scholarly journals Role of the private sector in the provision of immunization services in low- and middle-income countries

2011 ◽  
Vol 26 (Suppl. 1) ◽  
pp. i4-i12 ◽  
Author(s):  
A. Levin ◽  
M. Kaddar
2021 ◽  
Vol 6 (4) ◽  
pp. e004635
Author(s):  
Michelle Weinberger ◽  
Nicole Bellows ◽  
John Stover

IntroductionThe role of the private sector in family planning (FP) is well studied; however, few efforts have been made to quantify the role of private out-of-pocket (OOP) expenditures on FP commodities across low-and-middle-income countries (LMICs). Calculating OOP expenditures is important to illuminate the magnitude of these contributions and to inform discussions on how financial burdens can be reduced.MethodsEstimates of FP users and commodities consumed by women getting their FP methods from the private sector were made for 132 LMICs. Next, unit price data were compiled from to estimate the average price of commodities in the private sector at both a commercial and subsidised price point. These unit prices were applied to commodity consumption estimates to calculate total private OOP expenditures. Sensitivity testing was conducted.ResultsTotal estimated private OOP expenditures for FP commodities in 2019 was $2.73 billion across 132 LMICs. Spending on contraceptive pills accounted for 80% of this total, and just over three-quarters of expenditure came from upper-middle-income countries. OOP expenditures on subsidised commodities were small but accounted for 20% of expenditures in low-income countries. Non-subsidised unit prices were found to be between 5 and 20 times higher in upper-middle-income countries compared with low-income countries, although wide variation exists. For low-income and lower-middle-income countries, subsidies appear to be greatest for intrauterine devices (IUDs) and pills.ConclusionLarge OOP expenditures across all income levels highlight a need for financing approaches that ensure that a wide range of contraceptives are both accessible and affordable.


2013 ◽  
pp. 96-113 ◽  
Author(s):  
David Goldberg ◽  
Graham Thornicroft ◽  
Nadja van Ginneken

Demography ◽  
2019 ◽  
Vol 56 (5) ◽  
pp. 1899-1929 ◽  
Author(s):  
Stephanie R. Psaki ◽  
Erica Soler-Hampejsek ◽  
Jyotirmoy Saha ◽  
Barbara S. Mensch ◽  
Sajeda Amin

Abstract Global investments in girls’ education have been motivated, in part, by an expectation that more-educated women will have smaller and healthier families. However, in many low- and middle-income countries, the timing of school dropout and first birth coincide, resulting in a rapid transition from the role of student to the role of mother for adolescent girls. Despite growing interest in the effects of pregnancy on levels of school dropout, researchers have largely overlooked the potential effect of adolescent childbearing on literacy and numeracy. We hypothesize that becoming a mother soon after leaving school may cause the deterioration of skills gained in school. Using longitudinal data from Bangladesh, Malawi, and Zambia, we test our hypothesis by estimating fixed-effects linear regression models to address the endogeneity in the relationship between childbearing and academic skills. To our knowledge, this is the first study to examine the effects of adolescent childbearing on academic skills in low- and middle-income countries. Our results indicate that among those with low levels of grade attainment, first birth has a negative effect on English literacy and numeracy. Among those with higher levels of grade attainment, we find little evidence of effects of childbearing on academic skills. Childbearing also has little effect on local language literacy. Beyond the immediate loss of English literacy and numeracy, if these skills lead to better health and more economic productivity, then adolescent childbearing may have longer-term repercussions than previously understood. In addition to ongoing efforts to increase educational attainment and school quality in low- and middle-income countries, investments are needed to strengthen the academic skills of adolescent mothers to secure the demographic and economic promise of expanded education for girls and women.


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