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Faire progresser la mesure des changements sociaux et comportementaux en matière de planification familiale
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Coping with climate change: The role of climate related stressors in affecting the mental health of young people in Mexico
No full textYoung people today are predicted to experience more climate change related stressors and harms than the previous generation, yet they are often excluded from climate research, policy, and advocacy. Increasingly, this exposure is associated with experience of common mental health disorders (CMD). The VoCes-19 study collected surveys from 168,407 young people across Mexico (ages 15–24 years) through an innovative online platform, collecting information on various characteristics including CMD and experience of recent climate harms. Logistic regression models were fit to explore characteristics associated with CMD. Structural equation models were fit to explore pathways between exposure, feeling of concern about climate change, and a sense of agency (meaning the respondent felt they could help address the climate crisis) and how these relate to CMD. Of the respondents, 42% (n = 50,682) were categorized as experiencing CMD, higher among those who experienced a climate stressor (51%, n = 4,808) vs those not experiencing climate stressors (41%, n = 43,872). Adjusting for key demographic characteristics, exposure to any climate event increased the odds of CMD by 50% (Odd Ratio = 1.57; 95% Confidence Interval (CI) 1.49, 1.64), highest for heatwaves. Specific climate impacts such as housing damage, loss of or inability to work, damage to family business, leaving school and physical health affected were adversely related to CMD, though for different climate hazards. More concern and less agency were related to CMD through different pathways, particularly for those exposed to recent events. Future research regarding the cumulative exposures to climate change, not just acute events but as an ongoing crisis, and various pathways that influence the mental health and well-being of young people must be clearly understood to develop programs and policies to protect the next generation
Changes in mental health problems during the COVID-19 pandemic in Mexican youth: Insights from the Voces-19 study
No full textBackground: Previous research suggests that the mental health impacts of the COVID-19 pandemic were stronger during the first months of it. It has also been proposed that those impacts depended on gender and other social determinants. Aims: We aim to describe the change in prevalence of mental health problems (symptoms of common mental disorders [CMD], alcohol, and drug use) between two time periods during the pandemic, and the association of mental health problems with social determinants, in adolescents and young adults in Mexico. Methods: We conducted a repeated cross-section analysis of data from VoCes-19, an online survey in November 2020 to February 2021 and November 2021 to March 2022 (combined n = ×224,099). We assessed the change in the prevalence of mental health problems, the differences in prevalence and change in the prevalence by gender, and the association of social determinants and pandemic-related variables with mental health problems, by means of multivariate regression models. Results: The prevalence of CMD decreased (46.0% vs. 42.4%), while the prevalence of alcohol (frequent use 8.4% vs. 10.3%) and drug use (4.6% vs. 7.7%) increased. The three conditions increased more among girls/young women and trans/queer/non-binary participants than among boys/young men. Conclusions: The results point to the importance of considering the gendered social context of young people. A better understanding of the social circumstances that relate with mental health is required to inform interventions for these age groups
Improving provider and client communication around family planning in Togo: Results from a cross-sectional survey
No full textPrevious research has shown that clients are better able to achieve their reproductive intentions when family planning (FP) services meet their needs and they have satisfying client provider interactions. There are several areas of quality provider-client communication, including providers taking a complete reproductive history of their clients to best gauge their needs, communication around alternative FP methods and side effects captured in the method information index, and communication around sexually transmitted infections and HIV risk as it relates to FP choices. This study examines data from a clinic-based intervention in Togo that focuses on strengthening health provider counseling related to FP, including improving in these three areas of provider-client communication. A clustered sampling approach was used to select 650 FP clients from 23 intervention facilities and 235 clients from 17 control facilities in the Lomé and Kara districts of Togo. The FP clients’ interactions with providers were observed and clients exit interviews were conducted in December 2021. For each communication area measured through client interviews and observations, principal components analysis and Cronbach’s alpha scores were used to ensure that the individual components could be indexed. Outcomes variables based on an index of sub-questions were then created for those who had fulfilled each of the components within an index. Multivariate multilevel mixed-effects logit models accounted for clients nested within facilities and included independent variables capturing client demographic and facility variables. Multivariate results show that all three outcome variables representing the three provider-client communication areas were statistically significantly better for FP clients in intervention clinics versus control clinics (p \u3c 0.05). The results speak to the emphasis that the Togo Ministry of Health has placed on building the provider capacity to provide quality counseling and administration of FP methods and working to assist in achieving health programming goals through well-designed interventions
Effects of a single cash transfer on school re-enrollment during COVID-19 among vulnerable adolescent girls in Kenya: Randomized controlled trial
No full textCOVID-19 related school closures in Kenya were among the longest in Africa, putting older adolescent girls nearing the end of secondary school at risk of permanent dropout. Using a randomized-controlled trial we evaluated a logistically simple cash transfer intervention in urban areas designed to promote their return to school. There were no required conditions for receiving the transfer and the intervention is interpreted as a labeled cash transfer. It had substantial significant effects on re-enrollment of adolescent girls, with greater effectiveness for older girls and even for some not enrolled earlier in the school year. The program effectiveness demonstrates feasibility of the approach and underscores the potential importance of additional resources for schooling during the pandemic, when a large majority of households had suffered income losses
Adolescent girls’ agency and their labour force participation: Experimental evidence from rural Bangladesh
No full textIn many South Asian countries, recent improvement in girls’ education has not been reflected in increased labour force participation. We hypothesise girls’ agency as a necessary condition to enhance their labour force participation. Data from an experimental setting is utilised to examine whether addressing gender-awareness skills is effective in encouraging girls’ paid-work participation in Bangladesh as compared with strengthening knowledge learned in school or livelihood skills obtained in vocational training. We found strong evidence that addressing gender awareness encourages girls’ paid-work participation while tutoring support or livelihood skills training does not. In the context of a strong patriarchal society, gender-awareness skill may be the key to enhancing girls’ labour force participation. The current study includes an important policy implication suggesting that enhancing education and providing technical skills training may not translate to enhanced productivity in the labour market in the absence of agency to utilise them
Population and environment: The evolution of the debate between optimists and pessimists
No full textThe potential adverse effects of rapid population growth on human welfare and our natural environment have been the subject of lively debate since the time of Thomas Malthus. This debate has often been contentious with pessimists arguing that population growth has extensive harmful impacts and optimists claiming that advances in technology and smoothly operating markets can take care of society’s needs without irreversible damage to the environment. This essay summarizes the evolution of the positions of pessimists and optimists after the middle of the 20th century. From the 1950s to the late 1970s the international discussion of population and environment was dominated by concern about the potential negative impact of rapid population growth in the less developed world and by the feasibility of policy options for reducing the pace of growth. A reversal of this consensus occurred in the 1980 and 1990 s leading to a revisionist view that population growth was at best a minor problem. However, by the turn of the 21st century a broader population policy agenda evolved that included not only renewed interest in the unfavorable effects of population growth but also in other issues such as climate change, international migration, and rapid urbanization. A concluding section discusses the reasons why we don’t agree. Continuing disagreements between optimists and pessimists are now less about scientific facts and more about a host of economic, ethical, aesthetic, and political questions
Behavioral sentinel surveillance survey in Nigeria: Endline technical report
Get PDFThis technical report presents results from 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 are intended to assess changes in indicators targeted by the integrated social and behavior change (SBC) activities of the USAID-funded Breakthrough ACTION/Nigeria project. The Breakthrough ACTION/Nigeria project, which began in 2019 and is slated to run until 2025, focuses on the health areas of malaria; family planning; 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 and group meetings, and SBC messaging campaigns through mass media and digital media. The primary objective of this study is to compare the effectiveness of integrated SBC programming, as implemented by Breakthrough ACTION/Nigeria in Kebbi and Sokoto states, with single-focused vertical SBC programming, used by Breakthrough ACTION/Nigeria to target malaria outcomes in Zamfara state