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In page Literacy:

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It should be pointed out that in these challenging contexts, sometimes the teaching of literacy may have unforeseen barriers. The EL Gazette reported that in the trials carried out in Ethiopia, for example, it was found that all ten of the participants had problems with vision.[5] In order to overcome this or avoid such challenges, preliminary health checks can help inform pre-teaching in order to better assist in the teaching and learning of literacy.[citation needed]