scholarly journals Impact of International Monetary Fund programs on child health

2017 ◽  
Vol 114 (25) ◽  
pp. 6492-6497 ◽  
Author(s):  
Adel Daoud ◽  
Elias Nosrati ◽  
Bernhard Reinsberg ◽  
Alexander E. Kentikelenis ◽  
Thomas H. Stubbs ◽  
...  
Keyword(s):  
Child Health ◽  
Protective Effect ◽  
International Monetary Fund ◽  
Health Care Access ◽  
Rural Areas ◽  
Structural Adjustment ◽  
Parental Education ◽  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
Imf Programs

Parental education is located at the center of global efforts to improve child health. In a developing-country context, the International Monetary Fund (IMF) plays a crucial role in determining how governments allocate scarce resources to education and public health interventions. Under reforms mandated by IMF structural adjustment programs, it may become harder for parents to reap the benefits of their education due to wage contraction, welfare retrenchment, and generalized social insecurity. This study assesses how the protective effect of education changes under IMF programs, and thus how parents’ ability to guard their children’s health is affected by structural adjustment. We combine cross-sectional stratified data (countries, 67; children, 1,941,734) from the Demographic and Health Surveys and the Multiple Indicator Cluster Surveys. The sample represents ∼2.8 billion (about 50%) of the world’s population in year 2000. Based on multilevel models, our findings reveal that programs reduce the protective effect of parental education on child health, especially in rural areas. For instance, in the absence of IMF programs, living in an household with educated parents reduces the odds of child malnourishment by 38% [odds ratio (OR), 0.62; 95% CI, 0.66–0.58]; in the presence of programs, this drops to 21% (OR, 0.79; 95% CI, 0.86–0.74). In other words, the presence of IMF conditionality decreases the protective effect of parents’ education on child malnourishment by no less than 17%. We observe similar adverse effects in sanitation, shelter, and health care access (including immunization), but a beneficial effect in countering water deprivation.

scholarly journals Stunting Diagnostic and Awareness: Impact assessment study of sociodemographic factors of stunting among school-going children of Pakistan (Preprint)

2019 ◽  
Author(s):  
Mahvish Ponum ◽  
Saadia Khan ◽  
Osman Hasan ◽  
Muhammad Tahir Mahmood ◽  
Asad Abbas ◽  
...  
Keyword(s):  
Rural Areas ◽  
Parental Education ◽  
Work Capacity ◽  
Public Health Issue ◽  
P Value ◽  
Detailed Knowledge ◽  
Age Group ◽  
Cross Sectional ◽  
Factors Associated ◽  
Study Results

BACKGROUND Stunting is a major public health issue in most of developing countries. Although, its worldwide prevalence is decreasing slowly but the number of stunted children is still rising in Pakistan. Stunting is highly associated with several long-term consequences, including higher rate of mortality and morbidity, deficient cognitive growth, school performance, learning capacity, work capacity and work productivity. To prevent stunting, we proposed Stunting Diagnostic and Education app. This app includes detailed knowledge of stunting and it’s all forms, symptoms, causes, video tutorials and guidelines by the Pediatricians and Nutritionists. OBJECTIVE The aim and objective of this study is to assess the prevalence of stunting in school-going children in Multan District of Punjab Pakistan and to analyze the risk factors associated with stunting in children under and over 5 age. This study presents Stunting Diagnostic and Education app to prevent the stunting in children under 5 age and children over 5 age (where required). METHODS A cross-sectional study has been conducted in schools of Multan District, Pakistan for the period of January 2019 to June 2019. Sample data of 1420 children, aged 4 to 18 years using three age groups, were analyzed by using SPSS version 21.0 to assess the prevalence of stunting and to analyze the main factors associated with it. Chi square test was applied in comparison with rural and urban participants and p-value <0.05 was considered as significant. This study includes distribution of sociodemographic characteristics, parental education, working status of mothers, dietary patterns of school going children and prevalence of stunting in school going children. After getting study results, Stunting Diagnostic and Education app was developed according to the instructions of child experts and nutritionists. RESULTS 354 (24.93%) participants were stunted out of 1420, 11.9 % children were obese and 63.17% children were normal. Out of 354 stunted children, higher ratio of stunting was found in the age group of 8-11 years children with 51.98 percentage. 37.85% stunted children were found in the age group of 4-7 years and 10.17% stunting was found in the age group of 12-18 years children. It was observed in the study that male children were highly stunted than female with 57.91 % and 42.09% respectively. Children living in rural areas were more stunted affected as compared to the children living in urban society with percentage 58.76 and 41.24 respectively. CONCLUSIONS Our study concluded that 24.93% children were stunted, out of which, age group of 8-11 years children were highly stunted. The study showed that the literacy of mother or caregiver had high impact on children’s health. Therefore, Stunting Diagnostic and Education app was developed to educate mothers to prevent stunting.

scholarly journals Odds of Receiving Vaccines, but Not Vitamin A, Increased over Time in Urban and Rural Ethiopia, 2000–2016: A Secondary Data Analysis of DHS Data (P04-095-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Lauren Blacker ◽  
Shari Krishnaratne
Keyword(s):  
Child Health ◽  
Vitamin A ◽  
Health Systems ◽  
Rural Areas ◽  
Development Program ◽  
Wealth Index ◽  
Education Level ◽  
Demographic And Health Surveys ◽  
Access To Health ◽  
Over Time

Abstract Objectives Childhood vaccines and biannual vitamin A delivery by health systems are key to child health; suboptimal administration may be a result of inadequate coverage or access to health systems. There have been national programs set in Ethiopia, such as the health sector development program, to improve child health. Therefore, we sought to describe trends in infant vaccines and vitamin A in urban and rural settings in Ethiopia. We hypothesized there would be an increase over time in infants (1) receiving all basic vaccines and (2) vitamin A in the past 6 months. We also hypothesized (3) coverage would be higher in urban settings. Methods We used four nationally representative Demographic and Health Surveys (DHS) from Ethiopia between 2000 and 2016. The analysis comprised 11,621 infants 6–23 months old. Logistic regression models using a forward-stepwise approach were created to test these 3 hypotheses, controlling for wealth, age, sex of infant, and mother's highest education level. Interaction terms were fitted between survey year and education level, setting and education level, and setting and wealth index quintile, and tested using the Wald test. Results (1) The percentage of infants having received all basic vaccines increased from 11.1% in 2000 to 31.0% in 2016; the odds of having received these vaccines increased over time also. (2) This is not true for vitamin A, where there was no pattern in the odds of having received vitamin A between survey years. (3) Rural infants were 40% less likely to have received all basic vaccines, compared to urban infants (adjusted odds ratio (AOR): 0.60; 95% CI: 0.43, 0.83), and there was no evidence of an association between setting and receiving vitamin A (AOR: 0.81; 95% CI: 0.61, 1.09). There was strong evidence for interaction between setting and mother's highest education level, setting and wealth index quintile, and survey year and education level (all P < 0.01). Conclusions These results suggest that (1) while there has been improvement in infants receiving basic vaccines, (2) progress may be slowing slightly in vitamin A coverage and (3)there is a need to improve coverage of basic vaccines for infants in rural areas. Strengthening of and improved access to health services should remain a priority to ensure proper distribution of vaccines and vitamin A in Ethiopia. Funding Sources N/A. Supporting Tables, Images and/or Graphs

scholarly journals Trends, prevalence and risk factors of overweight and obesity among women of reproductive age in Bangladesh: a pooled analysis of five national cross-sectional surveys

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e018468 ◽  
Author(s):  
Muhammad Abdul Baker Chowdhury ◽  
Md Mohiuddin Adnan ◽  
Md Zakiul Hassan
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Low Cost ◽  
Wealth Index ◽  
Overweight And Obesity ◽  
Reproductive Age ◽  
Demographic And Health Surveys ◽  
Obesity Prevalence ◽  
Women Of Reproductive Age ◽  
Cross Sectional

ObjectiveTo determine the trends, prevalence and risk factors of overweight and obesity among Bangladeshi women of reproductive age from 1999 to 2014.DesignWe analysed nationally representative data from the 1999, 2004, 2007, 2011 and 2014 cross-sectional Bangladesh Demographic and Health Surveys.SettingBangladesh.ParticipantsWomen aged 15–49 years.Primary outcomeOverweight/obesity.ResultsA total of 58 192 women were included in the analysis. The prevalence of overweight and obesity among women of reproductive age increased significantly from 7.53% (95% CI 6.83 to 8.29) and 1.82% (95% CI 1.48 to 2.24) in 1999 to 28.37% (95% CI 27.49 to 29.28) and 10.77% (95% CI 10.22 to 11.35) in 2014, respectively. Age, education, wealth index, watching television and contraceptive use were associated with overweight and obesity in both urban and rural areas.ConclusionsOverweight and obesity prevalence increased significantly among Bangladeshi women of reproductive age between 1999 and 2014. Development of effective low-cost strategies to address the increasing burden of obesity should be a high priority.

Trends in inequalities in childhood stunting in Ethiopia from 2000 to 2016: a cross sectional study

2020 ◽  
Author(s):  
Betregiorgis Zegeye ◽  
Gebretsadik Shibre ◽  
Dina Idriss-Wheeler ◽  
Sanni Yaya
Keyword(s):  
Rural Areas ◽  
Economic Status ◽  
Statistical Significance ◽  
Population Attributable Risk ◽  
Cross Sectional Study ◽  
World Health ◽  
Demographic And Health Surveys ◽  
Uncertainty Interval ◽  
Cross Sectional ◽  
Agenda 2030

Abstract Background The decrease in the magnitude of stunting over the past 20 years has been slow in Ethiopia. To date, in Ethiopia, the trends in and extent of inequality in stunting have not been investigated using methods suitably developed for disparity studies. This paper investigated both the extent and overtime dynamics of stunting inequality in Ethiopia over the last 17 years. Methods Using the World Health Organization’s Health Equity Assessment Toolkit software, data from the Ethiopia Demographic and Health surveys (EDHS) were analyzed between 2000 and 2016. The inequality analysis consisted of disaggregated rates of stunting using five equity stratifiers (economic status, education, residence, region and sex) and four summary measures (Difference, Population Attributable risk, Ratio and Absolute Concentration Index). A 95% uncertainty interval was constructed around point estimates to measure statistical significance. Results The study showed that both absolute and relative inequalities in stunting exist in all the studied years in Ethiopia. The inequality disfavors children of mothers who are poor, uneducated and living in rural areas and specific regions such as Amhara. The pro-rich (R = 1.2; 1.1, 1.3 in 2000 to R = 1.7; 1.4, 2 in 2016) and pro-educated (R = 1.6; 95%UI = 1.3, 1.9 in 2000 and R = 2.3; 95%UI = 1.5, 3 in 2011) inequalities slightly increased with time. Male children bear a disproportionately higher burden of stunting, and the disparity increased between the first and the last time points (PAR = −1.5 95%UI = −2.5, −0.6 in 2000 and PAR = −2.9 95%UI = −3.9, −1.9) based on complex measures but remained constant with simple measures (R = 1; 95%UI = 0.9, 1.1 in 2000 and R = 1.1 95%UI = 1, 1.2 in 2016). Similarly, both the sub-national regional and residence-related stunting disparities generally widened over time according to some of the inequality measures. Conclusions Stunting appeared to be highly prevalent among certain sub-groups (i.e. poor, uneducated and living in rural regions). The subpopulations experiencing excessively high stunting prevalence should be the focus of policy makers’ attention as they work to achieve the WHO 40% reduction in stunting target by 2025 and the UN Agenda 2030 for Sustainable Development Goals.

scholarly journals Status of maternal and child health services amongst migrants in Ludhiana slums – how far from the MDG targets?

2017 ◽  
Vol 4 (4) ◽  
pp. 1188 ◽  
Author(s):  
Paramita Sengupta ◽  
Anoop I. Benjamin ◽  
Bontha V. Babu
Keyword(s):  
Health Care ◽  
Child Health ◽  
Antenatal Care ◽  
Health Care Providers ◽  
Rural Areas ◽  
Immunization Coverage ◽  
Child Health Services ◽  
Care Providers ◽  
Cross Sectional ◽  
Pregnancy And Childbirth

Background: It is essential to monitor the coverage of health interventions in subgroups of populations, especially the marginalized and those at higher risk, because national averages can hide important inequalities. This study was carried out to find out the utilization and coverage of MCH services among migrants in the slums of Ludhiana, Punjab.Methods: Cross-sectional sample study.  370 women, who had childbirth within two years prior to the survey, were randomly selected from the 3947 newer migrant households in 30 slum settlements in Ludhiana surveyed for provision of health care, and information obtained from them with regard to MCH services availed by them for their last pregnancy and childbirth. Their children 12-23 months old, 195 in number, were studied for child health services.Results: Antenatal care (ANC) was availed by 44.0% of the women, with 24.6% of them going for minimum 4 antenatal visits and 29.1% having an institutional delivery but only 35.9% by trained health personnel. Place of delivery was found to be a significant predictor of antenatal care. Women staying in Ludhiana availed the least ANC. Complete immunization coverage in the 12-23 month olds was 37.4%. Government health worker visited 7.8% of the homes.Conclusions: Despite the relative proximity and concentration of health centers in urban compared to rural areas, migrant slum-dwellers are still not able to access quality MCH care. The problem of non-availability of essential healthcare and uneven distribution of skilled health care providers is the central challenge in meeting our health goals. 

scholarly journals Assessment of the availability of infrastructure, manpower, materials and knowledge of health care providers regarding child health care services in the sub centers of a block of Dibrugarh district, Assam

2019 ◽  
Vol 6 (5) ◽  
pp. 2264
Author(s):  
Debarshi Paul ◽  
Gourangie Gogoi ◽  
Rupali Baruah
Keyword(s):  
Health Care ◽  
Child Health ◽  
Health Worker ◽  
Health Care Providers ◽  
Rural Areas ◽  
Health Care Services ◽  
Child Health Care ◽  
Care Providers ◽  
Closing Time ◽  
Cross Sectional

Background: The SCs are under constant criticism for their inability to deliver quality services. Every year some 12 million children of developing countries die before they reach their fifth birthday. Around 90% of mortality rate can be prevented by the improvement of health care quality.Methods: Cross-sectional study conducted among health care providers of sub-centers in a randomly selected block of Dibrugarh district of Assam.Results: All SCs had two health worker (female)/ANMs and a multipurpose health worker male (MPW Male). Only 20% SCs adhered to scheduled opening but 100% adhered to scheduled closing time of the health facilities. 100% of SCs were housed in government building. 70% of the SCs had motorable roads. All the SCs had a regular and good supply of BCG, OPV, measles, TT, pentavalent (90% SCs) vaccines.Conclusions: SCs play a crucial role to decrease the morbidity and mortality of under five children in the rural areas. Full-fledged SCs with sufficient manpower, good infrastructure and good knowledge of delivery of child health care among health care providers would definitely improve the level of child health care provided to the community.

scholarly journals SDG3-related inequalities in women’s, children’s and adolescents’ health: an SDG monitoring baseline for Latin America and the Caribbean using national cross-sectional surveys

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047779
Author(s):  
Antonio Sanhueza ◽  
Liliana Carvajal-Vélez ◽  
Oscar J Mújica ◽  
Luis Paulo Vidaletti ◽  
Cesar G Victora ◽  
...  
Keyword(s):  
Latin America ◽  
Health Inequalities ◽  
Rural Areas ◽  
Urban Areas ◽  
National Level ◽  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
The Sustainable Development ◽  
The Caribbean ◽  
Nationally Representative

ObjectivesLatin America and the Caribbean (LAC) countries have made important progress towards achieving the Sustainable Development Goal (SDG) targets related to health (SDG3) at the national level. However, vast within-country health inequalities remain. We present a baseline of health inequalities in the region, against which progress towards the SDGs can be monitored.SettingWe studied 21 countries in LAC using data from Demographic and Health Surveys and Multiple Indicator Cluster Survey carried out from 2011 to 2016ParticipantsThe surveys collect nationally representative data on women and children using multistage sampling. In total, 288 207 women and 195 092 children made part of the surveys in the 21 countries.Outcome measuresFive health intervention indicators were studied, related to reproductive and maternal health, along with adolescent fertility and neonatal and under-five mortality rates. Inequalities in these indicators were assessed through absolute and relative measures.ResultsIn most countries, subnational geographical health gradients were observed for nearly all women, child, and adolescent (WCA) indicators. Coverage of key interventions was higher in urban areas and among the richest, compared with rural areas and poorer quintiles. Analyses by woman’s age showed that coverage was lower in adolescent girls than older women for family planning indicators. Pro-urban and pro-rich inequalities were also seen for mortality in most countries.ConclusionsRegional averages hide important health inequalities between countries, but national estimates hide still greater inequalities between subgroups of women, children and adolescents. To achieve the SDG3 targets and leave no one behind, it is essential to close health inequality gaps within as well as between countries.

scholarly journals Regional variations and socio-economic disparities in neonatal mortality in Angola: a cross-sectional study using demographic and health surveys

2020 ◽  
Vol 37 (6) ◽  
pp. 785-792
Author(s):  
Sanni Yaya ◽  
Betregiorgis Zegeye ◽  
Bright Opoku Ahinkorah ◽  
Olanrewaju Oladimeji ◽  
Gebretsadik Shibre
Keyword(s):  
Neonatal Mortality ◽  
Rural Areas ◽  
Formal Education ◽  
Statistical Significance ◽  
Population Attributable Risk ◽  
Population Attributable Fraction ◽  
World Health ◽  
Demographic And Health Surveys ◽  
Gender Inequalities ◽  
Cross Sectional

Abstract Background Inequalities in neonatal mortality rates (NMRs) in low- and middle-income countries show key disparities at the detriment of disadvantaged population subgroups. There is a lack of scholarly evidence on the extent and reasons for the inequalities in NMRs in Angola. Objective The aim of this study was to assess the socio-economic, place of residence, region and gender inequalities in the NMRs in Angola. Methods The World Health Organization Health Equity Assessment Toolkit software was used to analyse data from the 2015 Angola Demographic and Health Survey. Five equity stratifiers: subnational regions, education, wealth, residence and sex were used to disaggregate NMR inequality. Absolute and relative inequality measures, namely, difference, population attributable fraction (PAF), population attributable risk (PAR) and ratio, were calculated to provide a broader understanding of the inequalities in NMR. Statistical significance was calculated at corresponding 95% uncertainty intervals. Findings We found significant wealth-driven [PAR = −14.16, 95% corresponding interval (CI): −15.12, −13.19], education-related (PAF = −22.5%, 95% CI: −25.93, −19.23), urban–rural (PAF = −14.5%, 95% CI: −16.38, −12.74), sex-based (PAR = −5.6%, 95% CI: −6.17, −5.10) and subnational regional (PAF = −82.2%, 95% CI: −90.14, −74.41) disparities in NMRs, with higher burden among deprived population subgroups. Conclusions High NMRs were found among male neonates and those born to mothers with no formal education, poor mothers and those living in rural areas and the Benguela region. Interventions aimed at reducing NMRs, should be designed with specific focus on disadvantaged subpopulations.

scholarly journals What the percentage of births in facilities does not measure: readiness for emergency obstetric care and referral in Senegal

2020 ◽  
Vol 5 (3) ◽  
pp. e001915
Author(s):  
Francesca L Cavallaro ◽  
Lenka Benova ◽  
El Hadji Dioukhane ◽  
Kerry Wong ◽  
Paula Sheppard ◽  
...  
Keyword(s):  
Rural Areas ◽  
Newborn Care ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
Public Facilities ◽  
Facility Births

IntroductionIncreases in facility deliveries in sub-Saharan Africa have not yielded expected declines in maternal mortality, raising concerns about the quality of care provided in facilities. The readiness of facilities at different health system levels to provide both emergency obstetric and newborn care (EmONC) as well as referral is unknown. We describe this combined readiness by facility level and region in Senegal.MethodsFor this cross-sectional study, we used data from nine Demographic and Health Surveys between 1992 and 2017 in Senegal to describe trends in location of births over time. We used data from the 2017 Service Provision Assessment to describe EmONC and emergency referral readiness across facility levels in the public system, where 94% of facility births occur. A national global positioning system facility census was used to map access from lower-level facilities to the nearest facility performing caesareans.ResultsBirths in facilities increased from 47% in 1992 to 80% in 2016, driven by births in lower-level health posts, where half of facility births now occur. Caesarean rates in rural areas more than doubled but only to 3.7%, indicating minor improvements in EmONC access. Only 9% of health posts had full readiness for basic EmONC, and 62% had adequate referral readiness (vehicle on-site or telephone and vehicle access elsewhere). Although public facilities accounted for three-quarters of all births in 2016, only 16% of such births occurred in facilities able to provide adequate combined readiness for EmONC and referral.ConclusionsOur findings imply that many lower-level public facilities—the most common place of birth in Senegal—are unable to treat or refer women with obstetric complications, especially in rural areas. In light of rising lower-level facility births in Senegal and elsewhere, improvements in EmONC and referral readiness are urgently needed to accelerate reductions in maternal and perinatal mortality.

scholarly journals Mobile and Online Health Information: Exploring Digital Media Use among Austrian Parents

2020 ◽  
Vol 17 (17) ◽  
pp. 6053 ◽  
Author(s):  
Daniela Haluza ◽  
Isabella Böhm
Keyword(s):  
Child Health ◽  
Digital Media ◽  
Health Information ◽  
Parental Education ◽  
Online Survey ◽  
Family Policy ◽  
Medical Condition ◽  
Online Information ◽  
Sources Of Information ◽  
Cross Sectional

In today’s digitalized world, most parents are Internet-savvy and use online sources for child health information, mainly due to the 24/7 availability of advice. However, parents are often not specifically trained to identify reliable, evidence-based sources of information. In this cross-sectional online survey among a purposive, non-probabilistic sample of Austrian parents (n = 90, 81.1% females), we assessed aspects of health app use and family policy benefits-related and scenario-based Internet seeking behavior. We found that the surveyed parents showed a high health app use. The participants indicated that they prefer online information seeking to any other option in a scenario describing that their child would be sick at after-work hours, with social media channels being the least preferred source of online information. Mothers and younger parents were more likely to retrieve online information on family policy benefits. With the smartphone in everybody’s pocket, parents seemed to rely on mobile and online content when searching for child health information. Pediatricians are best suited to decide what treatment fits the child or their current medical condition, but nowadays they face increasing numbers of pre-informed parents seeking health information online. Provision of targeted parental education and guidance through the online information jungle could effectively empower parents and smooth personal and digital contacts in the delicate doctor–parent–child triangle.

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