8 research outputs found
Health facility surveys : an introduction
No full textHealth facility surveys come in various guises. One dimension in which they vary is their motivation. Some seek to understand better links between households and providers. Others seek to understand better provider behavior and performance. Still others seek to understand the interrelationships between providers, while yet others seek to shed light on the linkages between government and providers. Health facility surveys differ too in the data they collect, in part due to the different motivations. Surveys also vary in the way they collect data, some relying on direct observation, some on record review, and some on interview. Some quality data are collected through clinical vignettes. Facility data have been put to a variety of uses, including planning and budgeting; monitoring, evaluation, and promoting accountability; and research. Lindel and Wagstaff review some of the literature under each heading and offer some conclusions regarding the current state of health facility surveys.Health Monitoring&Evaluation,Public Health Promotion,Health Systems Development&Reform,Early Child and Children's Health,Housing&Human Habitats,Health Monitoring&Evaluation,Health Systems Development&Reform,Agricultural Knowledge and Information Systems,Housing&Human Habitats,Health Economics&Finance
Africa's Lagging Demographic Transition: Evidence from Exogenous Impacts of Malaria Ecology and Agricultural Technology
No full textMuch of Africa has not yet gone through a "demographic transition" to reduced mortality and fertility rates. The fact that the continent's countries remain mired in a Malthusian crisis of high mortality, high fertility, and rapid population growth (with an accompanying state of chronic extreme poverty) has been attributed to many factors ranging from the status of women, pro-natalist policies, poverty itself, and social institutions. There remains, however, a large degree of uncertainty among demographers as to the relative importance of these factors on a comparative or historical basis. Moreover, econometric estimation is complicated by endogeneity among fertility and other variables of interest. We attempt to improve estimation (particularly of the effect of the child mortality variable) by deploying exogenous variation in the ecology of malaria transmission and in agricultural productivity through the staggered introduction of Green Revolution, high-yield seed varieties. Results show that child mortality (proxied by infant mortality) is by far the most important factor among those explaining aggregate total fertility rates, followed by farm productivity. Female literacy (or schooling) and aggregate income do not seem to matter as much, comparatively.
Health care demand in rural Mozambique
No full textDespite rapid economic growth in recent years, Mozambique remains a very poor country. Expenditure-based poverty measures are reflected in widespread food insecurity and poor health status. In recognition of these problems, the Government of Mozambique is promoting expanded and improved quality and equity in access to health care as an important component in the global strategy to fight poverty. Given years of colonial neglect and systematic destruction of health facilities during the civil war, recent government policy has focused on expanding the rural health network. However, insofar as the ultimate objective of the provision of curative services is to ensure that those in need of care receive effective treatment, it is also necessary to think beyond supply. Specifically, we need to consider how individuals behave during episodes of illness, and what factors affect this behavior. This paper provides quantitative evidence on the importance of individual, household, and community characteristics on individuals' care-seeking decisions during episodes of illness. The paper estimates a “flexible” multinomial model of health care provider choice conditional on illness using data from the 1996/97 Mozambique National Household Survey on Living Conditions (IAF). The empirical analysis is underpinned by a basic theoretical framework of utility maximization and household production of health. A number of individual and household characteristics, e.g., age, education, and reported symptoms, stand out as highly significant determinants of health seeking behavior. Also, prices, defined in the model as the composite of user fees and time costs associated with consultations at different providers, are found to be important determinants of choice. The results indicate that the eradication of poverty, independent of improvements in physical access to health care and education, will have only a negligible effect on health care choices.Poverty alleviation. ,Rural health services Mozambique. ,
Education and health at the household level in sub-Saharan Africa
No full textThis paper surveys the microeconomic evidence on the determinants of and returns to education and health in sub-Saharan Africa. A year of education is associated with 3-14% increases wages and productivity. The introduction or removal of user fees can have dramatic effects on take-up of health and education services.
The HERA-19 Commissioning Array: Direction-dependent Effects
No full textForeground power dominates the measurements of interferometers that seek a statistical detection of highly-redshifted H i emission from the Epoch of Reionization (EoR). The chromaticity of the instrument creates a boundary in the Fourier transform of frequency (proportional to k∥) between spectrally smooth emission, characteristic of the strong synchrotron foreground (the “wedge”), and the spectrally structured emission from H i in the EoR (the “EoR window”). Faraday rotation can inject spectral structure into otherwise smooth polarized foreground emission, which through instrument effects or miscalibration could possibly pollute the EoR window. For instruments pursuing a “foreground avoidance” strategy of simply measuring in the EoR window, and not attempting to model and remove foregrounds, as is the plan for the first stage of the Hydrogen Epoch of Reionization Array (HERA), characterizing the intrinsic instrument polarization response is particularly important. Using data from the HERA 19-element commissioning array, we investigate the polarization response of this new instrument in the power-spectrum domain. We perform a simple image-based calibration based on the unpolarized diffuse emission of the Global Sky Model, and show that it achieves qualitative redundancy between the nominally redundant baselines of the array and reasonable amplitude accuracy. We construct power spectra of all fully polarized coherencies in all pseudo-Stokes parameters, and discuss the achieved isolation of foreground power due to the intrinsic spectral smoothness of the foregrounds, the instrument chromaticity, and the calibration. We compare to simulations based on an unpolarized diffuse sky model and detailed electromagnetic simulations of the dish and feed, confirming that in Stokes I, the calibration does not add significant spectral structure beyond that expected from the interferometer array configuration and the modeled primary beam response. Furthermore, this calibration is stable over the 8 days of observations considered. Excess power is seen in the power spectra of the linear polarization Stokes parameters, which is not easily attributable to leakage via the primary beam, and results from some combination of residual calibration errors and actual polarized emission. Stokes V is found to be highly discrepant from the expectation of zero power, strongly pointing to the need for more accurate polarized calibration
Foreground modelling via Gaussian process regression: an application to HERA data
No full textInternational audienceThe key challenge in the observation of the redshifted 21-cm signal from cosmic reionization is its separation from the much brighter foreground emission. Such separation relies on the different spectral properties of the two components, although, in real life, the foreground intrinsic spectrum is often corrupted by the instrumental response, inducing systematic effects that can further jeopardize the measurement of the 21-cm signal. In this paper, we use Gaussian Process Regression to model both foreground emission and instrumental systematics in ∼2 h of data from the Hydrogen Epoch of Reionization Array. We find that a simple co-variance model with three components matches the data well, giving a residual power spectrum with white noise properties. These consist of an ‘intrinsic’ and instrumentally corrupted component with a coherence scale of 20 and 2.4 MHz, respectively (dominating the line-of-sight power spectrum over scales k_∥ ≤ 0.2 h cMpc^−1) and a baseline-dependent periodic signal with a period of ∼1 MHz (dominating over k_∥ ∼ 0.4–0.8 h cMpc^−1), which should be distinguishable from the 21-cm Epoch of Reionization signal whose typical coherence scale is ∼0.8 MHz
Books, Buildings and Learning Outcomes: an impact evaluation of World Bank assistance to basic education in Ghana
No full textThis paper demonstrates that the delivery of hardware inputs to Ghana’s basic education system – building classrooms and supplying textbooks – has had a substantial impact on higher enrollments and better learning outcomes. The Bank’s support for school building has been a major factor behind Ghana being on track to achieve the Millennium Development Goal of Universal Primary Education. The context for these improvements was a government strongly committed to implementing a program of educational reform that refocused government resources away from secondary and tertiary education and onto the basic sector. But the Bank’s support played a critical role in allowing the government to carry out its plans. Partly because of increased reliance on community contributions, a gap is opening up between the majority of schools and those in poorer communities, particularly in off-road rural areas. Facilities in schools in poorer areas are usually inferior and teacher absenteeism high, so that little learning can take place. Special attention needs to be paid to these least-privileged schools if Ghana is to remain on track to meet the education MDG.Impact evaluation, education, Ghana, Africa
