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2.
Front Public Health ; 10: 793673, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35937214

RESUMO

Introduction: Although, especially in the past decade, poverty measurement approaches have been duly developed in two paths (from unidimensional to multidimensional poverty and from absolute to relative poverty), merely a few studies have focused on the combination of both perspectives. However, with global aging, poverty among older adults simultaneously presents multidimensionality and relativity characteristics. This paper explores a multidimensional relative poverty index (MRPI) relative to the aged group in four dimensions, namely, health, social, mental, and material, and then empirically evaluates the specific effects on the MRPI of one of the key targeted anti-poverty policies, that is, the health poverty alleviation policy (HPAP), which includes public health service, medical expense reimbursement, rewarding assistance, basic medical insurance, and so on. Methods: Using pooled cross-sectional data of poverty alleviation from 2014 to 2020 with a total of 83,521 observations aged 60+ in County J, Shaanxi Province in China, we calculate the MRPI for the older adults via a fuzzy set approach. Statistical difference testing is used to analyze the characteristics and trends of the MRPI. In policy evaluation, to address endogenous problems, the treatment effect model based on Heckman's two-stage regression and finite distributed lag model are used with a controlled township cluster structure. Results: From 2014 to 2020, the MRPI shows a significant upward trend for older adults in rural China, and the health component takes the dominant MRPI position. Empirically, we find that the HPAP can significantly alleviate the MRPI of older adults. Furthermore, among the health poverty alleviation measures, basic medical insurance is the most effective anti-poverty policy to support older adults. Specifically, empirical evidence shows that there is a more statistically significant reduction in the MRPI with the HPAP for the sub-group of older adults with chronic diseases or disabilities. Conclusion: Both relativity and multidimensionality should be emphasized when analyzing poverty vis-à-vis the aging society, and for this, the MRPI is one of the effective tools. Comparing the relativity with the aged group engenders a more accurate understanding of their poverty situation. Moreover, the importance of the health component among all the four dimensions is more conducive to the detailed analysis of their poverty. The empirical analysis results show that regarding poverty reduction approaches in China, developing integrated health promotion systems is necessary and imminent, especially in the long run, such as long-term care insurance that covers typical disabled older adults with chronic diseases.


Assuntos
Pobreza , População Rural , Idoso , China , Estudos Transversais , Política de Saúde , Humanos , Estados Unidos
3.
Front Public Health ; 10: 928065, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35937225

RESUMO

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has intensified the urgency in addressing pressing global health access challenges and has also laid bare the pervasive structural and systemic inequities that make certain segments of society more vulnerable to the tragic consequences of the disease. This rapid systematic review analyses the barriers to COVID-19 health products in low-and middle-income countries (LMICs). It does so from the canon of global health equity and access to medicines by proposing an access to health products in low-and middle-income countries framework and typology adapted to underscore the complex interactive and multiplicative nature and effects of barriers to health products and their root cause as they coexist across different levels of society in LMICs. Methods: Modified versions of the Joanna Briggs Institute (JBI) reviewers' manual for evidence synthesis of systematic reviews and the PRISMA-ScR framework were used to guide the search strategy, identification, and screening of biomedical, social science, and gray literature published in English between 1 January 2020 and 30 April 2021. Results: The initial search resulted in 5,956 articles, with 72 articles included in this review after screening protocol and inclusion criteria were applied. Thirty one percent of the articles focused on Africa. The review revealed that barriers to COVID-19 health products were commonly caused by market forces (64%), the unavailability (53%), inaccessibility (42%), and unaffordability (35%), of the products, incongruent donors' agenda and funding (33%) and unreliable health and supply systems (28%). They commonly existed at the international and regional (79%), health sectoral (46%), and national cross-sectoral [public policy] (19%) levels. The historical heritage of colonialism in LMICs was a commonly attributed root cause of the barriers to COVID-19 health products in developing countries. Conclusion: This review has outlined and elaborated on the various barriers to health products that must be comprehensively addressed to mount a successful global, regional, national and subnational response to present and future epidemics and pandemics in LMICs.


Assuntos
COVID-19 , Pandemias , COVID-19/epidemiologia , Países em Desenvolvimento , Humanos , Renda , Pandemias/prevenção & controle , Pobreza
5.
Perspect Biol Med ; 65(2): 283-294, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35938436

RESUMO

Lower-income Black and Latina women with children are especially likely to be impacted by housing insecurity and instability and may engage in increased risk-taking behaviors to prevent housing loss, eviction, or displacement. This article explores housing insecurity as a system of exposure that confers survival-based risk that converges in the lives of women already experiencing some form of precarity. A discussion of vulnerability links disproportionate risk to the current social order, and an expanded reframing of risk is proposed. Finally, historical examples highlight how traditional and contemporary systems of gatekeeping and surveillance serve to increase housing instability and further undermine access to housing for those who need it most. The consistent focus on individual risk in many biomedical models of health obscures the larger issue of fundamental risk factors that lie behind the risk-health relationship. Should risk be conflated with poor individual decision-making, rather than action taken out of need, scarcity, or desperation? The implications of this question for clinicians, researchers, and policymakers are discussed.


Assuntos
Habitação , Pobreza , Criança , Feminino , Humanos , Fatores de Risco
6.
Proc Natl Acad Sci U S A ; 119(32): e2120025119, 2022 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-35914150

RESUMO

Hundreds of millions of poor families receive some form of targeted social assistance. Many of these antipoverty programs involve some degree of geographic targeting, where aid is prioritized to the poorest regions of the country. However, policy makers in many low-resource settings lack the disaggregated poverty data required to make effective geographic targeting decisions. Using several independent datasets from Nigeria, this paper shows that high-resolution poverty maps, constructed by applying machine learning algorithms to satellite imagery and other nontraditional geospatial data, can improve the targeting of government cash transfers to poor families. Specifically, we find that geographic targeting relying on machine learning-based poverty maps can reduce errors of exclusion and inclusion relative to geographic targeting based on recent nationally representative survey data. This result holds for antipoverty programs that target both the poor and the extreme poor and for initiatives of varying sizes. We also find no evidence that machine learning-based maps increase targeting disparities by demographic groups, such as gender or religion. Based in part on these findings, the Government of Nigeria used this approach to geographically target emergency cash transfers in response to the COVID-19 pandemic.


Assuntos
Pobreza , Seguridade Social , Geografia , Humanos , Nigéria
7.
J Glob Health ; 12: 10011, 2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-35916658

RESUMO

Background: Early and exclusive breastfeeding have been shown to protect young infants from all-cause and diarrhoea-related mortality. Ideally breastfeeding should be initiated within the first hour of birth. Despite efforts to increase rates of early and exclusive breastfeeding in low- and middle-income countries (LMICs), challenges with uptake remain. This analysis reviews trends in early and exclusive breastfeeding, and the impact of infant feeding interventions in reducing childhood diarrhoea. Methods: We conducted a detailed review of articles written in English between 1990 and 2020 on the impact and efficacy of breastfeeding and complementary feeding on diarrhoea in children aged 0-2 years in LMICs. Using data from 86 countries and all WHO global regions collected from the mid-1980s through 2018 obtained from publicly available Demographic Health Surveys, we assessed trends in five-year intervals of timing of breastfeeding initiation, exclusive breastfeeding, median and mean duration of exclusive breastfeeding, and complementary feeding. Results: The literature search identified ten articles that described variable rates of early initiation of breastfeeding from 20% in Pakistan to 76% in Egypt. An analysis of 288 DHS studies found that the proportion of women who reported initiating breastfeeding within an hour of birth increased from 32% in the early 1990s to 55% between 2016 and 2020. Exclusive breastfeeding increased from 20% in the late 1980s to 48% between 2016 and 2020 and the mean duration of exclusive breastfeeding of 2-to-4-month-old infants doubled. Early initiation of breastfeeding and exclusive breastfeeding was associated with reductions in diarrhoea prevalence in the South East Asian, Western Pacific, Eastern Mediterranean, and African regions. Eight studies evaluating the effectiveness of different maternal education interventions, health care worker training, and media campaigns demonstrated improvements in exclusive breastfeeding, and most resulted in reductions in the incidence or duration of diarrhoea. Conclusions: During the last two decades, early and exclusive breastfeeding have increased. Nevertheless, the uptake of this basic, low-cost intervention remains suboptimal across all global regions. Given the potential benefits the in reduction of diarrhoea and diarrhoea-associated mortality, interventions for improving the uptake of early and exclusive breastfeeding in different sociological contexts need to be designed, implemented, and evaluated.


Assuntos
Aleitamento Materno , Países em Desenvolvimento , Criança , Diarreia/epidemiologia , Diarreia/prevenção & controle , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Pobreza
8.
PLoS One ; 17(8): e0272519, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35930600

RESUMO

Developing countries have common goals of poverty eradication and improving people's livelihoods. As the largest developing country, China has made remarkable achievements in poverty alleviation during the 30 years of reform. Although a targeted poverty alleviation mechanism was established by the Chinese government in 2013, the identification of poor households has been an arduous journey. Based on a total of 688 samples of grassroots officials and 2,621 rural households from 69 village-level divisions in 9 provinces in China, this study conducted cross-validation on the impact of the participation of rural households in the identifying poor households that required government assistance. This was from the perspectives of grassroots officials and rural households. It was investigated whether this participation led to an anomaly between the identification of poor households and the actual situation. Empirical results show that the participation of rural households in appraisals significantly increases the probability of identifying a non-poor household as a poor household (first error) and decreases the probability of failing to identify a poor household as a poor household (second error). As the impact of the first error is greater than that of the second error, the participation of rural households in appraisals has the overall effect of increasing the incorrect registrations of poor households. These results are still valid after addressing the self-selection problem. For other developing countries to successfully apply effort into poverty alleviation, in addition to focusing on increasing farmers' participation in public affairs, they should prevent any bias that may be caused by farmers' participation in public affairs; strengthen publicity and guidance; focus on the nurture of officials; perfect top-level design; and set clearer targets for poverty alleviation policies.


Assuntos
Características da Família , Pobreza , China , Fazendeiros , Humanos , População Rural
11.
PLoS One ; 17(8): e0267192, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35925923

RESUMO

BACKGROUND: Evidence shows that a gap in the documentation of patients' past medical history leads to errors in, or duplication of, treatment and is a threat to patient safety. Home-based or patient-held records (HBR) are widely used in low and middle-income countries (LMIC) in maternal and childcare. The aim is to systematically review the evidence on HBRs in LMICs for (1) improving informational continuity for providers and women/families across health care visits and facilities, (2) to describe the perceived usefulness by women/families and healthcare providers, and (3) maternal and child health outcomes of using HBRs for maternal and child health care. METHODS: The protocol was registered in PROSPERO (CRD42019139365). We searched MEDLINE, EMBASE, CINAHL, and Global Index Medicus databases for studies with home-based records from LMICs. Search terms pertained to women or parent-held records and LMICs. Two reviewers assessed studies for inclusion using a priori study selection criteria- studies explaining the use of HBRs in LMIC for maternal and child health care. The included study quality was appraised using the Mixed Methods Appraisal Tool (MMAT). Results from all study designs were summarised narratively. RESULTS: In total, 41 papers were included in the review from 4514 potential studies. Included studies represented various study designs and 16 countries. The least evaluated function of HBR was information continuity across health care facilities (n = 6). Overall, there were limited data on the usefulness of HBRs to providers and mothers/families. Home-based records were mostly available for providers during health care visits. However, the documentation in HBRs varied. The use of HBRs is likely to lead to improved antenatal visits and immunisation uptake, and skilled birth delivery in some settings. Mothers' knowledge of breastfeeding practices and danger signs in pregnancy improved with the use of HBRs. One randomised trial found the use of HBRs reduced the risk of cognitive development delay in children and another reported on trial lessened the risk of underweight and stunted growth in children. CONCLUSION: There is limited literature from LMICs on the usefulness of HBRs and for improving information transfer across healthcare facilities, or their use by women at home. Current HBRs from LMICs are sub-optimally documented leading to poor informational availability that defeats the point of them as a source of information for future providers.


Assuntos
Saúde da Criança , Países em Desenvolvimento , Criança , Feminino , Humanos , Mães , Avaliação de Resultados em Cuidados de Saúde , Pobreza , Gravidez
12.
BMJ Glob Health ; 7(8)2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35918072

RESUMO

OBJECTIVE: Substandard and falsified (SF) veterinary medicines affect animal health, agricultural production and food security and will influence antimicrobial resistance (AMR) in both animals and humans. Yet, our understanding of their extent and impact is poor. We assess the available public domain evidence on the epidemiology of SF veterinary medicines, to better understand their prevalence and distribution and their public health impact on animals and humans. METHODS: Searches were conducted in Embase, PubMed, MEDLINE, Global Health, Web of Science, CAB Abstracts, Scopus, Google Scholar, Google and websites with interest in veterinary medicines quality up to 28 February 2021. Identified articles in English and French were screened for eligibility. The Medicine Quality Assessment Reporting Guidelines were used to assess the quality of prevalence surveys. RESULTS: Three hundred and fourteen publications were included with a failure frequency (the percentage of samples that failed at least one quality test) of 6.5% (2335/35 733). The majority of samples were from post-marketing surveillance by medicines regulatory authorities of the Republic of Korea and China. A small proportion (3.5%) of samples, all anti-infectives, were from 20 prevalence surveys, with more than half (53.1%, 662/1246) collected in low-income and lower middle-income countries in Africa and Asia. The prevalence survey sample size ranged from 4 to 310 samples (median (Q1-Q3): 50 (27-80)); 55.0% of surveys used convenience outlet sampling methods. In 20 prevalence surveys more than half of the samples (52.0%, 648/1246) failed at least one quality test. The most common defects reported were out-of-specification active pharmaceutical ingredient(s) (API) content, failure of uniformity of units and disintegration tests. Almost half of samples (49.7%, 239/481) that failed API content tests contained at least one of the stated APIs below pharmacopoeial limits. Fifty-two samples (4.2% of all samples) contained one or more incorrect API. One hundred and twenty-three publications described incidents (recalls/seizures/case reports) of SF veterinary medicines in 29 countries. CONCLUSION: The data suggest that SF veterinary products are likely to be a serious animal and public health problem that has received limited attention. However, few studies of SF veterinary medicines are available and are geographically restricted. Lower API content and disintegration/dissolution than recommended by pharmacopoeial standards risks treatment failure, animal suffering and contribute to AMR. Our findings highlight the need of more research, with robust methodology, to better inform policy and implement measures to assure the quality of veterinary medicines within supply chains. The mechanism and impact of SF veterinary products on animal and human health, agricultural production, their economy and AMR need more transdisciplinary research.


Assuntos
Medicamentos Falsificados , Saúde Única , Humanos , Renda , Pobreza , Saúde Pública
13.
Nature ; 608(7921): 108-121, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35915342

RESUMO

Social capital-the strength of an individual's social network and community-has been identified as a potential determinant of outcomes ranging from education to health1-8. However, efforts to understand what types of social capital matter for these outcomes have been hindered by a lack of social network data. Here, in the first of a pair of papers9, we use data on 21 billion friendships from Facebook to study social capital. We measure and analyse three types of social capital by ZIP (postal) code in the United States: (1) connectedness between different types of people, such as those with low versus high socioeconomic status (SES); (2) social cohesion, such as the extent of cliques in friendship networks; and (3) civic engagement, such as rates of volunteering. These measures vary substantially across areas, but are not highly correlated with each other. We demonstrate the importance of distinguishing these forms of social capital by analysing their associations with economic mobility across areas. The share of high-SES friends among individuals with low SES-which we term economic connectedness-is among the strongest predictors of upward income mobility identified to date10,11. Other social capital measures are not strongly associated with economic mobility. If children with low-SES parents were to grow up in counties with economic connectedness comparable to that of the average child with high-SES parents, their incomes in adulthood would increase by 20% on average. Differences in economic connectedness can explain well-known relationships between upward income mobility and racial segregation, poverty rates, and inequality12-14. To support further research and policy interventions, we publicly release privacy-protected statistics on social capital by ZIP code at https://www.socialcapital.org .


Assuntos
Status Econômico , Amigos , Renda , Capital Social , Mobilidade Social , Adulto , Criança , Relações Comunidade-Instituição , Conjuntos de Dados como Assunto , Status Econômico/estatística & dados numéricos , Mapeamento Geográfico , Humanos , Renda/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Racismo , Mídias Sociais/estatística & dados numéricos , Mobilidade Social/estatística & dados numéricos , Apoio Social , Estados Unidos , Voluntários
15.
BMJ ; 378: o1640, 2022 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-35793825

Assuntos
Homicídio , Pobreza , Humanos
17.
BMC Health Serv Res ; 22(1): 860, 2022 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-35787277

RESUMO

In 2009, the Democratic Republic of Congo (DRC) started its journey towards achieving Universal Health Coverage (UHC). This study examines the evolution of financial risk protection and health outcomes indicators in the context of the commitment of DRC to UHC. To measure the effects of such a commitment on financial risk protection and health outcomes indicators, we analyse whether changes have occurred over the last two decades and, if applicable, when these changes happened. Using five variables as indicators for the measurement of the financial risk protection component, there as well retained three indicators to measure health outcomes. To identify time-related effects, we applied the parametric approach of breakpoint regression to detect whether the UHC journey has brought change and when exactly the change has occurred.Although there is a slight improvement in the financial risk protection indicators, we found that the adopted strategies have fostered access to healthcare for the wealthiest quantile of the population while neglecting the majority of the poorest. The government did not thrive persistently over the past decade to meet its commitment to allocate adequate funds to health expenditures. In addition, the support from donors appears to be unstable, unpredictable and unsustainable. We found a slight improvement in health outcomes attributable to direct investment in building health centres by the private sector and international organizations. Overall, our findings reveal that the prevention of catastrophic health expenditure is still not sufficiently prioritized by the country, and mostly for the majority of the poorest. Therefore, our work suggests that DRC's UHC journey has slightly contributed to improve the financial risk protection and health outcomes indicators but much effort should be undertaken.


Assuntos
Gastos em Saúde , Cobertura Universal do Seguro de Saúde , Atenção à Saúde , República Democrática do Congo , Humanos , Pobreza
18.
J Occup Health ; 64(1): e12342, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35789160

RESUMO

OBJECTIVES: This study examined the association of presenteeism with experiences of poverty among Japanese workers during the COVID-19 pandemic. METHODS: A prospective cohort study of Japanese workers was conducted using an Internet monitoring survey. The baseline survey was conducted in December 2020, and a follow-up survey in December 2021. Of the 27 036 workers who participated, 18 560 (68.7%) completed the follow-up survey. The 11 081 who reported that they were not in financial difficulty in the baseline survey were included in the analysis. The degree of work functioning impairment was assessed at baseline using the Work Functioning Impairment Scale (WFun). Households' experience of not being able to pay for food and clothing was identified in the follow-up survey. The odds ratios (ORs) of presenteeism determined by WFun associated with poverty were estimated using a multilevel logistic model. The multivariate model included age, sex, marital status, job type, income, education, smoking, alcohol consumption, number of employees in the workplace, and the incidence rate of COVID-19 by prefecture at baseline. RESULTS: In the multivariate model, the odds ratio of experiencing food insecurity increased with high WFun score: compared with WFun scores of 13 or less, the OR was 1.87 (95% CI: 1.43-2.43, P < .001) for WFun scores of 14 or more and 3.26 (95% CI: 2.58-4.12, P < .001) for WFun scores of 21 or more. CONCLUSIONS: In addition to labor productivity, the adverse effects of presenteeism on social security-related concerns such as poverty require further attention.


Assuntos
COVID-19 , Presenteísmo , COVID-19/epidemiologia , Humanos , Japão/epidemiologia , Pandemias , Pobreza , Estudos Prospectivos
19.
J Health Popul Nutr ; 41(1): 30, 2022 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-35818082

RESUMO

BACKGROUND: Gender shapes household decision-making and access for nutritious diets, including animal source foods (ASFs) that impact on child health and nutrition status. However, research shows that the poorest households in the urban informal settlements of Nairobi have low ASFs consumption. This study was conducted to explore further from a qualitative perspective the gender, sociocultural factors affecting household ASF consumption this study. METHODS: To explore further on the topic of study, an exploratory qualitative study was carried out to establish the factors that influence access, allocation and consumption of animal source foods (ASFs) by households in urban informal settings of Nairobi. Nineteen focus group discussions with men and women were conducted to enable in-depth exploration of ASFs consumption. RESULTS: Gender influences decision-making of household ASFs dietary intake. Gendered power dynamics prevail with men as breadwinners and household heads often determining the food access and consumption of ASFs. Women are increasingly accessing short-term waged-based incomes in urban informal settings and now play a role in food and nutrition security for their households. This enforces the idea that women's decision-making autonomy is an important aspect of women empowerment, as it relates to women's dietary diversity and subsequently, better household nutritional status. As evidenced in this study, if a woman has bargaining power based on accessing incomes to support their household food needs, she will not jeopardize food security. The mobile digital money platform was key in enabling access to resources to access food. Use of trust to access food on credit and purchasing smaller packaged quantities of food were also enablers to access of food/ASFs.


Assuntos
Renda , Estado Nutricional , Animais , Dieta , Feminino , Abastecimento de Alimentos , Humanos , Quênia , Pobreza
20.
Sci Rep ; 12(1): 11924, 2022 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-35831382

RESUMO

Zero vegetable or fruit and egg and/or flesh foods are the latest indicators for assessing infant and young child feeding practices. Understanding national and subnational heterogeneity and regional clustering in children with SSA is becoming increasingly essential for geographic targeting and policy prioritization. Geographical case identification, determinants, and impacts were all investigated. SSA children's consumption of vegetable or fruit, egg and/or flesh food, and both were low. In SSA, some portions of the Southern, South direction of the Western and Central regions have a lower weight of all bad conditions than others, although children continue to suffer in considerable numbers in all disadvantage circumstances. Children under the age of 1 year, from rural areas, uneducated families, and low income were all disadvantaged by both feeding techniques. To improve child nutrition status, multisectoral collaboration is essential. This framework allows for the tracking, planning, and implementation of nutritional treatments.


Assuntos
Frutas , Verduras , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Dieta , Comportamento Alimentar , Humanos , Lactente , Pobreza
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