Impact of mobile phones on HIV public stigma: a cross-sectional and pseudo-panel analysis from Ghana.

OBJECTIVE: HIV-related stigma still remains a major barrier to testing and a significant burden for people living with HIV (PLWH) in sub-Saharan Africa. This paper investigates how mobile phone ownership can influence HIV-related stigma. DESIGN: This is an observational study using both cross-sectional and pseudo-panel data. Analysis is conducted at both community and individual levels. SETTING: The analysis is run for the country of Ghana using data from 2008 and 2014. PARTICIPANTS: Individual-level and household-level data were obtained from Ghana's Demographic and Health Survey. PRIMARY AND SECONDARY OUTCOME MEASURES: The analysis measures the impact of mobile phone ownership on prejudice against people with HIV. Secondary outcomes are knowledge of HIV, which is included as a mediating element. RESULTS: Community-level analysis finds that a 10% increase in the share of mobile phone owners reduces the prevalence of discriminatory attitudes towards PLWH/AIDS by up to 3%. Results are consistent at the individual level. Additionally, mobile phone-enabled HIV knowledge is found to mediate about 26% of the effect of mobile phones on public stigma. CONCLUSIONS: These findings shed light on the role played by access to mobile technology on HIV-related stigma and discrimination and can support the development of future awareness raising and health communication campaigns in Ghana and other West African countries.

Economic development, weather shocks and child marriage in South Asia: A machine learning approach.

Globally, 21 percent of young women are married before their 18th birthday. Despite some progress in addressing child marriage, it remains a widespread practice, in particular in South Asia. While household predictors of child marriage have been studied extensively in the literature, the evidence base on macro-economic factors contributing to child marriage and models that predict where child marriage cases are most likely to occur remains limited. In this paper we aim to fill this gap and explore region-level indicators to predict the persistence of child marriage in four countries in South Asia, namely Bangladesh, India, Nepal and Pakistan. We apply machine learning techniques to child marriage data and develop a prediction model that relies largely on regional and local inputs such as droughts, floods, population growth and nightlight data to model the incidence of child marriages. We find that our gradient boosting model is able to identify a large proportion of the true child marriage cases and correctly classifies 77% of the true marriage cases, with a higher accuracy in Bangladesh (92% of the cases) and a lower accuracy in Nepal (70% of cases). In addition, all countries contain in their top 10 variables for classification nighttime light growth, a shock index of drought over the previous and the last two years and the regional level of education, suggesting that income shocks, regional economic activity and regional education levels play a significant role in predicting child marriage. Given the accuracy of the model to predict child marriage, our model is a valuable tool to support policy design in countries where household-level data remains limited.

Which communication technology is effective for promoting reproductive health? Television, radio, and mobile phones in sub-Saharan Africa.

The use of radio and television as means to spread reproductive health awareness in Sub-Saharan Africa has been extensive, and its impacts significant. More recently, other means of communication, such as mobile phones, have received the attention of researchers and policy makers as health communication tools. However, evidence on which of the two types of communication (i.e. passive communication from TV/radio, or active communication through phones) is more effective in fostering better reproductive health choices is sparse. This study aims to identify the potential influence of TV or radio ownership as opposed to cell phone ownership on contraceptive use and access to maternal healthcare. Cross-sectional, individual analysis from eleven high-maternal mortality Sub-Saharan African countries is conducted. A total of 78,000 women in union are included in the analysis. Results indicate that ownership of TV or radio is more weakly correlated to better outcomes than mobile phone ownership is. Results are stronger for lower educated women and robust across all levels of wealth. Interestingly, the study also finds that decision-making power is a relevant mediator of cell phone ownership on contraceptive use, but not on maternal healthcare access. A key takeaway from the study is that, while the role of television and radio appears to have diminished in recent years, mobile phones have become a key tool for empowerment and behavioural change among Sub-Saharan African women. Health communication policies should be designed to take into account the now prominent role of mobile phones in affecting health behaviours.

Determinants and drivers of young children's diets in Latin America and the Caribbean: Findings from a regional analysis.

The Latin America and Caribbean region exhibit some of the lowest undernutrition rates globally. Yet, disparities exist between and within countries and countries in the region increasingly face other pressing nutritional concerns, including overweight, micronutrient deficiencies and inadequate child feeding practices. This paper reports findings from a regional analysis to identify the determinants and drivers of children's diets, with a focus on the complementary feeding window between the age of 6-23 months. The analysis consists of a narrative review and descriptive data analysis, complemented with qualitative interviews with key informants in four countries: Guatemala, Paraguay, Peru and Uruguay. Findings indicate that poverty and inequality (disparities within countries by wealth and residence), unequal access to services, inadequate coverage of social programmes and lack of awareness on appropriate feeding practices are important drivers for inadequate diets. We conclude that countries in the region need to invest in policies to tackle overweight and micronutrient deficiencies in young children, considering inequalities between and within countries, enhance coverage of social protection programmes, improve coordination between sectors to improve children's diets and expand the coverage and intensity of awareness campaigns on feeding practices, using iterative programme designs.

Migration and the Multi-Dimensional Well-Being of Elderly Persons in Georgia.

High rates of migration coupled with low formal social protection provisions may place many members of the elderly Georgian population in precarious living conditions that promote vulnerability and limit well-being achievement. This potential connection has been poorly explored in past literature, however, suggesting a need to better assess how the migration of an adult child may influence the multidimensional well-being of the elderly in Georgia. Using a novel dataset comprising 2202 elderly individuals across all regions of Georgia (excepting the territories of Abkhazia and South Ossetia), this paper proposes a multidimensional well-being index that has been specifically designed to encompass the unique resources and constraints faced by elderly individuals in different age cohorts. Following the construction of a multidimensional well-being index-comprised of domains including physical health and independence, housing well-being, social well-being, and emotional well-being-the outcomes of elderly individuals are compared by age and the presence/absence of adult children due to migration. Findings suggest that the migration status of an elderly person's adult children is related to the attainment of well-being. Elderly individuals with a migrant child are more likely to attain well-being in physical health as well as in the overall multidimensional well-being index.

Unpacking the Relationship between Parental Migration and Child well-Being: Evidence from Moldova and Georgia.

Using household survey data collected between September 2011 and December 2012 from Moldova and Georgia, this paper measures and compares the multidimensional well-being of children with and without parents abroad. While a growing body of literature has addressed the effects of migration for children 'left behind', relatively few studies have empirically analysed if and to what extent migration implies different well-being outcomes for children, and fewer still have conducted comparisons across countries. To compare the outcomes of children in current- and non-migrant households, this paper defines a multidimensional well-being index comprised of six dimensions of wellness: education, physical health, housing conditions, protection, communication access, and emotional health. This paper challenges conventional wisdom that parental migration is harmful for child well-being: while in Moldova migration does not appear to correspond to any positive or negative well-being outcomes, in Georgia migration was linked to higher probabilities of children attaining well-being in the domains of communication access, housing, and combined well-being index. The different relationship between migration and child well-being in Moldova and Georgia likely reflects different migration trajectories, mobility patterns, and levels of maturity of each migration stream.

Adult Child Migration and Elderly Multidimensional Well-Being: Comparative Analysis Between Moldova and Georgia.

Despite growing concern over the potential consequences of migration for the "left behind," few systematic attempts have been made to document the relationship between the migration of an adult child and the well-being of his or her elderly parent(s) remaining in the country of origin. This article proposes a multidimensional elderly well-being index that enables the identification and comparison of outcomes between elderly individuals with and without adult migrant children in Moldova and Georgia, two former Soviet states that are both experiencing demographic and mobility transitions. The outcomes of elderly individuals with and without children living abroad are compared to illustrate in what domains child absence through migration corresponds to differing well-being outcomes. The findings suggest that the migration of an adult child is not as significant a factor in shaping well-being outcomes as would be expected based on past literature; other factors may play much stronger roles in shaping of well-being.

Child Poverty in Vietnam: Providing Insights Using a Country-Specific and Multidimensional Model.

Despite a wide under-prioritization, the issue of child poverty has received increasing attention worldwide over the last decade. The acknowledgement in Vietnam that child-specific poverty measurement is crucial for poverty efforts directed towards children, and the current lack thereof, instigated the development of a Vietnam child poverty approach. This paper proposes a country-specific, multidimensional and outcome-based approach for the measurement of the incidence, depth and severity of child poverty. It does so at the level of the individual child using household survey data. The development of such an approach at the level of the individual child presents an appropriate alternative for or supplement to the widely used monetary poverty approach, allowing for the use of compatible analytical methods. Findings suggest that 37% of all children in Vietnam live in poverty, with the most pressing areas of deprivation being water, sanitation and leisure. We do not find evidence for a gender bias but do observe a large urban-rural divide, regional disparities and large ethnic inequalities. We argue that this tailor-made approach is a valuable new tool for policy makers and analysts in Vietnam as it enables identification and analysis of poor children, their characteristics and most pressing areas of deprivation within the country's specific social and cultural context.

The Importance of Choice and Definition for the Measurement of Child Poverty-the case of Vietnam.

Increased attention to childrens' special position within poverty measurement resulted in the development of various child poverty approaches in the last decade. Analysis shows that their development processes involve a similar set of steps and decisions, predominantly taken in the same sequence. However, it also becomes apparent that many of these decisions are made implicitly rather than explicitly, resulting in unclear and non-transparent underlying constructs. Consequently, child poverty approaches often lack a solid and robust foundation and are misinterpreted and misunderstood when used for analytical and policy purposes. This paper distills a generic construction process from the analysis of existing child poverty approaches, presenting a tool for clear and transparent development of such approaches. It is then applied to the case of Vietnam, using household survey data, to illustrate its practical use and develop a Vietnam-specific child poverty approach. Findings suggest that 37% of all children are poor, whilst observing a large rural-urban divide but no significant differences between boys and girls.