Primary health care coverage in Brazil: a dataset from 1998 to 2020.

OBJECTIVES: Primary health care builds the backbone of an effective healthcare system and can improve population health, reduce cost growth, and lessen inequality. We offer a machine-readable and open-access dataset on primary health care coverage in Brazil from 1998 to 2020. This dataset is interoperable with epidemiological data from two major studies and reusable by the research community worldwide for other purposes, such as monitoring progress toward universal health coverage and studying the association between primary health care and health outcomes. DATA DESCRIPTION: The dataset gathers official and public information from the "e-Gestor AB" platform of the Ministry of Health of Brazil and restricted data obtained by the Brazilian Access to Information Law. It includes 1,509,870 observations and 35 attributes aggregated by months/years and policy-relevant geographic units (country, macroregions, states, municipalities, and capitals) on primary health care team count and their absolute and relative population coverage estimates, information on the More Doctors Program implementation and physician counts, and spatial, demographic, and socioeconomic characteristics. We automated all data processing and curation in the free and open software R. The codes can be audited, replicated, and reused to produce alternative analyses.

Self-selection and intermunicipal migration in Canada.

"This paper investigates individual intermunicipal migration behaviour in Canada within the context of a human capital model that adjusts for the migrant's selectivity in computing expected income gains. In addition to the typical regional determinants of migration, housing and labour market characteristics are found to influence intermunicipal migration significantly, the effects differing with age. Structural coefficients remained more or less stable during the decade 1971-1981. It is shown that the failure to adjust income gains for selectivity bias results in an underestimation of the migration-impacts of income gains and municipal-specific factors."

The underemployment of American rural women: prevalence, trends and spatial inequality.

PIP: The growing numerical significance of women in the US nonmetropolitan labor force has not been matched by parallel efforts to document the changing quality of their employment. In this paper. Lichter uses the labor utilization framework of Clogg and Sullivan to examine the prevalence and spatial convergence of various forms of female underemployment during 1970-1985. Data from the March annual demographic files of the Current Population Survey reveal that underemployment has been a significant aspect of the employment experiences of nonmetropolitan women during this period. There has been little evidence of spatial or sex convergence in labor market outcomes. Roughly 1 of every 3 rural female workers today is a discouraged worker, jobless, employed part-time involuntarily, or working for poverty-level wages. Moreover, rural women continue to suffer substantially higher levels of economic underemployment than urban women and rural men. This study reinforces the view that rural women remain a seriously underutilized labor resource in the US.^ieng

Anganwadi worker's participation in rural newborn care.

Anganwadi worker was involved in rural newborn care as a link between a dai and a health worker. She was trained to ensure that, (i) borderline LBW/preterm baby was kept warm at home and (ii) a very small baby was referred to hospital. The training was conducted during routine monthly meetings and cost of equipping each anganwadi worked out to be Rs 110. Newborn survival, infant survivals and overall MCH performance improved. Thus, newborn care formed an ideal entry point into MCH activities.

PIP: The Rural Neonatal Care Program was initiated in January 1988 in Ganjad Primary Health Center, Dahanu, India, with the training of dais in care of the newborn. Later in the year training was conducted for anganwadi workers, who would follow-up newborn care until the child was 6 years of age. The anganwadi worker was a link between the dai and health worker and the health center. Home visits were made on the day of birth. The infant was measured and an health assessment made. If the infant was preterm or low birth weight and with a foot length of between 6.5 and 7 cm, repeat home visits were made to assess the breast feeding progress, the infant activity level, and general signs of health, as reflected in warm and pink feet. Training was conducted at monthly meetings at the block level, at the primary health care level, and during field visits to show how to care for hypothermic babies. A training manual and record book were developed and used. Footprints were made, and referrals were made to the hospital for those with feet under 6.5 to 7 cm. General observations were that birth registration improved, and infants were more easily identified for immunization. Newborn referral improved, and infant mortality declined. There was an important role for the anganwadi worker in providing continuity of care, identification of referrals, and training in the home for how to keep a baby warm. The number of referrals averaged 1-2 per month and 1-2 with special home attention. The training of the anganwadi worker in newborn care was included in the normal course of training and cost about Rs. 110 per worker.

Primary school teacher as a primary health care worker.

School children (1608) were examined for three items (nails, scalp hairs and teeth) relating to personal hygiene and relevant infective conditions from two sets of villages i.e. one set where primary school teacher was working as primary health care worker (Group I) and the other set where Community Health Volunteer (CHV) was delivering primary health care (Group II). The objective was to evaluate the efficiency of school teachers' role vis-a-vis CHVs' in imparting health education to school children. Out of 1608 school children, 801 belonged to Group I villages and the remaining 807 to Group II villages. From the results, it was evident that children of Group I villages were better with respect to all the items related to personal hygiene and infective conditions excepting scalp infections, where difference was not statistically significant, indicating teachers' superiority over the CHVs' in imparting health education to school children.

Population pressure, intensification of agriculture, and rural-urban migration.

"In this paper I provide an analytical basis for why labor absorption [in agriculture] may improve with higher population density. My argument is in two parts. First, analysing agriculture in isolation, I use the Boserup insight to show that higher population density is associated with more intensive techniques of land use. Second, using a two-sector model, I show that the rate of labor absorption (defined as the rate of natural population growth minus the rate of rural-urban migration) increases with the intensity of land use." Cross-sectional data for Iran are used to illustrate the model.

PIP: This paper considers the Malthusian implication that population density leads to the inability of agriculture to absorb labor. The argument is presented that higher population density is associated with more intensive techniques of land use, based on the Boserup model, and that the rate of labor absorption (natural population growth minus the rate of rural-to-urban migration) increases with the intensity of land use. The model reveals that the availability of jobs in urban areas slows agricultural intensification and increases migration. The Asian model is different in that urbanization and intensification occur simultaneously. The model is empirically tested with Iranian data. Results indicate negative signs for the intensity coefficients (irrigation ratio and cropping intensity), which means a negative influence on rural out-migration. Population density has a positive coefficient. The effect of the percentage of land tilled by tractors is positive, while the number of diesel pumps in operation reduces out-migration. The contrasting results of Annable, Bilsborrow, and Winegarden are considered plausible, since an intensification factor is not included and population density is picking up the negative effect of the intensity of cultivation. High rates of out-migration from low population density areas usually are explained by the poor natural resources available. It is argued that poor soil quality is related to cultivation intensity, and thus, soil fertility is exogenous. The results are intended not as a definitive proof of the direct effect of population density on agricultural employment, but as an alternative explanation for out-migration from low density areas. Population increases clearly cause declines in wages in the proposed model and may not lead to intensification but to out-migration. Increases in agricultural prices or lowering the cost of inputs can promote intensification. Population density will always reduce the potential of a region to absorb population. Government has the ability to influence public investment in agriculture and trading through its regulations, which can speed up intensification and the capacity to provide agricultural employment. Government can also indirectly encourage out-migration through the promotion of attractive urban labor markets.

Utilising dais to impart health and nutrition education: impact on growth.

PIP: To evaluate the effectiveness of using local dais to provide health and nutrition education to mothers, the weights of infants in an intervention area in the Uttar Pradesh district of Saharanpur were compared to those of infants in a nonintervention control group in the same district. The average weights of infants in the area where trained dais were utilized were significantly higher than those in the nonintervention area in the age groups 4-6 months and 7-9 months; mean weights did not differ significantly in the 0-3 month age group or at 9-12 months. Deviations in relation to age were least at 3 months. Overall, the intervention program was effective in bringing weights closer to all-India standards. Favorable changes were noted in the intervention area in terms of supplementary feedings, use of katori in milk feeding, and the lower incidence of infantile diarrhea. The mean weights of infants in this study were less than 80% of the 50th percentile of Harvard standards, suggesting widespread malnutrition in this area of India. It is hypothesized that after 9 months of age, the more effective functioning of health services, including broader immunization coverage, in the nonintervention area overrode the advantages conveyed by the dais' health education efforts in the study area.^ieng

Management of childhood illness in Africa. Early evaluations show promising results.

PIP: This article reports the positive evaluation results of the integrated management of childhood illness (IMCI) strategy for the last 3 years of operation in 28 countries in Africa. The strategy aimed to improve case management skills of health workers through training with locally adapted guidelines such as the use of clinical algorithms to detect the most common causes of childhood illnesses. In addition, the strategy was designed to improve the health system of the region, including the provision of essential drugs. A final component of the program seeks to optimize family and community practices in relation to child health, particularly care seeking behavior. Overall, the benefits include more rational drug use, increased attendance, improved provider morale, and improved perceptions of quality of care by mothers. Although its initial effects are rather small, it should be recognized that the proper implementation of IMCI should contribute to a steady reduction in childhood mortality in Africa.^ieng

Integrated health programmes.

PIP: Over a period of 10 years, a hospital in rural Africa slowly built an integrated primary and secondary health care program to the point where it has more than 40 elements. In its initial stage (1982-84), hospital staff and community participants were trained, the number of mobile clinics was increased, community participation was sought, and health education was emphasized. During 1985-86, 92 village health committees were organized with 70 trained Village Health Workers (VHWs). This led to a rapid increase in vaccination rates, the use of oral rehydration therapy, and training of traditional birth attendants. In 1987-88, 14 VHW were trained to use basic medical kits and distribute medicines. By 1990, 18,000 of the 72,000 outpatient treatments were administered by VHWs. In 1987, the hospital made a community diagnosis and increased the size of its advisory board (which became 60% female). Because the community identified food, water, and poverty as its priorities, the hospital took steps to improve the food supply, the water supply, and the financial position of the women. In 1989-90, the primary health care (PHC) project added the components of family planning, a weaning food production unit, food coupons, food for work, grain banks, a trust fund, literacy classes, health stamps, a mobile malnutrition clinic, subsidized fertilizer and seed, low-cost care for victims of AIDS, new malaria treatment schedules, and a housing association. The PHC program has resulted in a reduction in under-five deaths from the national average of 330/1000 to 145/1000 (other areas have reduced deaths to 270-300/1000. The program is also becoming increasingly cost-effective, costing about 6 pounds per capita over 10 years for a population of 50,000. Country-wide implementation of the PHC program would require only 30% of the present health budget.^ieng

Immigration from poor to wealthy countries: experience of the United States.

PIP: The U.S. experience with immigration from poor countries is examined using the results of two projects carried out by the National Bureau of Economic Research. Questions considered include what determines the supply of immigrants, how such immigrants fare in the U.S. job market, and how this immigration affects the prospects of native-born workers.^ieng

Gendered histories: garment production and migration in Mexico.

Data gathered in Aguascalientes during the 1990s are used to analyze how the garment industry in Mexico has responded to economic recession and trade liberalization. In particular, the relationship between industrial change and gendered patterns of migration are explored. The author concludes that "migration over recent years has increasingly allowed working women the possibility of entering a transnational labour force and given them important labouring and living experiences on both sides of the border."

Income, self-selection, and return and onward interprovincial migration in Canada.

"Estimated returns to migration based on comparison of individual migrants may be biased owing to self-selection in the migration process. Using data derived from the 1986 Canadian census, I will study the effects of expected wage differentials in determining the return or onward migration decision of nonnative adults aged 20 to 64 years. Evidence was found that return migrations were in the 'right' direction, as they are observed to respond to provincial economic variables (that is, average employment growth and income levels) in a rational manner. After accounting for self-selectivity, I found that...return migrants...are negatively selected, and experience lower income levels, following the return migration, than onward migrants would have, had they chosen the return migration option. This drop in expected wages decreases the propensity associated with making a return migration. Despite this drop in income, the large proportion selecting the return migration option suggests the importance of the province of birth in the mental map of nonnative migrants."

Re-thinking skilled international labour migration: world cities and banking organisations.

"Highly skilled professional and managerial labour migration has become an important facet of the contemporary world economy. The operations of transnational corporations have created more opportunities for skilled migrants to work abroad.... There is a growing interest amongst economic geographers to examine this form of migration through an appreciation of global economic restructuring, labour market change and world cities. Consequently, this paper introduces a new conceptual framework...[which] is based on the rationale that world cities, and the patterns of labour market demand that exist within them, are of paramount importance in influencing highly skilled professional and managerial labour migration within the world economy. The author uses an example of highly skilled labour migration within the transnational banking sector [in London] to illustrate this new conceptual framework."

Dual citizenship and political integration.

PIP: On the premise that representative government cannot properly function without the political participation of a large active segment of its constituents represented by permanent immigrants without citizenship, this article 1) reviews some attempts to resolve such an anomalous situation; 2) suggests naturalization as an instrument to correct it and describes the naturalization rate and the reasons for the low propensity for naturalization in various North European countries; 3) surveys the phenomenon of dual citizenship, the reasons for its increase as well as its increase as well as its inconveniences and advantages; and 4) hypothesizes that future increases in dual citizenship will protect political integration. Labor immigration will probably not be encouraged again, as it was some 20 years ago, but large international migration will take place both within Europe and to Europe from other continents. There are many indications that in the future many more Europeans will possess dual or multiple nationality, and this, in combination with more weight on a person's effective residence, will promote political integration of those large groups of immigrants and their descendants, who now stand outside the political systems without proper representation.^ieng

Income redistribution and migration.

"This paper analyses redistribution policies that transfer income between owners of immobile factors of production and workers in a given region. The menu of income distribution possibilities attainable through tax/transfer policy in the presence of labour mobility is characterized. Simple general equilibrium analysis shows that migration can lead to Pareto-inferior outcomes in the destination region if immigrants are the beneficiaries of redistributive transfers. All residents of the destination region may gain, however, if transfer payments are also paid to workers in the source region so as to reduce the level of immigration." (SUMMARY IN FRE)

Returning migrant characteristics and labor market demand in Greece.

Immigrants who repatriate bring with them modern work skills which many observers in labor exporting regions describe as a great contribution to the mother country. Using data from 2 samples of Greek repatriates as well as projections of industrial labor force demands in Greece for the 1980s, this article challenges this concept. The authors find that the uneven regional development and stunted industrial growth which pushed these workers abroad are also responsible for the narrowly limited employment options which they face once they repatriate. For the urban repatriate, the market is limited to unemployment, the urban informal sector and scattered jobs, while for the rural repatriate, small-scale agriculture, multiple job holdings and unemployment are the only viable options.

Job displacement effects of Canadian immigrants by country of origin and occupation.

"Some previous Canadian studies have shown that considering the labor market as a whole and also pooling all immigrants as a group, immigrants do not have any job displacement effects on the Canadian born. This study presents some new evidence. It disaggregates immigrants by country of origin and by occupation groups and provides an analysis of job displacement effects of immigrants on the native-born Canadians by these dimensions. The study finds that (1) U.S. immigrants and the Canadians are substitutes [for] competing groups in the labor market and the effect is quite significant; (2) Canadians and Europeans are competing groups in certain occupations, while they have complementary skills in others; and (3) immigrants from the Third World and the Canadians are slightly competing groups in certain occupations."

"No TEBA...forget TEBA": the plight of Malawian ex-migrant workers to South Africa, 1988-1994.

"This article is about the process of socioeconomic transformation in rural Malawi. It examines the survival strategies and enterprising spirit of Malawian migrant workers and their households. It argues that the strategies of these people often went beyond survival in the provision of basic necessities.... In March 1988, the South African Chamber of Mines stopped a century-old tradition of recruiting migrant workers from Malawi. This has arrested and put to a halt a process of accumulation taking place in the households of the returned migrant workers in the rural economy. Thus, the effects of the retrenchment of the workers will spread from the migrant and his family through the economic and social wellspring of all sectors of rural communities and their commercial lives."

Recruitment of labor migrants for the Middle East: the Sri Lankan case.

"This article deals with the social, economic and demographic aspects of labor migration from Sri Lanka to the Middle East. The findings are based on a survey covering 891 return migrants and 866 family members of current migrants, as well as a total of 407 nonmigrants who were interviewed as a control group. Although the elasticity of the demand for female domestic personnel is much smaller than that for male migrants, it was found that recruitment for female labor migrants has increased considerably in recent years. The enormous demand for foreign employment has led to a thriving recruitment sector and to numerous illegal activities also among authorized employment agents. Currently, prospective labor migrants have to incur huge debts to finance migration."

Immigrant qualifications: recognition and relative wage outcomes.

"One aim of this study is to examine the labor market outcomes of immigrants relative to the Australian born.... In particular, this article examines both the extent of formal nonrecognition of overseas qualifications and the indirect implications for wage outcomes of a lack of full recognition of qualifications. Immigrant relative wage analysis...is the subject of the second part of this article...."