scholarly journals The Experience of Self-Employment Among Young People: An Exploratory Analysis of 28 Low- to Middle-Income Countries

2018 ◽  
Vol 63 (2) ◽  
pp. 147-165 ◽  
Author(s):  
Brendan J. Burchell ◽  
Adam P. Coutts
2021 ◽  
Author(s):  
Catherine Porter ◽  
Annina Hittmeyer ◽  
Marta Favara ◽  
Douglas Scott ◽  
Alan Sánchez

Background Though COVID-19 presents less risk to young people of serious morbidity or mortality, the resulting economic crisis has impacted their livelihoods. There is relatively little evidence on young people's mental health in Low-and-Middle-Income-Countries (LMICs) as the pandemic has progressed. Methods Two consecutive phone-surveys (August/October and November/December 2020) in Ethiopia, India, Peru and Vietnam interviewed around 9,000 participants of a 20-year cohort study who grew up in poverty (now aged 19 and 26). We investigate how young people's mental health has evolved in the four countries during the pandemic. Rates of (at least mild) anxiety (depression) measured by GAD-7 (PHQ-8) were compared across countries; between males/females, and food secure/food insecure households. Results Overall, rates of at least mild anxiety (depression) significantly decreased in all countries but Ethiopia as infection rates fell. However, young people in food insecure households report high rates of anxiety and depression and have not shown consistent improvements. Food insecure households are poorer, and have significantly more children (p<0.05) except in Ethiopia. Conclusions Food insecurity has increased during the COVID-19 pandemic and is negatively associated with young people's mental health. Urgent support is needed for the most vulnerable. Keywords COVID-19, mental health, anxiety, depression, food insecurity, youth


2020 ◽  
Vol 11 (1) ◽  
pp. 91-110
Author(s):  
Panos Vostanis ◽  
Sadiyya Haffejee ◽  
Hikmet Yazici ◽  
Sajida Hussein ◽  
Munevver Ozdemir ◽  
...  

The concept of resilience is increasingly influential in the development of interventions and services for young people, yet there is limited knowledge of how resilience-building strategies are conceptualized by young people across different cultures, particularly in low- and middle-income countries. The aim of this study was to capture 274 young people’s voices in disadvantaged communities in Kenya, Turkey, Pakistan, and Brazil through participatory research methods. Young people defined strategies in response to 4 adversity scenarios reflecting socioecological systems (young person, family, school, and community). Template analysis, underpinned by thematic design, was used to establish three broad themes of intrapersonal (self-management, cognitive re-appraisal, agency), interpersonal (social engagement, informal supports, formal supports), and religious resources. Proposed strategies were largely similar across the sites, with some contextual differences depending on the scenario (stressor) and cultural group. The findings support an ecological systems approach to resilience, which is consistent with the development of multimodal interventions for vulnerable youth and their families in disadvantaged communities in low- and middle-income countries.


2021 ◽  
Author(s):  
Mariano Bosch ◽  
Stephanie González ◽  
María Teresa Silva Porto

Evasion of labor market regulations in middle income countries is systemic. This is generally known as informality. In Latin America, where less than 50% of workers are registered with social security, this is a permanent phenomenon and encompasses a variety of economic realities ranging from subsistence self-employment to evasion of certain regulations including social security contributions. In this study we analyze the role of enforcement in curbing informality in large formal firms in Peru, where informality levels are around 70%. Through the Peruvian National Labor Control Superintendence (SUNAFIL) we randomly sent 697 letters to formal Peruvian firms of more than 50 workers, indicating their obligation to enroll workers in social insurance systems (health and pensions). Two types of letters were sent, one with a deterrence message and one emphasizing the benefits of formalization. One year after the letters were sent, we found a positive and statistically significant effect on the number of workers enrolled in social security (9.8% on average). Only strict deterrence messages had a significant impact, and only in very large firms. This evidence suggests that there is room for improvement in compliance with labor regulations through more proactive monitoring and behavioral tools such as reminders, but effects could be concentrated in the largest firms.


10.2196/15914 ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e15914
Author(s):  
Laura Ospina-Pinillos ◽  
Tracey A Davenport ◽  
Alvaro Andres Navarro-Mancilla ◽  
Vanessa Wan Sze Cheng ◽  
Andrés Camilo Cardozo Alarcón ◽  
...  

Background Health information technologies (HITs) hold enormous promise for improving access to and providing better quality of mental health care. However, despite the spread of such technologies in high-income countries, these technologies have not yet been commonly adopted in low- and middle-income countries. People living in these parts of the world are at risk of experiencing physical, technological, and social health inequalities. A possible solution is to utilize the currently available HITs developed in other counties. Objective Using participatory design methodologies with Colombian end users (young people, their supportive others, and health professionals), this study aimed to conduct co-design workshops to culturally adapt a Web-based Mental Health eClinic (MHeC) for young people, perform one-on-one user-testing sessions to evaluate an alpha prototype of a Spanish version of the MHeC and adapt it to the Colombian context, and inform the development of a skeletal framework and alpha prototype for a Colombian version of the MHeC (MHeC-C). Methods This study involved the utilization of a research and development (R&D) cycle including 4 iterative phases: co-design workshops; knowledge translation; tailoring to language, culture, and place (or context); and one-on-one user-testing sessions. Results A total of 2 co-design workshops were held with 18 users—young people (n=7) and health professionals (n=11). Moreover, 10 users participated in one-on-one user-testing sessions—young people (n=5), supportive others (n=2), and health professionals (n=3). A total of 204 source documents were collected and 605 annotations were coded. A thematic analysis resulted in 6 themes (ie, opinions about the MHeC-C, Colombian context, functionality, content, user interface, and technology platforms). Participants liked the idea of having an MHeC designed and adapted for Colombian young people, and its 5 key elements were acceptable in this context (home page and triage system, self-report assessment, dashboard of results, booking and video-visit system, and personalized well-being plan). However, to be relevant in Colombia, participants stressed the need to develop additional functionality (eg, phone network backup; chat; geolocation; and integration with electronic medical records, apps, or electronic tools) as well as an adaptation of the self-report assessment. Importantly, the latter not only included language but also culture and context. Conclusions The application of an R&D cycle that also included processes for adaptation to Colombia (language, culture, and context) resulted in the development of an evidence-based, language-appropriate, culturally sensitive, and context-adapted HIT that is relevant, applicable, engaging, and usable in both the short and long term. The resultant R&D cycle allowed for the adaptation of an already available HIT (ie, MHeC) to the MHeC-C—a low-cost and scalable technology solution for low- and middle-income countries like Colombia, which has the potential to provide young people with accessible, available, affordable, and integrated mental health care at the right time.


10.2196/25847 ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. e25847
Author(s):  
Susanna Lehtimaki ◽  
Jana Martic ◽  
Brian Wahl ◽  
Katherine T Foster ◽  
Nina Schwalbe

Background An estimated 1 in 5 adolescents experience a mental health disorder each year; yet because of barriers to accessing and seeking care, most remain undiagnosed and untreated. Furthermore, the early emergence of psychopathology contributes to a lifelong course of challenges across a broad set of functional domains, so addressing this early in the life course is essential. With increasing digital connectivity, including in low- and middle-income countries, digital health technologies are considered promising for addressing mental health among adolescents and young people. In recent years, a growing number of digital health interventions, including more than 2 million web-based mental health apps, have been developed to address a range of mental health issues. Objective This review aims to synthesize the current evidence on digital health interventions targeting adolescents and young people with mental health conditions, aged between 10-24 years, with a focus on effectiveness, cost-effectiveness, and generalizability to low-resource settings (eg, low- and middle-income countries). Methods We searched MEDLINE, PubMed, PsycINFO, and Cochrane databases between January 2010 and June 2020 for systematic reviews and meta-analyses on digital mental health interventions targeting adolescents and young people aged between 10-24 years. Two authors independently screened the studies, extracted data, and assessed the quality of the reviews. Results In this systematic overview, we included 18 systematic reviews and meta-analyses. We found evidence on the effectiveness of computerized cognitive behavioral therapy on anxiety and depression, whereas the effectiveness of other digital mental health interventions remains inconclusive. Interventions with an in-person element with a professional, peer, or parent were associated with greater effectiveness, adherence, and lower dropout than fully automatized or self-administered interventions. Despite the proposed utility of digital interventions for increasing accessibility of treatment across settings, no study has reported sample-specific metrics of social context (eg, socioeconomic background) or focused on low-resource settings. Conclusions Although digital interventions for mental health can be effective for both supplementing and supplanting traditional mental health treatment, only a small proportion of existing digital platforms are evidence based. Furthermore, their cost-effectiveness and effectiveness, including in low- and middle-income countries, have been understudied. Widespread adoption and scale-up of digital mental health interventions, especially in settings with limited resources for health, will require more rigorous and consistent demonstrations of effectiveness and cost-effectiveness vis-à-vis the type of service provided, target population, and the current standard of care.


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