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Investing in the sexual and reproductive health of adolescents in Pakistan
Get PDFMany adolescents in Pakistan are at risk of experiencing poor reproductive health, which is associated with adverse consequences such as early childbearing and parenthood, pregnancy complications, and maternal death and disability. For instance, about one in five married adolescent women aged 15–19 years in Pakistan have begun childbearing, often without the support of policies and programs that would enable them to make informed and voluntary decisions to protect their health and exercise their reproductive rights. The data in this fact sheet come from the Adding It Up project, which examines the need for, impact of and cost of fully investing in reproductive health care in low- and middle-income countries, and the 2017–2018 Pakistan Demographic and Health Survey. The fact sheet presents data on the unmet needs for reproductive health care for adolescent women aged 15–19 in Pakistan, as well as the related benefits and costs of meeting such needs
Testing theory of change assumptions of health behavior change interventions: A blended approach exploring local contexts
No full textThis paper used a blended approach that involves multiple techniques to, first, test a set of assumptions around a health behavior change communication intervention theory of change (ToC) and, second, surface some unidentified assumptions involving the local context. The intervention was integrated with women’s self-help groups (SHGs) in Uttar Pradesh, India. The key assumption tested in this paper was the linkage between SHG membership, program exposure, and maternal, newborn, and child health practices. Learnings were substantiated through empirical investigations, including structural equation modeling and mediation analysis, as well as ‘co-learning’ workshops within the community. The workshops aimed to capture and interpret the heterogeneity of local contexts through deep dialogues with the community and program implementers at various levels. Statistical analyses indicated a significant association between the amount of women’s program exposure and their health practices. SHG membership was shown to affect maternal health practices; however, it did not have a direct effect on neonatal or child health practices. The ‘co-learning’ workshops revealed crucial aspects, such as prevailing socio-cultural norms, which prevented pregnant or recently delivered women from participating in SHG meetings. This paper encourages evaluators to work with the community to interpret and co-construct meaning in unpacking the contextual forces that seldom appear in the program ToC
Behavioral sentinel surveillance survey in Nigeria: Endline technical report for couples
Get PDFThis technical report presents information from married couples on health norms, attitudes, and beliefs as part of the Behavioral Sentinel Surveillance (BSS) endline survey undertaken by Breakthrough RESEARCH/Nigeria in Kebbi, Sokoto and Zamfara States between October 1 and November 10, 2022. BSS surveys assess changes in indicators targeted by the integrated social and behavior change (SBC) activities of the USAID-funded Breakthrough ACTION/Nigeria’s project. Breakthrough ACTION/Nigeria, which is slated to run from 2019 to 2025, utilizes SBC focused on the health areas of malaria; family planning (FP); and maternal, newborn, and child health plus nutrition (MNCH+N) in Kebbi and Sokoto states, as well as malaria-only SBC activities in Zamfara State. The project uses three primary SBC approaches: advocacy outreach to opinion leaders and community influencers at the state and local government area (LGA) levels, direct engagement of community members through community dialogues, group meetings and household visits, and SBC messaging campaigns through mass media and digital media
A shot at economic prosperity: Long-term effects of India’s childhood immunization program on earnings and consumption expenditure
No full textRoutine childhood vaccinations are among the most cost-effective child health interventions. In recent years, the broader benefits of vaccines, which include improved cognitive and schooling outcomes, have also been established. This paper evaluates the long-term economic benefits of India’s national program of childhood vaccinations, known as the Universal Immunization Programme (UIP). We combine individual-level data from the 68th round of the National Sample Survey of India (2011–12) with district-wise data on the rollout of UIP from 1985 to 1990. We employ age-district fixed-effects regression models to compare the earnings and per capita household consumer spending of 21-to 26-year-old adults who were born in UIP-covered districts vis-à-vis non-UIP districts between 1985 and 1990. We find that exposure to UIP in infancy increases weekly wages by 13.8 percent (95 percent CI: 7.6–20.3 percent, p \u3c 0:01) and monthly per capita household consumption expenditure by 2.9 percent (95 percent CI: 0.7–5.0 percent, p \u3c 0:01). Program exposure also reduces the probability that an individual’s household relies on agriculture as the main source of income by 1.9 percent (95 percent CI: 0.0–3.5 percent, p \u3c 0:01). The findings are robust to several specifications including varying study duration and accounting for potential migration. The effects vary by sex, location, and caste group
Climate-related experiences and harms in the wake of the COVID-19 pandemic: Results from a survey of 152,088 Mexican youth
No full textThe dual crises of COVID-19 and climate change are impacting the lives of adolescents and young people as they transition to adulthood in an uncertain world, yet they are often excluded from research and political discourse. We surveyed young people about their needs and experiences, critical to engaging them and designing effective programs and policies to address these intersecting harms. The 2022 round of a national online survey through the Violence Outcomes in COVID-19 Epoch (VoCes) Study surveyed 152,088 Mexican youth (15–24 years). Logistic regressions were implemented to identify characteristics associated with four climate responses (economic, work-related, receiving government support, or social network support). Overall, 8.1% of participants experienced a recent climate hazard, with major impacts including housing damage from floods, and crop/livestock losses from drought. Participants who experienced a climate hazard were more likely to have experienced a pandemic-related harm, suggesting a dual impact. Poor youth were more likely to report economic losses from both the pandemic and a climate event but least likely to receive government support. Economic effects from the pandemic are exacerbating climate-related harms, unequally threatening the poorest youth. Engaging young people in decision-making and supporting the most vulnerable youth is critical for the next generation to thrive
