Your mileage may vary: Have road-fuel income and price elasticities changed over time in middle-income countries?

2021 ◽  
Author(s):  
Brant Liddle ◽  
Fakhri Hasanov ◽  
Steven Parker
Keyword(s):  
Middle Income ◽  
Price Elasticities ◽  
Middle Income Countries ◽  
Income And Price Elasticities ◽  
Over Time

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 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 A Uniform Substitute Demand Model with Varying Coefficients

2000 ◽  
Vol 32 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Mark G. Brown ◽  
Jong-Yinq Lee
Keyword(s):  
Orange Juice ◽  
Demand System ◽  
Demand Model ◽  
Demand Modeling ◽  
Price Elasticities ◽  
Varying Coefficients ◽  
Modeling Approach ◽  
Income And Price Elasticities ◽  
Over Time

AbstractThis study extends Batten's synthetic demand modeling approach to increase the flexibility of the uniform substitute specification of the Rotterdam demand system. Marginal propensities to consume (MPC) vary with budget shares and Slutsky coefficients are defined in terms of varying MPCs. An application of the model to orange-juice products shows that the pattern of income and price elasticities over time is much different than when MPCs are restricted to be constant.

scholarly journals Opening up ‘fever’, closing down medicines

2019 ◽  
Vol 6 (4) ◽  
Author(s):  
Clare Chandler ◽  
Justin Dixon
Keyword(s):  
Antimicrobial Resistance ◽  
Global Health ◽  
Integrated Management ◽  
Childhood Illness ◽  
High Tech ◽  
Middle Income ◽  
Middle Income Countries ◽  
Opening Up ◽  
Over Time ◽  
Global Algorithm

Rising concerns about antimicrobial resistance have sparked a renewed push to rationalise and ration the use of medicines. This article explores the case of the Integrated Management of Childhood Illness (IMCI) guideline, a periodically updated ‘global’ algorithm that shapes and normalises the centrality of medicines to care in low- and middle-income countries and, increasingly, the imperative to ration them. Using ‘classification work’ as analytic frame, we firstly consider the IMCI algorithm as a blueprint for global health that classifies illnesses, patients, and care in particular ways relative to available medicines. Zooming in on this blueprint, we then offer a classificatory reading of ‘fever’ over time, tracing ‘nonmalarial fever’ from being malaria’s residual ‘other’ category to becoming increasingly legible through attention to diagnostics and antibiotic (over)use. Our reading suggests that an apparent refinement of the ‘fever’ category may concurrently entail the closing down of medicine options. This raises the possibility that an increasingly high-tech but ‘empty’ form of pharmaceuticalised care is being incidentally worked into the infrastructure of weak health systems.

scholarly journals Short-term, medium-term and long-term effects of early parenting interventions in low- and middle-income countries: a systematic review

2021 ◽  
Vol 6 (3) ◽  
pp. e004067
Author(s):  
Joshua Jeong ◽  
Helen O Pitchik ◽  
Günther Fink
Keyword(s):  
Parenting Interventions ◽  
Long Term Effects ◽  
Medium Term ◽  
Short Term ◽  
Middle Income ◽  
Middle Income Countries ◽  
Development Outcomes ◽  
Over Time

IntroductionParenting interventions during early childhood are known to improve various child development outcomes immediately following programme implementation. However, less is known about whether these initial benefits are sustained over time.MethodsWe conducted a systematic literature review of parenting interventions in low- and middle-income countries (LMICs) that were delivered during the first 3 years of life and had completed a follow-up evaluation of the intervention cohort at least 1 year after the primary postintervention endpoint. We summarized intervention effects over time by child-level and parent-level outcomes as well as by timing of follow-up rounds in the short-term (1–3 years after programme completion), medium-term (4–9 years), and long-term (10+ years). We also conducted exploratory meta-analyses to compare effects on children’s cognitive and behavioral development by these subgroups of follow-up rounds.ResultsWe identified 24 articles reporting on seven randomised controlled trials of parenting interventions delivered during early childhood that had at least one follow-up study in seven LMICs. The majority of follow-up studies were in the short-term. Three trials conducted a medium-term follow-up evaluation, and only two trials conducted a long-term follow-up evaluation. Although trials consistently supported wide-ranging benefits on early child development outcomes immediately after programme completion, results revealed a general fading of effects on children’s outcomes over time. Short-term effects were mixed, and medium-term and long-term effects were largely inconclusive. The exploratory meta-analysis on cognitive development found that pooled effects were significant at postintervention and in the short-term (albeit smaller in magnitude), but the effects were not significant in the medium-term and long-term. For behavioural development, the effects were consistently null over time.ConclusionsThere have been few longer-term follow-up studies of early parenting interventions in LMICs. Greater investments in longitudinal intervention cohorts are needed in order to gain a more comprehensive understanding of the effectiveness of parenting interventions over the life course and to improve the design of future interventions so they can have greater potential for achieving and sustaining programme benefits over time.

scholarly journals How global is global health research? A large-scale analysis of trends in authorship

2021 ◽  
Vol 6 (1) ◽  
pp. e003758
Author(s):  
Michelle C Dimitris ◽  
Matthew Gittings ◽  
Nicholas B King
Keyword(s):  
Global Health ◽  
Low Income ◽  
Health Research ◽  
Large Scale ◽  
Health Science ◽  
Global Health Research ◽  
Middle Income ◽  
Middle Income Countries ◽  
Income Status ◽  
Over Time

Many have called for greater inclusion of researchers from low- and middle-income countries (LMICs) in the conduct of global health research, yet the extent to which this occurs is unclear. Prior studies are journal-, subject-, or region-specific, largely rely on manual review, and yield varying estimates not amenable to broad evaluation of the literature. We conducted a large-scale investigation of the contribution of LMIC-affiliated researchers to published global health research and examined whether this contribution differed over time. We searched titles, abstracts, and keywords for the names of countries ever classified as low-, lower middle-, or upper middle-income by the World Bank, and limited our search to items published from 2000 to 2017 in health science-related journals. Publication metadata were obtained from Elsevier/Scopus and analysed in statistical software. We calculated proportions of publications with any, first, and last authors affiliated with any LMIC as well as the same LMIC(s) identified in the title/abstract/keywords, and stratified analyses by year, country, and countries’ most common income status. We analysed 786 779 publications and found that 86.0% included at least one LMIC-affiliated author, while 77.2% and 71.2% had an LMIC-affiliated first or last author, respectively; however, analagous proportions were only 58.7%, 36.8%, and 29.1% among 100 687 publications about low-income countries. Proportions of publications with LMIC-affiliated authors increased over time, yet this observation was driven by high research activity and representation among upper middle-income countries. Between-country variation in representation was observed, even within income status categories. We invite comment regarding these findings, particularly from voices underrepresented in this field.

scholarly journals Feminine Appeals on Cigarette Packs Sold in 14 Countries

2021 ◽  
Vol 66 ◽  
Author(s):  
Lauren Czaplicki ◽  
Kevin Welding ◽  
Joanna E. Cohen ◽  
Katherine Clegg Smith
Keyword(s):  
Substantial Proportion ◽  
Middle Income ◽  
Global Trends ◽  
Plain Packaging ◽  
Middle Income Countries ◽  
Gender Neutral ◽  
Traditional Femininity ◽  
Over Time ◽  
Cigarette Packs ◽  
Low And Middle Income

Objective: Limited research has examined feminine marketing appeals on cigarette packs in low-and middle-income countries (LMICs). We reviewed a systematically collected sample of cigarette packs sold across 14 LMICs in 2013 (Wave 1) and 2015–2017 (Wave 2).Methods: Packs in Wave 1 (n = 3,240) and Wave 2 (n = 2,336) were coded for feminine imagery and descriptors (flowers, fashion, women/girls, color “pink”). We examined trends in feminine appeals over time, including co-occurrence with other pack features (slim or lipstick shape, flavor, reduced harm, and reduced odor claims).Results: The proportion of unique feminine cigarette packs significantly decreased from 8.6% (n = 278) in Wave 1 to 5.9% (n = 137) in Wave 2 (p &lt; 0.001). Among all feminine packs, flower-and fashion-related features were most common; a substantial proportion also used flavor and reduced odor appeals.Conclusion: While there was a notable presence of feminine packs, the decline observed may reflect global trends toward marketing gender-neutral cigarettes to women and a general contempt for using traditional femininity to market products directly to women. Plain packaging standards may reduce the influence of branding on smoking among women.

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