scholarly journals Consumer Taxes on Alcohol: An International Comparison over Time

2020 ◽  
Vol 15 (1) ◽  
pp. 42-70 ◽  
Author(s):  
Kym Anderson
Keyword(s):  
Decision Making ◽  
International Comparison ◽  
Alcoholic Beverages ◽  
Middle Income ◽  
Middle Income Countries ◽  
Government Decision ◽  
Alcohol Taxation ◽  
Over Time ◽  
Jel Classifications

AbstractRates of alcohol taxation, and the types of tax instruments used, vary enormously between countries and have tended to rise in recent times. Within each country, they also vary between beverages and often between qualities and styles of each beverage. This article computes consumer tax equivalents in U.S. dollars per litre of alcohol and as percentages of wholesale prices of representative beverages for 42 high- and middle-income countries. That allows comparisons across countries of taxes not just for each product on its own, but also relative to those for other alcoholic beverages. The wide dispersion of rates and differences in tax instruments across countries and products suggest differing strengths of health and welfare lobbyists and industry groups in influencing government decision-making. (JEL Classifications: D12, D62, E62, H23, I18, P46)

scholarly journals SWPER Global: A survey-based women’s empowerment index expanded from Africa to all low- and middle-income countries

2020 ◽  
Author(s):  
Fernanda Ewerling ◽  
Anita Raj ◽  
Cesar G. Victora ◽  
Franciele Hellwig ◽  
Carolina V. N. Coll ◽  
...  
Keyword(s):  
Decision Making ◽  
Women's Empowerment ◽  
Women’S Empowerment ◽  
List Type ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
World Regions ◽  
Over Time ◽  
Low And Middle Income

AbstractIntroductionIn 2017, a survey-based women’s empowerment index (SWPER) was proposed for African countries, including three domains: social independence, decision making and attitude to violence. External validity and predictive value of the SWPER has been demonstrated in terms of coverage of maternal and child interventions and use of modern contraception. To determine its value for global monitoring, we explored the applicability of the SWPER in national health surveys from low- and middle-income countries (LMICs) in other world regions.MethodsWe used data from the latest Demographic and Health Survey for 62 LMICs since 2000. 14 pre-selected questions (items) were considered during the validation process. Content adaptations included the exclusion of women’s working status and recategorization of the decision-making related items. We compared the loading patterns obtained from principal components analysis performed for each country separately with those obtained in a pooled dataset with all countries combined. Country rankings based on the score of each SWPER domain were correlated with their rankings in the Gender Development Index (GDI) and the Gender Inequality Index (GII) for external validation.ResultsConsistency regarding item loadings for the three SWPER empowerment domains was observed for most countries. Correlations between the scores generated for each country and global score obtained from the combined data were 0.89 or higher for all countries. Correlations between the country rankings according to SWPER and GDI were, respectively, 0.74, 0.72 and 0.67 for social independence, decision-making, and attitude to violence domains. The correlations were equal to 0.81, 0.67, and 0.44, respectively, with GII.ConclusionThe indicator we propose, named SWPER Global, is a suitable common measure of women’s empowerment for LMICs, addressing the need for a single consistent survey-based indicator of women’s empowerment that allows for tracking of progress over time and across countries at the individual and country levels.SummaryWhat is already known?Although survey-based women’s empowerment indicators have been used in the literature, until 2017 there was no indicator proposed for use in a large set of countries that would be comparable between and within countries.In 2017, we proposed the Survey-based Women’s emPowERment indicator (SWPER, pronounced as “super”), to be used in African countries, that encompasses three wellrecognized domains of women’s empowerment (attitude to violence, social independenceand decision making).The external validity and predictive value of the SWPER has been demonstrated in terms of coverage of maternal and child interventions and use of modern contraception.Validation of the index was restricted to African countries, and a common measure to allow comparisons across low and middle-income countries (LMICs) from all world regions was still lacking.What are the new findings?We show that the SWPER Global may serve as a valid common measure of women’s empowerment among LMICs, as consistent patterns were obtained for most countries and world regions.The SWPER Global index addresses the need for a single cross-cultural standardized survey-based indicator of women’s empowerment in the context of LMICs that enables comparability between countries and over time and subgroup analyses, extending previously proposed indicators such as the Gender Development Index which is limited to the country-levelWhat do the new findings imply?The SWPER Global index enables the study of how women’s empowerment is linked to developmental and health outcomes, allowing for broad comparisons across countries and world regions.As a comprehensive cross-cultural standard tool, it also contributes to the monitoring and accountability of country progress over time in advancing gender equality and women’s empowerment.The new tool may help target and prioritize policy and advocacy efforts toward SDG 5 (achieve gender equality and empower all women and girls) at the regional and country levels.

scholarly journals Maternal mortality in six low and lower-middle income countries from 2010 to 2018: risk factors and trends

2020 ◽  
Vol 17 (S3) ◽  
Author(s):  
Melissa Bauserman ◽  
Vanessa R. Thorsten ◽  
Tracy L. Nolen ◽  
Jackie Patterson ◽  
Adrien Lokangaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Maternal Mortality ◽  
Maternal Deaths ◽  
Middle Income ◽  
Maternal Risk ◽  
Live Births ◽  
Middle Income Countries ◽  
Risk Of Death ◽  
Increased Risk ◽  
Over Time

Abstract Background Maternal mortality is a public health problem that disproportionately affects low and lower-middle income countries (LMICs). Appropriate data sources are lacking to effectively track maternal mortality and monitor changes in this health indicator over time. Methods We analyzed data from women enrolled in the NICHD Global Network for Women’s and Children’s Health Research Maternal Newborn Health Registry (MNHR) from 2010 through 2018. Women delivering within research sites in the Democratic Republic of Congo, Guatemala, India (Nagpur and Belagavi), Kenya, Pakistan, and Zambia are included. We evaluated maternal and delivery characteristics using log-binomial models and multivariable models to obtain relative risk estimates for mortality. We used running averages to track maternal mortality ratio (MMR, maternal deaths per 100,000 live births) over time. Results We evaluated 571,321 pregnancies and 842 maternal deaths. We observed an MMR of 157 / 100,000 live births (95% CI 147, 167) across all sites, with a range of MMRs from 97 (76, 118) in the Guatemala site to 327 (293, 361) in the Pakistan site. When adjusted for maternal risk factors, risks of maternal mortality were higher with maternal age > 35 (RR 1.43 (1.06, 1.92)), no maternal education (RR 3.40 (2.08, 5.55)), lower education (RR 2.46 (1.54, 3.94)), nulliparity (RR 1.24 (1.01, 1.52)) and parity > 2 (RR 1.48 (1.15, 1.89)). Increased risk of maternal mortality was also associated with occurrence of obstructed labor (RR 1.58 (1.14, 2.19)), severe antepartum hemorrhage (RR 2.59 (1.83, 3.66)) and hypertensive disorders (RR 6.87 (5.05, 9.34)). Before and after adjusting for other characteristics, physician attendance at delivery, delivery in hospital and Caesarean delivery were associated with increased risk. We observed variable changes over time in the MMR within sites. Conclusions The MNHR is a useful tool for tracking MMRs in these LMICs. We identified maternal and delivery characteristics associated with increased risk of death, some might be confounded by indication. Despite declines in MMR in some sites, all sites had an MMR higher than the Sustainable Development Goals target of below 70 per 100,000 live births by 2030. Trial registration The MNHR is registered at NCT01073475.

scholarly journals Comparing use and acceptability of menstrual cups and sanitary pads by schoolgirls in rural Western Kenya

2019 ◽  
Vol 8 (8) ◽  
pp. 2974
Author(s):  
Linda Mason ◽  
Elizabeth Nyothach ◽  
Anna Maria Van Eijk ◽  
David Obor ◽  
Kelly T. Alexander ◽  
...  
Keyword(s):  
Linear Trend ◽  
Prior Experience ◽  
Middle Income ◽  
Western Kenya ◽  
Middle Income Countries ◽  
Product Use ◽  
Sanitary Pads ◽  
Menstrual Products ◽  
Over Time

Background: Girls in low and middle-income countries (LMIC) lack access to hygienic and affordable menstrual products. We explore Kenyan schoolgirls’ use and views of the cup compared to girls provided with disposable sanitary pads for a feasibility study.Methods: Schoolgirls aged 14-16 years, received a menstrual cup in 10 schools or 16 pads/month in another10 schools. All were trained by nurses on puberty, hand washing, and product use. They self-completed a net book survey at baseline and twice a term during a year follow-up. We examined their reported ease of insertion and removal, also comfort, soreness, and pain with product use. An aggregate ‘acceptability’ score was compiled for each product and girls’ socio-demographic and menstrual characteristics were compared.Results: 195 participants received cups and 255 pads. Mean age was 14.6 years, menarchial age was 13.6 years, with an average 3.8 days menses per month. Cup use was 39% in month 1, rising to 80% by month 12 (linear trend p<0.001). Pad use rose from 85% to 92% (linear trend p=0.15). Measures of cup acceptability demonstrated girls had initial problems using the cup but reported difficulties with insertion, removal and comfort reduced over time. Girls using pads reported fewer acceptability issues. At baseline, approximately a quarter of girls in the pad arm reported inserting pads intravaginally although this was significantly lower among girls with prior experience of pad use (aRR 0.62; 0.45-0.87).Conclusions: While a smaller proportion of girls provided with cups used them in the first months compared to girls given pads, reported use was similar by study-end, and early acceptability issues reduced over time. Girls in LMIC may successfully and comfortably use cups, but require instruction, support and some persistence.

scholarly journals Election Administration, Resource Allocation, and Turnout: Evidence From Kenya

2020 ◽  
pp. 001041402093808
Author(s):  
J. Andrew Harris
Keyword(s):  
Decision Making ◽  
Resource Allocation ◽  
Political Behavior ◽  
Large Scale ◽  
Regression Discontinuity ◽  
Regression Discontinuity Design ◽  
Middle Income ◽  
Election Administration ◽  
Middle Income Countries ◽  
Policy Choices

Decisions about how to organize and run an election can shape political participation. Policy choices may distribute election resources unequally, skewing voting outcomes. In low- and middle-income countries where electoral capacity and resources are scarce and decision-making highly centralized, election administration has the potential to shape results on a large scale. In the context of Kenya’s August 2017 elections, I study the consequences of a legislated threshold that determines the capacity of polling centers to quickly serve voters by reducing election-day lines. Using a regression discontinuity design, I find that turnout is 2.4% lower in congested polling places just below the threshold relative to polling places above the threshold. Relative to other hypothetical thresholds, the chosen threshold benefits the incumbent president, as incumbent strongholds receive more polling resources than opposition areas. The results demonstrate how electoral resource allocation shapes political behavior and election outcomes.

Health Care Coverage Decision Making in Low- and Middle-Income Countries: Experiences from 25 Coverage Schemes

2015 ◽  
Vol 18 (4) ◽  
pp. 265-271 ◽  
Author(s):  
Hialy Gutierrez ◽  
Ashwini Shewade ◽  
Minghan Dai ◽  
Pedro Mendoza-Arana ◽  
Octavio Gómez-Dantés ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Middle Income ◽  
Health Care Coverage ◽  
Middle Income Countries ◽  
Coverage Decision ◽  
Low And Middle Income

scholarly journals Oral Morphine Use in South India: A Population-Based Study

2017 ◽  
Vol 3 (6) ◽  
pp. 720-727 ◽  
Author(s):  
M.R. Rajagopal ◽  
Safiya Karim ◽  
Christopher M. Booth
Keyword(s):  
Temporal Trends ◽  
Oral Morphine ◽  
Population Based ◽  
Private Institutions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Provider Characteristics ◽  
Regional Trends ◽  
Per Capita ◽  
Over Time

Purpose Access to opioids for pain control is recognized as an urgent issue in low- and middle-income countries. Here we report temporal and regional trends in morphine use in Kerala, India. Methods Oral morphine use data for the State of Kerala (2012 to 2015) was used to describe temporal trends, regional variation, and provider characteristics. Total morphine use was calculated for each district of Kerala to derive an annual per capita use rate (milligrams per capita). Each provider was classified as government, private, nongovernment organization (NGO), or NGO partnership. Results Oral morphine use for Kerala was 1.32 mg/capita and increased over the study period 27% (from 1.23 mg/capita to 1.56 mg/capita). There was substantial variation in morphine use across districts (range, 0.49 mg/capita to 2.97 mg/capita; six-fold difference). This variation increased over time (19-fold difference in 2015). In 2015, 31% of morphine providers (51 of 167) were government institutions; they delivered 48% of total morphine in Kerala. Corresponding data for other providers are private institutions, 23% of centers and 13% of morphine; NGOs, 41% of centers and 34% of morphine; and NGO partnerships, 5% of centers and 4% of morphine. From 2012 to 2015, the total number of centers increased by 35%, from 124 to 167. Conclusion Oral morphine use has increased over time in Kerala but remains substantially lower than estimated need. There is significant geographic variation of use. Efforts are needed to improve palliative care in Kerala and to reduce regional disparities in access to opioids.

scholarly journals Turning ‘evidence for development’ on its head: A view from Africa

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Ruth Stewart
Keyword(s):  
Decision Making ◽  
Global South ◽  
African Philosophy ◽  
Informed Decision Making ◽  
Middle Income ◽  
Middle Income Countries ◽  
The North ◽  
Poverty And Inequality ◽  
Resource Poor ◽  
Global North

The ‘evidence for development’ community aims to produce research that is useful and used to address issues of poverty and inequality, largely in low- and middle-income countries (often referred to as the ‘global South’). The unspoken norm, however, is that much of the engagement, funding and attention is focused on organizations and individuals in the global North, with the assumption that they are effective in supporting the needs of the global South. In this research paper, I explore the initiatives and the individuals and organizations that are working within the ‘evidence for development’ community in Africa, using the lens of the African philosophy of ubuntu. I present findings from a programme of work undertaken across Africa to identify and better understand the innovation in evidence-informed decision-making taking place across the continent. I demonstrate that, while resource-poor and not well publicized, the evidence community in Africa is world leading in a number of respects. These include the interconnections within its continent-wide network, and the engagement of some governments within its ecosystem. Reflecting on these findings, I discuss and critique the underlying foundations of patriarchy, development and coloniality that shape the field of ‘evidence for development’. I highlight how, in an era of decoloniality, post-‘development’ and antipatriarchy, the ‘evidence for development’ community risks becoming outdated and being ineffective if it does not engage with the challenges inherent within these concepts. I argue that using the alternative lens of ubuntu enables us to celebrate the successes of Southern evidence communities, and to work together on a level footing with the North to tackle the challenges of poverty and inequality through better use of evidence.

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