This article addresses the question of whether literacy could be mediating the relationships of schooling to maternal
health behavior in populations undergoing demographic transition. Recent studies in which literacy was directly
assessed suggest a literacy pathway to demographic change. The literacy skills of 167 urban and rural mothers of
school-aged children in Lalitpur District of the Kathmandu Valley of Nepal were assessed by tests of reading
comprehension, academic language proficiency, health media skills and health narrative skill, as part of studies in the
urban and rural communitiesthat included a maternal interview and ethnographic fieldwork on the contexts of family
life, health care and female schooling. Regression analysis of the data indicates the retention of literacy skills in
adulthood and their influence on health behavior; ethnographic evidence shows that selective bias in school attainment
does not account for the results. Further direct assessment studies are recommended.
