C. M. Shah, A. M. Griffith, J. Ciera, E. M. Zulu, Tia Palermo
To examine trends in equity in contraceptive use, and in contraceptive-prevalence rates in six East African countries.
In this repeated cross-sectional study, Demographic and Health Surveys Program data from women aged 15–49 years in Ethiopia, Kenya, Malawi, Rwanda, Tanzania, and Uganda between 2000 and 2010 were analyzed. Individuals were ranked according to wealth quintile, stratified urban/rural populations, and calculated concentration index–a statistic integrating information from all wealth quintiles to analyze disparities.
Equity and contraceptive-prevalence rates increased in most country regions over the study period. Notably, in rural Rwanda, contraceptive-prevalence rates increased from 3.9 to 44.0, and urban Kenya became the most equitable country region, with a concentration index of 0.02. The Pearson correlation coefficient between improvements in concentration index and contraceptive-prevalence rates was 0.52 (P = 0.011).
The results indicate that countries seeking to increase contraceptive use should prioritize equity in access to services and contraceptives.
Sudhanshu Handa, D. Seidenfeld, B. David, G. Tembo, Zambia Evaluation Cash Transfer Team
Accumulated evidence from dozens of cash transfer (CT) programs across the world suggests that there are few interventions that can match the range of impacts and cost-effectiveness of a small, predictable monetary transfer to poor families in developing countries. However, individual published impact assessments typically focus on only one program and one outcome. This article presents two-year impacts of the Zambian Government's Child Grant, an unconditional CT to families with children under age 5, across a wide range of domains including consumption, productive activity, and women and children's outcomes, making this one of the first studies to assess both protective and productive impacts of a national unconditional CT program. We show strong impacts on consumption, food security, savings, and productive activity. However, impacts in areas such as child nutritional status and schooling depend on initial conditions of the household, suggesting that cash alone is not enough to solve all constraints faced by these poor, rural households. Nevertheless, the apparent transformative effects of this program suggest that unconditional transfers in very poor settings can contribute to both protection and development outcomes.
Sudhanshu Handa, Tia Palermo, Molly Rosenberg, Audrey Pettifor, Carolyn Tucker Halpern, Harsha Thirumurthy
Sudhanshu Handa, Amber Peterman, D. Seidenfeld, G. Tembo
R. Kidman, Tia Palermo
Kelly Kilburn, Harsha Thirumurthy, Carolyn Tucker Halpern, Audrey Pettifor, Sudhanshu Handa
This study investigates the causal effect of Kenya's unconditional cash transfer program on mental health outcomes of young people.
Selected locations in Kenya were randomly assigned to receive unconditional cash transfers in the first phase of Kenya's Cash Transfer Program for orphans and Vulnerable Children. In intervention locations, low-income households and those with orphans and vulnerable childrens began receiving monthly cash transfers of $20 in 2007. In 2011, 4 years after program onset, data were collected on the psychosocial status for youth aged 15–24 years from households in intervention and control locations (N = 1960). The primary outcome variable was an indicator of depressive symptoms using the 10-question Center for Epidemiologic Studies Depression Scale. Secondary outcomes include an indicator for hopefulness and physical health measures. Logistic regression models that adjusted for individual and household characteristics were used to determine the effect of the cash transfer program.
The cash transfer reduced the odds of depressive symptoms by 24 percent among young persons living in households that received cash transfers. Further analysis by gender and age revealed that the effects were only significant for young men and were larger among men aged 20–24 years and orphans.
This study provides evidence that poverty-targeted unconditional cash transfer programs, can improve the mental health of young people in low-income countries.
C. C. Undie, Mary Catherine Maternowska, M. Mak'anyengo, I. Askew
Amber Peterman, J. Bleck, Tia Palermo
Young women are at elevated risk of violence victimization, yet generalizable evidence on age at which abuse first occurs is lacking. This analysis provides new descriptive evidence on age and duration into partnership of women's first intimate partner violence (IPV) victimization.
Data come from ever married women ages of 15–49 years in nationally representative Demographic and Health Surveys in 30 countries collected from 2005 to 2014 in Africa, Asia, Eastern Europe, and Latin America and the Caribbean. Descriptive analysis is performed.
Approximately 29.0% (95% confidence interval [CI]: 28.8, 29.3) of women reported any physical or sexual IPV. Among ever married women who first experienced violence post-union, abuse began, on average, 3.5 years (95% CI 3.4, 3.5), after union formation. Approximately 38.5% (95% CI 37.9, 39.0) and 67.5% (95% CI 67.0, 68.1) of those ever experiencing abuse did so within 1 year and 3 years, respectively, of union formation. Regionally, average years into union of abuse initiation showed little variation and average age at first abuse among once married women is 22.1 years.
Results imply that primary prevention for IPV must take place on average before first union before age 19 years, to capture the most relevant and at risk target population. Resources allocated toward risk factors in childhood and adolescence may be most effective in combating initiation of IPV globally. Despite this finding, there remains a lack of evidence on effective interventions for primary prevention of abuse during women's early years in developing settings.
Michael P. Dunne, Wan Yuen Choo, Bernadette Madrid, Ramya Subrahmanian, Lauren Rumble, Stephen Blight, Mary Catherine Maternowska
Up to the year 2000, there was very little scientific evidence in this region about the scale of child maltreatment, its effects on children, families, and society, and the resultant economic burden. Since then, many agencies large and small, government and nongovernment, and university-based researchers have worked independently with diverse groups of people to measure violence, neglect and other childhood adversities and to understand the harmful consequences.
While the accumulated evidence is mostly patchy and the methodological quality is variable, there is now enough data to compose an overall regional picture. Guided by the UNICEF East Asia and Pacific office in Bangkok, researchers completed several systematic reviews between 2012 to 2015 and that work has been complemented by reviews focused on China and Australia.
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