scholarly journals Cash Transfer Programs and HIV-Related Outcomes: an Analysis of 42 Countries from 1996 to 2019

2021 ◽  
Author(s):  
Aaron Richterman ◽  
Harsha Thirumurthy
Keyword(s):  
Fixed Effects ◽  
Intervention Group ◽  
Cash Transfer ◽  
Lower Probability ◽  
Middle Income ◽  
Individual Level ◽  
Transfer Programs ◽  
Middle Income Countries ◽  
Hiv Test ◽  
Low And Middle Income

Background Many low- and middle-income countries have introduced cash transfer programs as part of their poverty reduction and social protection strategies. These programs have the potential to overcome various drivers of HIV risk behaviors and usage of HIV services, but their overall effects on a broad range of HIV-related outcomes remains unknown. Methods We used publicly reported data to determine whether low- and middle-income countries with HIV prevalence >1% and baseline annual incidence >1/1000 had conditional or unconditional cash transfer programs that covered >5% of the impoverished population, and the year in which those programs began and ended. We obtained country- and individual-level data on HIV-related outcomes from UNAIDS and population-representative household surveys, focusing on the period between 1996 and 2019. We conducted difference-in-differences analyses with country and year fixed effects to evaluate the effects of cash transfer programs on country- and individual-level HIV-related outcomes. Findings Forty-two countries across three continents were included. Among these, 21 were in the intervention group, having implemented cash program(s) with impoverished population coverage greater than 5% during the study period. Cash transfer programs were associated with lower probability of reporting sexually transmitted infection within the last 12 months among females (odds ratio [OR] 0.67, 95% confidence interval [CI] 0.50-0.91) and higher probability of an HIV test within the last 12 months among females (OR 2.61, 95% CI 1.15-5.88) and males (OR 3.19, 95% CI 2.45-4.15). For country-level outcomes, cash transfer programs were associated with a reduction in new HIV infections (incidence rate ratio [IRR] 0.94, 95% CI 0.89-0.99), but not with the proportion of people with HIV receiving antiretroviral therapy (5.0%, 95% CI -0.2-10.1) or AIDS-related deaths (IRR 0.99, 95% CI 0.95-1.03), though temporal analyses showed delayed improvements in both antiretroviral coverage and deaths. Interpretations Cash transfer programs, which are being expanded in the context of the COVID-19 pandemic, have the potential to promote ongoing efforts to end HIV as a public health threat. Alongside the already existing focus on expanding biomedical services, these anti-poverty programs can play a greater role in achieving global targets for HIV prevention and treatment. Funding None

scholarly journals Using pictorial action instructions to build a basic humanitarian engineering project

2019 ◽  
Vol 14 (1) ◽  
pp. 60-70
Author(s):  
Kathleen Paco Cadman ◽  
Du Feng
Keyword(s):  
Self Efficacy ◽  
Intervention Group ◽  
Control Group ◽  
Low Literacy ◽  
Engineering Project ◽  
Middle Income ◽  
Middle Income Countries ◽  
Humanitarian Engineering ◽  
Engineering Projects ◽  
Low And Middle Income

Humanitarian engineering projects mitigate environmental hazards disproportionately affecting health in low- and middle-income countries. However, widespread literacy deficits can create barriers in training low-literacy adults to construct these projects, indicating a need for literacy-adapted training materials. A randomized control trial in rural Guatemala tested the usability of pictorial action instructions, compared to demonstration-only methods, in training low-literacy adults (N = 60; n = 30 per group) to construct a solar bottle bulb. Fourteen days after the training, participants individually constructed the solar bottle bulb. The intervention group received pictorial action instructions to guide them, and the control group completed construction based on memory. Usability was evaluated by measuring the effectiveness and efficiency of construction, as well as user satisfaction and self-efficacy levels. Effectiveness and self-efficacy were significantly better among those in the intervention group compared to the control group. Considering this, the findings support the use of pictorial action instructions in training low-literacy adults to construct humanitarian engineering projects. This method may allow more individuals in rural regions of low- and middle-income countries to successfully construct their own humanitarian engineering projects in a way that is sustainable and scalable. Further research is needed to test these instructions in different settings, on a larger scale, as well as to test the long-term effects of using pictorial action instructions. 

The Impact of Cash Transfers: A Review of the Evidence from Low- and Middle-income Countries

2018 ◽  
Vol 48 (03) ◽  
pp. 569-594 ◽  
Author(s):  
FRANCESCA BASTAGLI ◽  
JESSICA HAGEN-ZANKER ◽  
LUKE HARMAN ◽  
VALENTINA BARCA ◽  
GEORGINA STURGE ◽  
...  
Keyword(s):  
Evidence Base ◽  
Cash Transfers ◽  
Cash Transfer ◽  
Future Research ◽  
Unintended Effects ◽  
Screening Process ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Impact ◽  
Low And Middle Income

AbstractThis article presents the findings of a review of the impact of non-contributory cash transfers on individuals and households in low- and middle-income countries, covering the literature of 15 years, from 2000 to 2015. Based on evidence extracted from 165 studies, retrieved through a systematic search and screening process, this article discusses the impact of cash transfers on 35 indicators covering six outcome areas: monetary poverty; education; health and nutrition; savings, investment and production; work; and empowerment. For most of the studies, cash transfers contributed to progress in the selected indicators in the direction intended by policymakers. Despite variations in the size and strength of the underlying evidence base by outcome and indicator, this finding is consistent across all outcome areas. The article also investigates unintended effects of cash transfer receipt, such as potential reductions in adult work effort and increased fertility, finding limited evidence for such unintended effects. Finally, the article highlights gaps in the evidence base and areas which would benefit from additional future research.

scholarly journals Systematic review of the costs and effectiveness of interventions to increase infant vaccination coverage in low- and middle-income countries

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cristina Munk ◽  
Allison Portnoy ◽  
Christian Suharlim ◽  
Emma Clarke-Deelder ◽  
Logan Brenzel ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Scale Up ◽  
Immunization Coverage ◽  
Health Systems Strengthening ◽  
Cash Transfer ◽  
Immunization Programs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Objective Evidence ◽  
Low And Middle Income

Abstract Background In recent years, several large studies have assessed the costs of national infant immunization programs, and the results of these studies are used to support planning and budgeting in low- and middle-income countries. However, few studies have addressed the costs and cost-effectiveness of interventions to improve immunization coverage, despite this being a major focus of policy attention. Without this information, countries and international stakeholders have little objective evidence on the efficiency of competing interventions for improving coverage. Methods We conducted a systematic literature review on the costs and cost-effectiveness of interventions to improve immunization coverage in low- and middle-income countries, including both published and unpublished reports. We evaluated the quality of included studies and extracted data on costs and incremental coverage. Where possible, we calculated incremental cost-effectiveness ratios (ICERs) to describe the efficiency of each intervention in increasing coverage. Results A total of 14 out of 41 full text articles reviewed met criteria for inclusion in the final review. Interventions for increasing immunization coverage included demand generation, modified delivery approaches, cash transfer programs, health systems strengthening, and novel technology usage. We observed substantial heterogeneity in costing methods and incompleteness of cost and coverage reporting. Most studies reported increases in coverage following the interventions, with coverage increasing by an average of 23 percentage points post-intervention across studies. ICERs ranged from $0.66 to $161.95 per child vaccinated in 2017 USD. We did not conduct a meta-analysis given the small number of estimates and variety of interventions included. Conclusions There is little quantitative evidence on the costs and cost-effectiveness of interventions for improving immunization coverage, despite this being a major objective for national immunization programs. Efforts to improve the level of costing evidence—such as by integrating cost analysis within implementation studies and trials of immunization scale up—could allow programs to better allocate resources for coverage improvement. Greater adoption of standardized cost reporting methods would also enable the synthesis and use of cost data.

scholarly journals Infant Mortality in Low- and Middle-income Countries: Does Government Health Spending Matter?

2020 ◽  
Vol 5 (1) ◽  
pp. 54-73
Author(s):  
Micheal Kofi Boachie ◽  
Tatjana Põlajeva ◽  
Albert Opoku Frimpong
Keyword(s):  
Infant Mortality ◽  
Health Outcomes ◽  
Health Expenditure ◽  
Fixed Effects ◽  
Health Sector ◽  
Health Spending ◽  
Middle Income ◽  
Government Health ◽  
Middle Income Countries ◽  
Low And Middle Income

The issue of whether government health spending improves health outcomes has been a matter of contention over the years. There have been calls for governments to reduce their financing role in the health sector since such funding do not produce better health. This article examines the effect of public (i.e., government) health expenditure on infant mortality, a proxy of health outcomes, in low- and middle-income countries. We use data from the World Bank’s World Development Indicators database and employ fixed effects estimation technique, with three-stage least squares as a robustness check. The data cover the period 1995–2014. We find that public health expenditure improves health outcomes significantly, as it reduces infant mortality. The results further show that rising income and access to safe water are some of the reasons for improved health outcomes in low- and middle-income countries. Based on these results and the expected redistributive impact of government spending, governments in low- and middle-income countries may consider increasing health spending for better healthcare systems and improved health.

scholarly journals Assessing mortality registration in Kerala: the MARANAM study

Genus ◽  
2022 ◽  
Vol 78 (1) ◽  
Author(s):  
Aashish Gupta ◽  
Sneha Sarah Mani
Keyword(s):  
Vital Statistics ◽  
Middle Income ◽  
Registration System ◽  
Individual Level ◽  
Civil Registration ◽  
Middle Income Countries ◽  
Registration Data ◽  
Life Expectancy At Birth ◽  
Sample Registration System ◽  
Low And Middle Income

AbstractComplete or improving civil registration systems in sub-national areas in low- and middle-income countries provide several opportunities to better understand population health and its determinants. In this article, we provide an assessment of vital statistics in Kerala, India. Kerala is home to more than 33 million people and is a comparatively low-mortality context. We use individual-level vital registration data on more than 2.8 million deaths between 2006 and 2017 from the Kerala MARANAM (Mortality and Registration Assessment and Monitoring) Study. Comparing age-specific mortality rates from the Civil Registration System (CRS) to those from the Sample Registration System (SRS), we do not find evidence that the CRS underestimates mortality. Instead, CRS rates are smoother across ages and less variable across periods. In particular, the CRS records higher death rates than the SRS for ages, where mortality is usually low and for women. Using these data, we provide the first set of annual sex-specific life tables for any state in India. We find that life expectancy at birth was 77.9 years for women in 2017 and 71.4 years for men. Although Kerala is unique in many ways, our findings strengthen the case for more careful attention to mortality records within low- and middle-income countries, and for their better dissemination by government agencies.

scholarly journals Exposure to landscape fire smoke extremely reduced birthweight in low- and middle-income countries

2021 ◽  
Author(s):  
jiajianghui li ◽  
Tianjia Guan ◽  
Qian Guo ◽  
Guannan Geng ◽  
Huiyu Wang ◽  
...  
Keyword(s):  
Fixed Effects ◽  
Low Birthweight ◽  
Fine Particulate Matter ◽  
Binary Outcomes ◽  
Middle Income ◽  
Middle Income Countries ◽  
Gestational Exposure ◽  
Fire Smoke ◽  
Fixed Effects Regression ◽  
Low And Middle Income

Landscape fire smoke (LFS) has been associated with reduced birthweight, but evidence from low and middle income countries (LMICs) is rare. Here, we present a sibling matched case control study of 227,948 newborns to identify an association between fire sourced fine particulate matter (PM2.5) and birthweight in 54 LMICs from 2000 to 2014. We selected mothers from the geocoded Demographic and Health Survey with at least two children and valid birthweight records. Newborns affiliated with the same mother were defined as a family group. Gestational exposure to LFS was assessed in each newborn using the concentration of fire sourced PM2.5. We determined the associations of the within group variations in LFS exposure with birthweight differences between matched siblings using a fixed effects regression model. Additionally, we analyzed the binary outcomes of low birthweight (LBW) or very low birthweight (VLBW). According to fully adjusted models, a 1 ug/m3 increase in the concentration of fire sourced PM2.5 was significantly associated with a 2.17 g (95% confidence interval [CI]: 0.56, 3.77) reduction in birthweight, a 2.80% (95% CI: 0.97, 4.66) increase in LBW risk, and an 11.68% (95% CI: 3.59, 20.40) increase in VLBW risk. Our findings indicate that gestational exposure to LFS harms maternal health.

scholarly journals Does government expenditure reduce inequalities in infant mortality rates in low- and middle-income countries?: A time-series, ecological analysis of 48 countries from 1993 to 2013

2018 ◽  
Vol 14 (2) ◽  
pp. 249-273 ◽  
Author(s):  
Peter Baker ◽  
Thomas Hone ◽  
Aaron Reeves ◽  
Mauricio Avendano ◽  
Christopher Millett
Keyword(s):  
Infant Mortality ◽  
Health Expenditure ◽  
Fixed Effects ◽  
Government Expenditure ◽  
Health Expenditures ◽  
Mortality Rates ◽  
Demographic And Health Surveys ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractInequalities in infant mortality rates (IMRs) are rising in some low- and middle-income countries (LMICs) and decreasing in others, but the explanation for these divergent trends is unclear. We investigate whether government expenditures and redistribution are associated with reductions in inequalities in IMRs. We estimated country-level fixed-effects panel regressions for 48 LMICs (142 country observations). Slope and Relative Indices of Inequality in IMRs (SII and RII) were calculated from Demographic and Health Surveys between 1993 and 2013. RII and SII were regressed on government expenditure (total, health and non-health) and redistribution, controlling for gross domestic product (GDP), private health expenditures, a democracy indicator, country fixed effects and time. Mean SII and RII was 39.12 and 0.69, respectively. In multivariate models, a 1 percentage point increase in total government expenditure (% of GDP) was associated with a decrease in SII of −2.468 [95% confidence intervals (CIs): −4.190, −0.746] and RII of −0.026 (95% CIs: −0.048, −0.004). Lower inequalities were associated with higher non-health government expenditure, but not higher government health expenditure. Associations with inequalities were non-significant for GDP, government redistribution, and private health expenditure. Understanding how non-health government expenditure reduces inequalities in IMR, and why health expenditures may not, will accelerate progress towards the Sustainable Development Goals.

scholarly journals Effects of Pantawid Pamilyang Pilipino Program (4Ps) and other Conditional Cash Transfer (CCT) Programs of Low and Middle – Income Countries on Human Development

2021 ◽  
Vol 2 (1) ◽  
pp. 2-11
Author(s):  
Ronald Diaz
Keyword(s):  
Human Development ◽  
Human Development Index ◽  
Conditional Cash Transfer ◽  
The Philippines ◽  
Cash Transfer ◽  
Transfer Program ◽  
Middle Income ◽  
Development Index ◽  
Middle Income Countries ◽  
Low And Middle Income

Despite the economic growth experienced by the Philippines in the recent years in terms of high GDP, poverty in the country still prevails. Prevalence of many poor families and individuals in the country prompted the Philippine government to implement the Pantawid Pamilyang Pilipino Program (Bridging Program for the Filipino Family) also known as 4Ps, the country’s conditional cash transfer (CCT) program that aims to provide conditional cash grants to the poorest of the poor. This paper aims to examine the effect of 4Ps on the country’s Human Development Index (HDI). It also seeks to find out if conditional cash transfer program provides significant effect on the HDIs of low and middle-income countries worldwide. The mean Human Development Index (HDI) of the Philippines before and throughout the implementation of 4Ps was compared. The difference between the HDIs of selected countries (low and middle-income) implementing and non-implementing the conditional cash transfer programs was determined. The findings of this study show that the Philippines has a significantly higher mean HDI during the implementation of 4Ps since 2008 to 2018 compared to its years when there was no 4Ps. The results further indicate that low and middle–income countries with CCT programs have significantly higher HDIs in comparison to their counterparts. A thorough evaluation of the CCT programs in terms of issues such as dependency and reviewing the conditionalities of the program to provide more significant and promising effect on HDI needs to be undertaken. Keywords: Pantawid Pamilyang Pilipino Program (4Ps), conditional cash transfer (CCT), Human Development Index (HDI)  

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