his wording, but just wanted to emphasize that it is not acceptable for elite universities such as Oxford to have very few students from black and minority ethnic groups.

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New York, NY, United States (AHN) – According to a recent study, three in 10 Americans aged 21 and older consume alcohol at least once a week.

The study also found that 5 percent drink daily whereas 10 percent drink numerous times a week.

Beer, domestic wine and vodka appear to be the alcoholic beverages of choice

Other findings include one in five Americans 21 or older (20 percent) say they drink alcohol at least once a month and 15 percent drink it several times a year.

Another 22 percent report they never touch liquid libations.

Males were also found to be more frequent drinkers than women. Almost two in five men (38 percent) say they drink at least once a week compared to 21 percent of women.

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Madison, WI, United States (AHN) – A newly-released study finds that teenage fatherhood tends to stunt educational development.

Researchers studied 362 men younger than 18 years old beginning in 1994 and 1995. The study compared young men whose partners were pregnant and suffered a miscarriage and those whose partners gave birth.

The researchers said that only 64 percent of all study participants received a high school diploma and 16 percent received a GED. But fatherhood reduced the chances of graduating high school by 15 percentage points and increased the chances of receiving a GED by 11 percentage points.

Teenage fatherhood also increased the likelihood of early marriage and cohabitation. Out of the participants, 26 percent were married and 62 percent were living with their partners.

The researchers also said that the negative effects of teenage fatherhood may also limit the men’s children.

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DADAAB, Kenya (IRIN) – In one of the largest and oldest refugee settlements in the world, education is a luxury denied most of the 90,739 children who live there.

Set up at the outset of Somalia’s civil war in’91 to accommodate 90,000 refugees, three camps near the northeastern Kenyan town of Dadaab – Hagadera, Ifo and Dagahaley – are now home to more than three times that number, and persistent conflict in Somalia, from where 95 percent of the refugees originate, means the population grows daily.

According to the UN Children’s Fund (UNICEF), the primary school attendance rate is 43 percent while in secondary schools the rate is just 12 percent. Across the three camps, there are’ primary schools, funded by the UN Refugee Agency (UNHCR). In addition there are 11 private, fee-paying primary and six secondary schools.

In 2010, some 2,500 refugee children sat for the Kenya Certificate of Primary Education. Of these, barely a fifth won a place at secondary school. National statistics for Kenya are considerably higher, at 82 percent and 49 percent for primary and secondary attendance respectively. The picture is far worse in Somalia itself, , where primary school enrolment is 20 percent, with fewer than 10 percent going on to secondary school, according to UNICEF.

In Dadaab, money is the main problem. Despite being classified as a fundamental human right and recognized as providing much-needed psychological, physical and cognitive protection in emergency situations, education is the most underfunded sector in humanitarian aid. According to a recent report by the UN Educational, Scientific and Cultural Organization (UNESCO), only 2 percent of total humanitarian assistance is spent on education.

In 2010, UNHCR received only 20 percent of the US$30 million required to educate refugee children. Worldwide, according to UNICEF, approximately 75 million children are not enrolled in primary school. Half of them live in countries affected by conflict.

“The international community is failing Somali refugees by not prioritizing access to education,” Elizabeth Campbell of Refugees International (RI), an advocacy group, told IRIN. “The main reasons are lack of funding and lack of trained teachers. Even if there were more funding, there is a capacity problem that will be more challenging to address.

“Also, the Kenyan authorities have made it difficult to expand educational opportunities in Dadaab by not providing additional land required to build new structures.”

According to a 2010 report by UNICEF assessing education in Dadaab’s refugee camps, primary schools are stretched far beyond the standards for quality education, with each class accommodating 80 pupils instead of the stipulated 45. The schools also “have few Kenyan qualified teachers with nine trained and 800 untrained teachers in primary, 50 untrained and 35 trained teachers in secondary school”.

Community initiatives

Three secondary schools have been set up by refugees themselves, but they only very partially bridge the gap in educational needs and they suffer from their own resource constraints.

“It is very difficult to manage a high school on a zero budget. We ask the students to pay some money for the teachers and maintenance,” Mohamed Kasim, chairman and founder of the community-run secondary schools, told IRIN.

Another obstacle to quality education comes from a lack of materials such as laboratory apparatus and basic equipment for practical classes like science subjects. “I have never attended a laboratory class for the past three years. I am very worried about how I will handle the practical examination during the KCSE [Kenya Certificate of Secondary Education],” said Aweys, a form-four student.

The headmaster of Towfiq Community Secondary School in Ifo camp, Hassan A. Saney, said that despite the hardships, he is optimistic about his students sitting his school’s first upcoming national examination. “We are expecting to receive some laboratory equipment by mid-March and hopefully we will have done something before we sit for the final examination,” he said.

The community initiative attracted support from NGOs Windle Trust Kenya (WTK) and CARE in the form of donations toward stationery and reference books. UNHCR also brought in qualified national teachers to the community schools.

WTK said a funding crisis meant money for schooling had to go to refugee teachers serving the schools and end-of-term examination papers. In addition, each student is required to pay KSh3,300, or $38 to be fully registered for 2011 admission, which many cannot afford. “We ourselves are forced to pay this money but in reality, we cannot afford it. We have to sell the little food we are given by WFP [World Food Programme] which is not even enough,” said Farhio, a form-four student from Towfiq Community Secondary School.

Schoolteachers insist that non-payment of fees should not be a hindrance. “We never allow qualified students to leave the school because they can’t afford to pay the money but a contribution from the community is paramount for a better society,” said Abdullahi, a teacher in Dagahaley community secondary school.

A grim future

Except in the unlikely event of resettlement to a third country, even those who manage to complete secondary education in Dadaab have few opportunities for employment within the camps. But as RI’s Campbell says: “I don’t think that should be a reason to deny any child access to education. Some of the refugee graduates filter into urban areas or move elsewhere in the region and are able to start businesses and gain access to income and self-sufficiency.”

Refugee teachers are paid about $70 a month. While many refugees work for aid agencies in various capacities, they tend to receive meagre “incentive payments” rather than proper salaries, purportedly because of Kenya’s restrictive labour laws.

Lack of opportunity is a concern: “These idle youths turn to drugs and then indulge in criminal activities which in turn lead to insecurity problems. If something is not done I am afraid that these youth might even join the militia groups fighting back in their homes of origin,” said Liban Rashid, a youth spokesperson from Ifo camp.

In 2009, Human Rights Watch reported that Somalia’s Transitional Federal Government was also recruiting in the Dadaab camps and claimed that despite their denials, the Kenyan government was involved in the process.

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Montreal, Quebec, Canada (AHN) – The Canadian province of Quebec fined McGill University $2 million on Tuesday for hiking tuition fee for its Master in Business Administration course by about 900 percent.

Tuition jumped to $29,500 from $1,700.

McGill upped in September the yearly tuition fee to the two-year MBA program despite Quebec’s yearly cap on tuition at $3,400 annually.

The province has imposed the freeze on tuition fee for about a decade, but McGill officials said the cost of an MBA education was $10,000 more than the combined tuition and subsidy given by Quebec for each student.

McGill said its needs to charge higher tuition to make the university’s MBA program competitive with its counterparts in Canada and the U.S.

Quebec provides almost $11,000 subsidy for each MBA student in a bid to make the MBA program more accessible to residents. Quebec universities charge the lowest tuition fees across Canada.

The government said the fines – which will be in the form of reductions in government subsideis – will not be lifted until McGill cuts its MBA tuition.

Quebec is scheduled to announce a budget that would increase tuition fees in the province, which is being opposed by students.

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