Causal effect of children’s secondary education on parental health outcomes: findings from a natural experiment in Botswana

ObjectivesA growing literature highlights the intergenerational transmission of human capital from parents to children. However, far less is known about ‘upward transmission’ from children to parents. In this study, we use a 1996 Botswana education policy reform as a natural experiment to identify the causal effect of children’s secondary schooling on their parents’ health.SettingBotswana’s decennial census (2001 and 2011). Data were obtained through the Integrated Public Use Microdata Series and are 10% random samples of the complete population in each of these census years.ParticipantsSurvey respondents who were citizens born in Botswana, at least 18 years old at the time of the census and born in or after 1975 (n=89 721).Primary and secondary outcome measuresParental survival and disability at the time of the census, separately for mothers and fathers.ResultsThe 1996 reform caused a large increase in grade 10 enrolment, inducing an additional 0.4 years of schooling for the first cohorts affected (95% CI 0.3 to 0.5, p<0.001). The reform, however, had no effect on parental survival and disability by the time exposed child cohorts reach age 30. Results were robust to a wide array of sensitivity analyses.ConclusionsThis study found little evidence that parents’ survival and disability were affected by their offspring’s educational attainment in Botswana. Parents’ health may not be necessarily affected by increasing their offspring’s educational attainment.

Physical, motor and biochemistry assessments of children exposed to HIV

According to data from the Ministry of Health, the number of HIV positive pregnant women is still worrying, so it is necessary to carry out targeted care for these children exposed to HIV, assessing their development and growth thus promoting a normal life as any other child. In this context, the objective was to evaluate the physical, motor and some biochemical parameters of children exposed to HIV. It is a quantitative, descriptive / observational study with 10 children exposed to HIV, attended at the Sinop-MT Specialized Service, between March and May 2015. Of the children evaluated, 20% were overweight and obese and 30% demonstrated elevated height for age. As for socioeconomic conditions, the average family income was R $ 1,568.00, an average of 4 people in the residences and 70% of the women were married. Of the pregnant women, 90% performed elective cesarean section, 90% used intravenous AZT and 100% used AZT syrup. Changes in the hemogram of some children were observed, indicating that ART can induce disorders such as hematocrit and hemoglobin decrease, consequently anemia and thrombocytopenia. Regarding viral load, 60% presented undetectable results. The development of the exposed child was similar to that of a child without HIV exposure, showing that child development growth had not been affected. The development of children exposed to HIV is significantly similar to that of non-exposed children when all recommended protective measures are taken to prevent vertical transmission.

Reporting Maltreatment to Child Protective Services in the Context of Intimate Partner Violence Research

Given the overlap between intimate partner violence (IPV) and child maltreatment, IPV-exposed child participants in research might disclose instances of child maltreatment. Such disclosures might require researchers to report the maltreatment to child protective services (CPS). However, the literature provides minimal guidance on how to navigate the complex challenges and ethical dilemmas around reporting in the context of research. To help address this gap and stimulate discussion regarding protocols and policies for reporting child maltreatment, this article presents a CPS reporting protocol developed as part of a community-engaged research project evaluating a parenting intervention for system-involved mothers experiencing IPV.