Search

Technology can help to reduce inefficiencies and inequalities in developing countries. Although whether this happens in practice often depends on the social and geographic context. Deployment of solar home systems (SHS) across Nepal provides one such example. We examine a policy to promote SHS through a subsidy for adoption and its downstream benefits - children’s education, time allocated to agricultural and household work (both unpaid), and working for a wage. We overcome the challenges of the non-random assignment of subsidies by using geographic regression discontinuity design using (cost) distance as the assignment variable. This is based on the assumption that households cannot perfectly control the assignment variable because migrating to a different region, simply to acquire an additional solar subsidy of maximum NRs4000, is challenging and unlikely in the case of Nepal. Our results show that subsidy-eligible households are about 43% more likely to adopt SHS. We find a positive effect of the SHS adoption on the grade for age and educational z-score of children’s educations with the effect being higher on girls than boys. We also find that females are 14.2% more likely to participate and spend more time (about 19 extra days in a year) in agricultural practices by reducing their engagement in family work. However, there is no effect on the participation rates across the labour market. Results also show that males increase their contribution to household work.

How can non-profit organizations improve their governance to increase their social impact? This study examines the effectiveness of a bundle of governance mechanisms (consisting of pro-social incentives and auditing) in the context of a randomized governance program conducted in the Democratic Republic of Congo's healthcare sector. Within the program, a set of health centers were randomly assigned to a governance treatment while others were not. We find that the governance treatment leads to i) higher operating efficiency and ii) improvements in social performance (measured by a reduction in the occurrence of stillbirths and neonatal deaths). Furthermore, we find that funding is not a substitute for governance—health centers that only receive funding increase their scale, but do not show improvements in operating efficiency nor social performance. Overall, our results suggest that corporate governance plays an important role in achieving the non-profits' objectives and increasing the social impact of the funds invested.

International audience; Introduction: Smoking has been linked with depressive symptoms in adolescents, but data on secondhand smoking and depressive symptoms in low- and middle-income countries are scarce. Thus, this study analyzes the association between secondhand smoking and depressive symptoms among in-school adolescents from 22 low- and middle-income countries. Methods: Data from the 2003–2008 Global School-Based Student Health Survey were analyzed in June 2019. Data on past-week exposure to secondhand smoke and past-year depressive symptoms were collected. The association between secondhand smoke and depressive symptoms was studied using multivariable logistic regressions and meta-analyses. Results: The sample consisted of 37,505 adolescents aged 12–15 years who never smoked. The prevalence of depressive symptoms increased from 23.0% in adolescents with no secondhand smoking to 28.9% in those with secondhand smoking every day in the past week. After adjusting for sex, age, food insecurity, and country, there was a dose–response relationship between secondhand smoking and depressive symptoms in the overall sample (0 days: reference; 1–2 days: OR=1.06, 95% CI=0.95, 1.18; 3–6 days: OR=1.38, 95% CI=1.20, 1.58; 7 days: OR=1.63, 95% CI=1.44, 1.86). The country-wise analysis showed that secondhand smoking on at least 3 days (versus

Background : Ensuring a good life for all parts of the population, including children, is high on the public health agenda in most countries around the world. Information about children’s perception of their health-related quality of life (HRQoL) and its socio-demographic distribution is, however, limited and almost exclusively reliant on data from Western higher income countries. Objectives : To investigate HRQoL in schoolchildren in Tonga, a lower income South Pacific Island country, and to compare this to HRQoL of children in other countries, including Tongan children living in New Zealand, a high-income country in the same region. Design : A cross-sectional study from Tonga addressing all secondary schoolchildren (11–18 years old) on the outer island of Vava’u and in three districts of the main island of Tongatapu (2,164 participants). A comparison group drawn from the literature comprised children in 18 higher income and one lower income country (Fiji). A specific New Zealand comparison group involved all children of Tongan descendent at six South Auckland secondary schools (830 participants). HRQoL was assessed by the self-report Pediatric Quality of Life Inventory 4.0. Results : HRQoL in Tonga was overall similar in girls and boys, but somewhat lower in children below 15 years of age. The children in Tonga experienced lower HRQoL than the children in all of the 19 comparison countries, with a large difference between children in Tonga and the higher income countries (Cohen’s d 1.0) and a small difference between Tonga and the lower income country Fiji (Cohen’s d 0.3). The children in Tonga also experienced lower HRQoL than Tongan children living in New Zealand (Cohen’s d 0.6). Conclusion : The results reveal worrisome low HRQoL in children in Tonga and point towards a potential general pattern of low HRQoL in children living in lower income countries, or, alternatively, in the South Pacific Island countries. Keywords : adolescent health; child health; community health; Epidemiology; low-income population; mental health; quality of life (Published: 20 August 2014) Citation : Glob Health Action 2014, 7 : 24896 - http://dx.doi.org/10.3402/gha.v7.24896

Background: Knowledge of the aggregate effects of multiple socioeconomic vulnerabilities is important for shedding light on the determinants of growing health inequalities and inequities in maternal healthcare.Objective: This paper describes patterns of inequity in maternal healthcare utilization and analyzes associations between inequity and multiple socioeconomic vulnerabilities among women in Vietnam.Design: This is a repeated cross-sectional study using data from the Vietnam Multiple Indicator Cluster Surveys 2000, 2006, and 2011. Two maternal healthcare indicators were selected: (1) skilled antenatal care and (2) skilled delivery care. Four types of socioeconomic vulnerabilities – low education, ethnic minority, poverty, and rural location – were assessed both as separate explanatory variables and as composite indicators (combinations of three and four vulnerabilities). Pairwise comparisons and adjusted odds ratios were used to assess socioeconomic inequities in maternal healthcare.Results: In all three surveys, there were increases across the survey years in both the proportions of women who received antenatal care by skilled staff (68.6% in 2000, 90.8% in 2006, and 93.7% in 2011) and the proportions of women who gave birth with assistance from skilled staff (69.9% in 2000, 87.7% in 2006, and 92.9% in 2011). The receipt of antenatal care by skilled staff and birth assistance from skilled health personnel were less common among vulnerable women, especially those with multiple vulnerabilities.Conclusions: Even though Vietnam has improved its coverage of maternal healthcare on average, policies should target maternal healthcare utilization among women with multiple socioeconomic vulnerabilities. Both multisectoral social policies and health policies are needed to tackle multiple vulnerabilities more effectively by identifying those who are poor, less educated, live in rural areas, and belong to ethnic minority groups.Keywords: healthcare; skilled antenatal care; skilled delivery; multiple socioeconomic vulnerabilities; inequity; inequality(Published: 29 February 2016)Citation: Glob Health Action 2016, 9: 29386 - http://dx.doi.org/10.3402/gha.v9.29386This paper is part of the Special Issue: Millennium Development Goals in Vietnam: the Progress and Social Determinants. More papers from this issue can be found at www.globalhealthaction.net