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Objective Examine how disability status among adolescents is associated with the following domains of personal well-being: schooling, livelihoods, health, violence and psychosocial well-being. It is hypothesised that adolescents with a disability will have greater deficits in these areas of well-being compared with their healthier counterparts.Design Cross-sectional data from 2018 were obtained from the second round of an on-going study of adolescents living in poor households in two regions of the Southern Highlands of Tanzania (Iringa and Mbeya). We use the Washington Group (WG) Short Set indicators to measure disability and undertook logistic and linear multivariate regressions to understand the association between disability and the outcomes of interest.Participants The sample included 2274 participants aged 15–20 years living in households participating in a government social protection programme targeted to households living in extreme poverty.Results Overall, 310 participants (14%) were classified as having disabilities. Outcomes not associated with disability status included literacy, schooling, livelihoods and self-efficacy. Adolescents with disabilities were less likely to report good or very good health (adjusted OR (aOR)=0.39, 95% CI 0.29 to 0.52) and had increased odds of reporting depressive symptoms in (aOR=1.46, 95% CI 1.11 to 1.90), emotional violence (aOR=2.18, 95% CI 1.49 to 3.20) and physical violence (aOR=1.71, 95% CI 1.13 to 2.59), compared with those without disabilities. Reports of depression were higher among men, and violence was more prevalent among women. Patterns of association were generally similar between men and women, although the association of disability with markers of well-being reached statistical significance more often among men.Conclusion This study highlights areas where adolescents with disabilities are falling behind their peers in terms of personal well-being. These findings suggest that interventions may be needed to mainstream disability in programmes and policies aiming to improve well-being, mental health and violence prevention among adolescents.Trial registration number Pan African Clinical Trial Registry (PACTR201804003008116).

Objectives The study aimed to understand the impact of integrating a fee waiver for the National Health Insurance Scheme (NHIS) with Ghana’s Livelihood Empowerment Against Poverty (LEAP) 1000 cash transfer programme on health insurance enrolment.Setting The study was conducted in five districts implementing Ghana’s LEAP 1000 programme in Northern and Upper East Regions.Participants Women, from LEAP households, who were pregnant or had a child under 1 year and who participated in baseline and 24-month surveys (2497) participated in the study.Intervention LEAP provides bimonthly cash payments combined with a premium waiver for enrolment in NHIS to extremely poor households with orphans and vulnerable children, elderly with no productive capacity and persons with severe disability. LEAP 1000, the focus of the current evaluation, expanded eligibility in 2015 to those households with a pregnant woman or child under the age of 12 months. Over the course of the study, households received 13 payments.Primary and secondary outcome measures Primary outcomes included current and ever enrolment in NHIS. Secondary outcomes include reasons for not enrolling in NHIS. We conducted a mixed-methods impact evaluation using a quasi-experimental design and estimated intent-to-treat impacts on health insurance enrolment among children and adults. Longitudinal qualitative interviews were conducted with an embedded cohort of 20 women and analysed using systematic thematic coding.Results Current enrolment increased among the treatment group from 37.4% to 46.6% (n=5523) and decreased among the comparison group from 37.3% to 33.3% (n=4804), resulting in programme impacts of 14 (95% CI 7.8 to 20.5) to 15 (95% CI 10.6 to 18.5) percentage points for current NHIS enrolment. Common reasons for not enrolling were fees and travel.Conclusion While impacts on NHIS enrolment were significant, gaps remain to maximise the potential of integrated programming. NHIS and LEAP could be better streamlined to ensure poor households fully benefit from both services, in a further step towards integrated social protection.Trial registration number RIDIE-STUDY-ID-55942496d53af.

Objectives To define key stressors experienced and coping behaviours within poor agrarian communities in sub-Saharan Africa.Design Descriptive qualitative study incorporating inductive thematic analysis.Participants 81 participants purposely sampled, stratified by age (adolescents and young adults) and sexSetting The study was conducted in villages in Ghana, Malawi, and Tanzania.Results Stressors were thematically grouped into those directly related to poverty and the lack of basic necessities (eg, food insecurity), and additional stressors (eg, drought) that worsen poverty-related stress. Impacts on functioning, health and well-being and key coping behaviours, both positive and negative, were identified. The findings together inform a more nuanced view of stress within these contexts.Conclusion Although participants were asked to provide general reflections about stress in their community, the salience of poverty-related stressors was ubiquitously reflected in respondents’ responses. Poverty-related stressors affect development, well-being and gender-based violence. Future research should focus on interventions to alleviate poverty-related stress to achieve the United Nations Sustainable Development Goals.

OBJECTIVE: We aim to assess the opinions of Mexicans in the state of Tlaxcala on abortion and other topics concerning women's reproductive health and status in society. MATERIAL AND METHODS: We summarize opinions on abortion and women's roles in society and perform logit regressions to assess characteristics correlated with support for abortion rights. RESULTS: A majority of respondents were against a woman's right to abortion when asked generally, but when asked about specific circumstances, a majority supported the right to abortion in five of the nine hypothetical circumstances proposed. In multivariate analysis, age, education, religion, religious service attendance, and views regarding women's roles in society had significant effects on support for the right to abortion. CONCLUSIONS: Our results demonstrate that residents of Tlaxcala view abortion as a personal decision and support a woman's right to abortion in more circumstances than currently allowed under state law.OBJETIVO: Describir opiniones sobre salud sexual y reproductiva, aborto y rol social de las mujeres entre un grupo de residentes de Tlaxcala, México. MATERIAL Y MÉTODOS: El análisis de regresión logística analizó características asociadas con una postura de apoyo al derecho al aborto. RESULTADOS: La mayoría no favoreció el derecho de las mujeres a interrumpir un embarazo cuando se preguntó de manera general. Al momento de circunscribirlo a circunstancias específicas, la mayoría estuvo a favor en cinco de las nueve de situaciones hipotéticas planteadas. En análisis multivariado, edad, escolaridad, religión, asistencia a servicios religiosos y opiniones sobre el rol social femenino fueron variables significativas del apoyo que se brinda a una mujer para ejercer su derecho a interrumpir un embarazo. CONCLUSIONES: Los residentes de Tlaxcala perciben el tema del aborto como una decisión personal y apoyan el derecho de una mujer a interrumpirlo especialmente bajo causales contempladas en la ley de Tlaxcala.

Objectives: To assess the oft-perceived protective relationship between women's asset ownership and experience of intimate partner violence (IPV) in the previous 12 months., Methods: We used international survey data from women aged 15 to 49 years from 28 Demographic and Health Surveys (2010-2014) to examine the association between owning assets and experience of recent IPV, matching on household wealth by using multivariate probit models. Matching methods helped to account for the higher probability that women in wealthier households also have a higher likelihood of owning assets., Results: Asset ownership of any type was negatively associated with IPV in 3 countries, positively associated in 5 countries, and had no significant relationship in 20 countries (P < .10). Disaggregation by asset type, sole or joint ownership, women's age, and community level of women's asset ownership similarly showed no conclusive patterns., Conclusions: Results suggest that the relationship between women's asset ownership and IPV is highly context specific. Additional methodologies and data are needed to identify causality, and to understand how asset ownership differs from other types of women's economic empowerment.