Search

This paper examines the way in which learning quality has been conceptualised and measured in school effectiveness surveys conducted by Young Lives, a longitudinal study of child poverty. Primary school surveys were conducted in Vietnam in 2010–11 and Ethiopia in 2012–13, and surveys at upper-primary and secondary level were conducted in Ethiopia, India and Vietnam in 2016–17. The paper discusses the design of cognitive tests to assess Maths and reading at primary level, and then focuses on the development of cognitive tests to assess Maths, functional English and transferable skills at upper-primary and secondary level. In particular, the paper explores how learning quality can be conceptualised and measured in relation to ‘twenty-first century skills’, which are increasingly seen as an important outcome of secondary education. The challenges of designing cognitive tests to measure and compare learning quality across three diverse country contexts are also explored. [ABSTRACT FROM PUBLISHER]

Sanitation change continues to be on the forefront of the global development agenda, even as it is becoming clear that the targets established in the Sustainable Development Goals will not be met. But since improving access to safely managed sanitation facilities remains a cost-effective and impactful measure to improve people's lives, it is still important to assess currently implemented policies to be able to learn from best practices and to understand how different approaches work under different contexts. This paper provides comparative analysis of country-level policies in India and Ethiopia, two countries that achieved notable progress in eliminating open defecation through distinct sanitation strategies, with the aim of confronting the advantages and disadvantages of both approaches. While in India the primary emphasis has been on the supply-side, i.e., provision of subsidized sanitation infrastructure, Ethiopian strategy prioritized the demand-side by addressing change in sanitation behavior through Community Total Led Sanitation. The analysis shows that neither of the strategies can fully achieve the sanitation change and a combination of both seems to be the most impactful approach in combating open defecation. It also argues that policymakers must consider not only local socioeconomic and budgetary constraints but also historical, institutional, sociocultural, and geographical specifics in deciding what type of subsidies would be the most fitting. At the same time, they also need to address the appropriate social norms to achieve the desirable change in sanitation behavior. [ABSTRACT FROM AUTHOR]

Health management information systems (HMIS) produce large amounts of data about health service provision and population health, and provide opportunities for data-based decision-making in decentralized health systems. Yet the data are little-used locally. A well-defined approach to district-level decision-making using health data would help better meet the needs of the local population. In this second of four papers on district decision-making for health in low-income settings, our aim was to explore ways in which district administrators and health managers in low- and lower-middle-income countries use health data to make decisions, to describe the decision-making tools they used and identify challenges encountered when using these tools. A systematic literature review, following PRISMA guidelines, was undertaken. Experts were consulted about key sources of information. A search strategy was developed for 14 online databases of peer reviewed and grey literature. The resources were screened independently by two reviewers using pre-defined inclusion criteria. The 14 papers included were assessed for the quality of reported evidence and a descriptive evidence synthesis of the review findings was undertaken. We found 12 examples of tools to assist district-level decision-making, all of which included two key stages-identification of priorities, and development of an action plan to address them. Of those tools with more steps, four included steps to review or monitor the action plan agreed, suggesting the use of HMIS data. In eight papers HMIS data were used for prioritization. Challenges to decision-making processes fell into three main categories: the availability and quality of health and health facility data; human dynamics and financial constraints. Our findings suggest that evidence is available about a limited range of processes that include the use of data for decision-making at district level. Standardization and pre-testing in diverse settings would increase the potential that these tools could be used more widely. [ABSTRACT FROM AUTHOR]

Integrating nutrition interventions into antenatal care (ANC) requires adapting global recommendations to fit existing health systems and local contexts, but the evidence is limited on the process of tailoring nutrition interventions for health programmes. We developed and integrated maternal nutrition interventions into ANC programmes in Bangladesh, Burkina Faso, Ethiopia and India by conducting studies and assessments, developing new tools and processes and field testing integrated programme models. This paper elucidates how we used information and data to contextualize a package of globally recommended maternal nutrition interventions (micronutrient supplementation, weight gain monitoring, dietary counselling and counselling on breastfeeding) and describes four country‐specific health service delivery models. We developed a Theory of Change to illustrate common barriers and strategies for strengthening nutrition interventions during ANC. We used multiple information sources including situational assessments, formative research, piloting and pretesting results, supply assessments, stakeholder meetings, household and service provider surveys and monitoring data to design models of maternal nutrition interventions. We developed detailed protocols for implementing maternal nutrition interventions; reinforced staff capacity, nutrition counselling, monitoring systems and community engagement processes; and addressed micronutrient supplement supply bottlenecks. Community‐level activities were essential for complementing facility‐based services. Routine monitoring data, rapid assessments and information from intensified supervision were important during the early stages of implementation to improve the feasibility and scalability of models. The lessons from addressing maternal nutrition in ANC may serve as a guide for tackling missed opportunities for nutrition within health services in other contexts. Key messages: Integrating evidence‐based nutrition interventions into ANC to reach PW at scale is urgently needed for improving maternal and newborn health and nutrition.The Theory of Change and steps for strengthening nutrition interventions based on four‐country experiences provide practical guidance on addressing missed opportunities for nutrition in ANC.Strategic use of data can contextualize global maternal nutrition guidelines, protocols, capacity building and supervision approaches, and improve micronutrient supply chains and record‐keeping as part of health services strengthening.Engaging family and community members to support PW and improving the knowledge and self‐confidence of PW are important elements of all country programme models. [ABSTRACT FROM AUTHOR]

The study aims to understand the foremost challenges in the transition to online teaching and learning during the COVID-19 pandemic. The study adopts the PRISMA approach to screening the selection of journal articles and review papers according to the research aims and the inclusion criteria. The journal articles and review papers were extracted and stored in Microsoft Excel and Google Scholar, Academic. Microsoft, Semantic Scholar, Elsevier, and Emerald Insight databases searched relevant documents using formulated keywords. A statistical technique was applied using the M.S. Excel analysis tool (PivotTable and an independent t-Test) to analyze data and determine the differences between teachers and students. The review revealed the evidence that the majority of the studies were primarily focused on the individual developing countries and results from other developing countries were not considered. In addition, the foremost challenges in the transition to online teaching and learning during the COVID-19 pandemic were inadequate skills and training, inadequate Internet/Infrastructure, lack of supporting resources and lack of online student engagement and feedback. Finally, the independent t-test reveals there is no statistically significant difference in challenges in the transition to online teaching and learning during the COVID-19 pandemic. Both teachers and students encounter similar challenges. The systematic review raised concerns that higher learning needs to effectively implement long term strategies and support teachers and students in getting into online teaching and learning.

An introduction is presented in which the editor discusses various reports including the significance and impact of leadership on success of organization, causal relationship between economic growth and government revenue growth in Ethiopia, and handloom industry in Uttarakhand, India.

Increasing participation in family decision making is an integral part of adolescent development. This paper uses longitudinal data from four low and middle income countries—Ethiopia, India, Peru and Vietnam—to assess the relationship between young people's involvement in schooling decision making and schooling outcomes. In the pooled sample, compared to young adults who indicate to have no say in educational choices at age 19, adolescents who make these decisions unilaterally or jointly with parents are on average 17%–23% more likely to drop out by age 22. The effects are, however, heterogenous across countries. [ABSTRACT FROM AUTHOR]

Ethiopia is witnessing new twists and turns both in its domestic and foreign policy domain of late with the incumbent government in power adopting political and economic reforms aimed at fostering changes to bring about development. This has invariably provided an opportunity for India to consolidate its relationship with Ethiopia further. The new domestic political and economic reforms and the friendly gestures that the present government under Abiy Ahmed has made with its neighbors has drawn the attention of the international community to the extent of awarding him with Nobel Peace Prize. Such reform measures of Ethiopia have given India with wide scope to engage itself constructively and extend political and economic support in areas where both countries stand to gain. India's active engagement with Africa in general and Ethiopia in particular is all the more important given the China factor that has been competing with other countries of the region. This paper describes the domestic political developments in Ethiopia during the post Cold War era and its struggle to maintain the intricate ethnic balance that has characterized its nation-building process by tracing it from the days of King Haile Selassie I. It further analyzes the steps taken by the government to remove obstacles to peace and development through adopting economic liberalization measures and foreign policy changes. These are discussed in a chronological manner starting with a conceptual framework and using predominantly secondary sources and relying on personal observations. [ABSTRACT FROM AUTHOR]

Background: Maternal mental health is becoming recognized as a global health priority. Mental distress among mothers of young children may be exacerbated by exposure to adversity. Social capital may buffer the impact of adversity on mental distress during the postnatal period and beyond. This paper examines the relationship between adversity, cognitive social capital and mental distress among mothers of young children in three low and middle-income countries. Methods: This study uses data from the Young Lives study on 5,485 women from Ethiopia, India, and Vietnam. Logistic regression was used to examine the association between exposure to stressful life events (SLEs) and mental distress in women between 6 months and 1.5 years post-partum. Logistic and linear regression was used to examine the potential for effect modification by social capital. Results: The proportion of women with mental distress during the period between 6–18 months following the birth of a child in the sample was 32.6% in Ethiopia, 30.5% in India and 21.1% in Vietnam. For each additional SLE to which a woman was exposed, the odds of MMD increased by 1.28 (95% CI: 1.22, 1.36; p<0.001) in Ethiopia, 1.17 (1.11, 1.25; p<0.001) in India, and 1.98 (1.75, 2.25; p<0.001) in Vietnam. Exposure to family SLEs was significantly associated with MMD in all three countries with odds ratios of 1.76 (95% CI: 1.30, 2.38; p<0.001), 1.62 (95% CI: 1.12, 2.33; p<0.01 in India), 1.93 (95% CI: 1.27, 2.92; p<0.01), respectively. In Ethiopia and India, economic SLEs were also significantly associated with MMD after adjustment (Ethiopia OR: 1.68; 95% CI: 1.12, 2.52; p<0.01 and India OR: 1.44; 95% CI: 1.01, 2.05; p<0.05), while in India, crime SLEs (OR: 1.93; 95% CI: 1.27, 2.92; p<0.01) were associated with MMD. Cognitive social capital was found to modify the association between SLEs and symptomology of mental distress in Ethiopia, India and Vietnam. Conclusions: This study suggests that adversity may increase the risk of maternal mental distress in three LMICs, while social capital may buffer its effect. [ABSTRACT FROM AUTHOR]

During the post-Green Revolution era, numerous improved wheat varieties were released and disseminated to enhance tolerance to biotic and abiotic stresses and increase productivity. Still, in the wheat-based farming systems of the Global South, gender-based and other social inequalities continue to undermine equitable access to improved varieties, especially for women, poor, and marginalized farmers. Here, we present a case for gender-sensitive technology development, dissemination, and evaluation as part of wheat varietal improvement programs. We take stock of the various challenges that persist in the uptake of modern wheat varieties by male and female smallholders. We focus on Ethiopia and India, two geographies with substantive wheat economies, widespread poverty, and gender inequalities. The socio-economic literature on wheat is relatively thin with limited and dated gender-sensitive evaluation studies on varietal technologies in these countries. Varietal technology evaluations could ideally cover gender differences in relation to wheat varietal trait preferences, technology adoption, and associated decision-making and labor-use changes related to new varieties and complementary technologies, as well as nutritional and economic benefits. The paper calls for a need to change the institutional arrangements in wheat research-and-development (R&D) programs to understand and pursue better paths for wheat improvement to proactively contribute toward gender equity and inclusivity. [ABSTRACT FROM AUTHOR]

Low-resource settings often have limited use of local data for health system planning and decision-making. To promote local data use for decision-making and priority setting, we propose an adapted framework: a data-informed platform for health (DIPH) aimed at guiding coordination, bringing together key data from the public and private sectors on inputs and processes. In working to transform this framework from a concept to a health systems initiative, we undertook a series of implementation research activities including background assessment, testing and scaling up of the intervention. This first paper of four reports the feasibility of the approach in a district health systems context in five districts of India, Nigeria and Ethiopia. We selected five districts using predefined criteria and in collaboration with governments. After scoping visits, an in-depth field visit included interviews with key health stakeholders, focus group discussions with service-delivery staff and record review. For analysis, we used five dimensions of feasibility research based on the TELOS framework: technology and systems, economic, legal and political, operational and scheduling feasibility. We found no standardized process for data-based district level decision-making, and substantial obstacles in all three countries. Compared with study areas in Ethiopia and Nigeria, the health system in Uttar Pradesh is relatively amenable to the DIPH, having relative strengths in infrastructure, technological and technical expertise, and financial resources, as well as a district-level stakeholder forum. However, a key challenge is the absence of an effective legal framework for engagement with India's extensive private health sector. While priority-setting may depend on factors beyond better use of local data, we conclude that a formative phase of intervention development and pilot-testing is warranted as a next step. [ABSTRACT FROM AUTHOR]

Introduction: There is limited guidance on strategies for delivering complex global health programs. We synthesized available evidence on implementation strategies and outcomes utilized in the global polio eradication initiative (GPEI) across low and middle-income country (LMIC) settings. Methods: We nested our scoping review into a literature review conducted as part of a parent study, STRIPE. This review systematically searched PubMed for articles between 1 January 1988 and 25 April 2018 using polio search terms. Strategies from included studies were organized according to the Expert Recommendations for Implementing Change (ERIC) framework, specified using Proctor's framework, and linked to various outcomes (implementation, services delivery, impact). Results: 152 unique articles fulfilled our inclusion criteria (from 1,885 articles included in the parent study). Only 43 out of the 152 articles described a suitable quantitative study design for evaluating outcomes. We extracted 66 outcomes from the 43 unique studies. Study publication dates ranged from 1989 to 2018 and represented diverse country settings. The most common implementation strategies were developing mechanisms for feedback, monitoring, and evaluation (n = 69); increasing awareness among the population (n = 58); involving stakeholders, workers, and consumers in the implementation efforts (n = 46); conducting workshops (n = 33); using mass media (n = 31); and building robust record systems to capture outcomes (n = 31). Coverage (n = 13) and morbidity (n = 12) were the most frequently identified outcomes, followed by effectiveness (n = 9) and fidelity (n = 6). Feasibility and sustainability were rarely evaluated. Conclusions: This review provides a catalogue of implementation strategies and outcomes relevant for advancing global health services delivery in LMICs drawing from the GPEI. Implementation strategies reviewed were poorly described and not adequately linked to outcomes. It calls for additional implementation research to unravel the mechanisms of implementation strategies and their effectiveness, and adaptation of the ERIC framework in LMICs. [ABSTRACT FROM AUTHOR]

Background: Birth preparedness and complication readiness is a holistic approach that empowers mothers and families with the knowledge, attitude, and resources to alleviate potential challenges during childbirth. Despite its benefits, husbands' participation in maternal care differs significantly between countries and regions. There is a lack of previous studies that look at husbands' responses to birth preparedness and complication readiness in the research area. Thus, the primary goal of this study is to find out how husbands who have wives with infants under 12 months old feel about birth preparation, readiness for problems, and its associated factors. Methods: A community-based cross-sectional study design was conducted from May 30 to July 29, 2022. Simple random sampling was employed to select 499 husbands. An interviewer-administered, structured, and pretested questionnaire was used to collect the data. Data entry and analysis were performed using Epi Data version 4.6 and SPSS version 25, respectively. We used multivariable logistic regression to find statistically significant factors. P-values less than 0.05, 95% confidence intervals, and adjusted odds ratios are used to declare statistical significance. The findings were shown in figures, tables, and text. Results: The study found that 55.9% (95% CI: 51.4 to 61.4%) of husbands responded to birth preparedness and complication readiness. This response was significantly associated with being employed (AOR = 3.7, 95% CI: 2.27–5.95), engaging in self-business (AOR = 5.3, 95% CI: 2.34–12.01), having wives who delivered in health facilities (AOR = 7.1, 95% CI: 3.92–12.86), accompanying wives for antenatal care (AOR = 2.2, 95% CI: 1.39–3.56), possessing good knowledge of danger signs during labor (AOR = 2.0, 95% CI: 1.08–3.74) and the postnatal period (AOR = 7.1, 95% CI: 3.14–16.01). Interestingly, residents living near a health facility (AOR = 0.6, 95% CI: 0.39–0.97) were less likely to respond. Conclusion: The present study found that nearly 6 out of 10 husbands actively responded in terms of birth preparedness and complication readiness. While husbands in this study showed some involvement in birth preparedness and complications, it is good when compared to studies carried out nationally. To improve this, educating husbands by focusing on the danger signs and their role in childbirth is recommended. [ABSTRACT FROM AUTHOR]

The papers making up this Special Section reveal important findings and begin to fill gaps in existing literature about children's and young people's understanding and developing beliefs about socioeconomic inequality and poverty. We draw on our research experience with children growing up in poverty in Ethiopia, India, Peru, and Vietnam (Young Lives) from the perspective of sociology of childhood and social anthropology. The commentary discusses the papers in the Special Section and calls for policies and practices that argue for social justice for children and young people in political and economic terms and emphasizes the importance of including children's views and descriptions of their experiences in research about poverty and inequality. [ABSTRACT FROM AUTHOR]

Background: From conception to 6 months of age, an infant is entirely dependent for its nutrition on the mother: via the placenta and then ideally via exclusive breastfeeding. This period of 15 months - about 500 days - is the most important and vulnerable in a child's life: it must be protected through policies supporting maternal nutrition and health. Those addressing nutritional status are discussed here. Objective and design: This paper aims to summarize research on policies and programs to protect women's nutrition in order to improve birth outcomes in low- and middle-income countries, based on studies of efficacy from the literature, and on effectiveness, globally and in selected countries involving in-depth data collection in communities in Ethiopia, India and Northern Nigeria. Results of this research have been published in the academic literature (more than 30 papers). The conclusions now need to be advocated to policy-makers. Results: The priority problems addressed are: intrauterine growth restriction (IUGR), women's anemia, thinness, and stunting. The priority interventions that need to be widely expanded for women before and during pregnancy, are: supplementation with iron-folic acid or multiple micronutrients; expanding coverage of iodine fortification of salt particularly to remote areas and the poorest populations; targeted provision of balanced protein energy supplements when significant resources are available; reducing teenage pregnancies; increasing interpregnancy intervals through family planning programs; and building on conditional cash transfer programs, both to provide resources and as a platform for public education. All these have known efficacy but are of inadequate coverage and resourcing. The next steps are to overcome barriers to wide implementation, without which targets for maternal and child health and nutrition (e.g. by WHO) are unlikely to be met, especially in the poorest countries. Conclusions: This agenda requires policy decisions both at Ministry and donor levels, and throughout the administrative system. Evidence-based interventions are established as a basis for these decisions, there are clear advocacy messages, and there are no scientific reasons for delay. [ABSTRACT FROM AUTHOR]

Antenatal care (ANC) is the largest health platform globally for delivering maternal nutrition interventions (MNIs) to pregnant women. Yet, large missed opportunities remain in nutrition service delivery. This paper examines how well evidence‐based MNIs were incorporated in national policies and programs in Bangladesh, Burkina Faso, Ethiopia and India. We compared the nutrition content of ANC protocols against global recommendations. We used survey data to elucidate the coverage of micronutrient supplementation, weight gain monitoring, dietary and breastfeeding counselling. We reviewed literature, formative research and program assessments to identify barriers and enabling factors of service provision and maternal nutrition practices. Nutrition information in national policies and protocols was often fragmented, incomplete and did not consistently follow global recommendations. Nationally representative data on MNIs in ANC was inadequate, except for iron and folic acid supplementation. Coverage data from subnational surveys showed similar patterns of strengths and weaknesses. MNI coverage was consistently lower than ANC coverage with the lowest coverage of weight gain monitoring and variable coverage of dietary and breastfeeding counselling. Key common factors associated with coverage were micronutrient supply disruptions; suboptimal counselling on maternal diet, weight gain, and breastfeeding; and limited or no record keeping. Adherence of women to micronutrient supplementation and dietary recommendations was low and associated with late and too few ANC contacts, poor maternal knowledge and self‐efficacy, and insufficient family and community support. Models of comprehensive nutrition protocols and health systems that deliver maternal nutrition services in ANC are urgently needed along with national data systems to track progress. Key points: Delivering nutrition services to all pregnant women is essential for maternal and child health outcomes but remains a challenge.Nutrition gaps in antenatal care (ANC) include lack of specificity in national guidelines and protocols, bottlenecks in micronutrient supplies, low ANC provider knowledge and skills, inadequate supervision to reinforce counseling, and not engaging families to encourage key practices.National protocols for ANC should be more specific for the four nutrition interventions (micronutrient supplements, weight gain monitoring, counseling on diets and counseling on breastfeeding) and assign accountability for coverage and quality.Country models are needed for improving provision and utilisation of nutrition interventions through ANC that are based on comprehensive policy frameworks. [ABSTRACT FROM AUTHOR]

This article maps the scientific production and the contents associated with the sustainable development goals and their integration with universities during the past 21 years. Although many of the topics related to sustainable development goals (SDGs) have been addressed in different studies for decades, it is since 2015 onwards that they gained greater prominence due to the inclusion of higher education as an important actor in the fulfillment of the 2030 agenda and the United Nations SDGs. For the purpose of this paper, a bibliometric analysis of 871 papers, 535 documents in Scopus, and 336 in Web of Science (WoS) from 1998 to 2019 was performed, and the Bibliometrix analysis tool was used. The objective of this mapping is to answer the following research question: Is the integration of the Sustainable Development Goals and Universities a field of study? An analysis of the network of collaborators and trend topics in Scopus and WoS allows us to identify the concurrence and relationships of some keywords, such as sustainable development, sustainability and planning, and some background words, such as humans and global health. In another analysis, the word "higher education" is related to change. This article suggests that the integration of the Sustainable Development Goals in Universities is becoming a field of study under exploration, with a peak of production in 2016 and that has remained stable in the last three years, but thanks to the leading role assigned to Universities, intellectual production should increase in the following years.

The papers making up this Special Section reveal important findings and begin to fill gaps in existing literature about children's and young people's understanding and developing beliefs about socio-economic inequality and poverty. We draw on our research experience with children growing up in poverty in Ethiopia, India, Peru, and Vietnam (Young Lives) from the perspective of sociology of childhood and social anthropology. The commentary discusses the papers in the Special Section and calls for policies and practices that argue for social justice for children and young people in political and economic terms and emphasizes the importance of including children's views and descriptions of their experiences in research about poverty and inequality.

Aim: To estimate incremental costs of an implementation model for scaling up Kangaroo Mother Care (KMC) for neonates with birthweight <2000 g. Methods: Seven sites across Ethiopia and India collected data for 2018–19 to calculate incremental recurrent costs (of health worker time, supplies, and operations) and start‐up costs for KMC scale up. The costs were estimated per live newborn <2000 g eligible for KMC identified in the study population. Results: Scaling up KMC in study districts required average incremental costs of US$59 (95% CI US$ 52–67) in Ethiopia and US$72 (95% CI US$ 41–103) in India per eligible newborn in the population. Most of these costs were recurrent; the annualised start‐up costs per eligible newborn ranged from 12%–25% of total costs in Ethiopia and 9%–16% in India. The major cost driver was human resources, followed by initial and recurrent training, supplies, and communications costs. Incremental infrastructure costs were only 2%–6% of total costs in both countries. Most of the costs were for activities at the KMC implementing facility, accounting for 79%–88% of the total costs in Ethiopia and 89%–93% of those in India. Conclusion: The costs for successful scale up of KMC seem affordable but must be included in programme budgets. [ABSTRACT FROM AUTHOR]

Background: Donors often fund projects that develop innovative practices in low and middle-income countries, hoping recipient governments will adopt and scale them within existing systems and programmes. Such innovations frequently end when project funding ends, limiting longer term potential in countries with weak health systems and pressing health needs. This paper aims to identify critical actions for externally funded project implementers to enable scale-up of maternal and newborn child health innovations originally funded by the Bill & Melinda Gates Foundation ('the foundation'), or influenced by innovations that were originally funded by the foundation in three low-income settings: Ethiopia, the state of Uttar Pradesh in India and northeast Nigeria. We define scale-up as the adoption of donor-funded innovations beyond their original project settings and time periods.Methods: We conducted 71 in-depth, semi-structured interviews with representatives from government, donors and other development partner agencies, donor-funded implementers including frontline providers, research organisations and professional associations. We explored three case study maternal and newborn innovations. Selection criteria were: a) innovations originally funded by the Bill & Melinda Gates Foundation ('the foundation'), or influenced by innovations that were originally funded by the foundation; b) innovations for which a decision to scale-up had been made, allowing us to reflect on the factors influencing those decisions; c) innovations with increased geographical reach, benefitting a greater number of people, beyond districts where foundation-funded implementers were active. Our data were analysed based on a common analytic framework to aid cross-country comparisons.Results: Based on study respondents' accounts, we identified six critical steps that donor-funded implementers had taken to enable the adoption of maternal and newborn health innovations at scale: designing innovations for scale; generating evidence to influence and inform scale-up; harnessing the support of powerful individuals; being prepared for scale-up and responsive to change; ensuring continuity by being part of the transition to scale; and embracing the aid effectiveness principles of country ownership, alignment and harmonisation.Conclusions: Six critical actions identified in this study were associated with adopting and scaling maternal and newborn health innovations. However, scale-up is unpredictable and depends on factors outside implementers' control. [ABSTRACT FROM AUTHOR]

Background: Obtaining representative abortion incidence estimates is challenging in restrictive contexts. While the confidante method has been increasingly used to collect this data in such settings, there are several biases commonly associated with this method. Further, there are significant variations in how researchers have implemented the method and assessed/adjusted for potential biases, limiting the comparability and interpretation of existing estimates. This study presents a standardized approach to analyzing confidante method data, generates comparable abortion incidence estimates from previously published studies and recommends standards for reporting bias assessments and adjustments for future confidante method studies. Methods: We used data from previous applications of the confidante method in Côte d'Ivoire, Ethiopia, Ghana, Java (Indonesia), Nigeria, Uganda, and Rajasthan (India). We estimated one-year induced abortion incidence rates for confidantes in each context, attempting to adjust for selection, reporting and transmission bias in a standardized manner. Findings: In each setting, majority of the foundational confidante method assumptions were violated. Adjusting for transmission bias using self-reported abortions consistently yielded the highest incidence estimates compared with other published approaches. Differences in analytic decisions and bias assessments resulted in the incidence estimates from our standardized analysis varying widely from originally published rates. Interpretation: We recommend that future studies clearly state which biases were assessed, if associated assumptions were violated, and how violations were adjusted for. This will improve the utility of confidante method estimates for national-level decision making and as inputs for global or regional model-based estimates of abortion. [ABSTRACT FROM AUTHOR]

This paper examines the way in which learning quality has been conceptualised and measured in school effectiveness surveys conducted by Young Lives, a longitudinal study of child poverty. Primary school surveys were conducted in Vietnam in 2010-11 and Ethiopia in 2012-13, and surveys at upper-primary and secondary level were conducted in Ethiopia, India and Vietnam in 2016-17. The paper discusses the design of cognitive tests to assess Maths and reading at primary level, and then focuses on the development of cognitive tests to assess Maths, functional English and transferable skills at upper-primary and secondary level. In particular, the paper explores how learning quality can be conceptualised and measured in relation to "twenty-first century skills", which are increasingly seen as an important outcome of secondary education. The challenges of designing cognitive tests to measure and compare learning quality across three diverse country contexts are also explored.

Livestock provides an important source of income and nourishment for around one billion rural households worldwide. Demand for livestock food products is increasing, especially in developing countries, and there are opportunities to increase production to meet local demand and increase farm incomes. Estimating the scale of livestock yield gaps and better understanding factors limiting current production will help to define the technological and investment needs in each livestock sector. The aim of this paper is to quantify livestock yield gaps and evaluate opportunities to increase dairy production in Sub-Saharan Africa and South Asia, using case studies from Ethiopia and India. We combined three different methods in our approach. Benchmarking and a frontier analysis were used to estimate attainable milk yields based on survey data. Household modelling was then used to simulate the effects of various interventions on dairy production and income. We tested interventions based on improved livestock nutrition and genetics in the extensive lowland grazing zone and highland mixed crop-livestock zones of Ethiopia, and the intensive irrigated and rainfed zones of India. Our analyses indicate that there are considerable yield gaps for dairy production in both countries, and opportunities to increase production using the interventions tested. In some cases, combined interventions could increase production past currently attainable livestock yields. [ABSTRACT FROM AUTHOR]

Far fewer people migrate than global disparities in wealth and well-being would lead us to predict, yet we know relatively little about why those who presumably have much to gain from migration prefer to stay in place. This article examines the motivations of young people who express the preference to stay put, and asks what individual and household characteristics are associated with voluntary immobility. Using survey data collected in Ethiopia, India, and Vietnam for the Young Lives Project, we find that the majority of young people surveyed envision a future within their home country, and between 32 per cent (Ethiopia) and 60 per cent (Vietnam) prefer to stay in their current location. Most youth prefer to stay for family-related reasons. Living in an urban area and engagement in farm work are associated with greater staying aspirations, but only for youth from the most resource-poor or the wealthiest households. Higher levels of schooling, wealth, feelings of self-efficacy and paid employment are consistently associated with diminished desires to stay, with stronger effects for youth from rural settings, resource-poor households, and women. Our results reveal the social patterning of staying aspirations and have important implications for development interventions that seek to enhance aspirations and capabilities of individuals to stay in place. [ABSTRACT FROM AUTHOR]

This study aimed to identify the prevalence and physical health consequences of family structure transitions among children in Ethiopia, India, Peru, and Vietnam. In many high-income countries, family structure transitions are common, and research suggests that they can lead to worse physical health for children. However, we know little about either the prevalence or consequences of family structure transitions for children in low-and middle-income countries, who make up the vast majority of the world's children. First, we estimated the number of family structure transitions by age 12 using four rounds of Young Lives data from four low-and middle-income countries (N = 8062, Ethiopia, India, Peru, and Vietnam) and validated our prevalence estimates with another dataset from these same countries. The proportion of children experiencing a family structure transition by age 12 was: 14.8% in Ethiopia, 5.6% in India, 22.0% in Peru, and 7.7% in Vietnam. We put these estimates in context by comparing them to 17 high- and upper-middle-income countries. Second, using linear mixed models, we found that family structure transitions were not directly associated with worse physical health for children in Ethiopia, India, Peru, and Vietnam. Children in Peru experienced higher rates of family structure transitions relative to children in the other Young Lives countries, and similar rates to many of the 17 comparison countries, yet physical health was unaffected. It is possible that in low-and middle-income countries, the environment may overwhelm family stability as a determinant of physical health. Highlights: The prevalence of children experiencing a family structure transition by age 12 in Ethiopia, India, Peru, and Vietnam was 5.6–22.0%: a wide-range, similar to what has been observed in high-income contexts. Family structure transitions are not directly associated with children's general physical health in Ethiopia, India, Peru, or Vietnam. Family structure transitions do not influence children's general physical health trajectories over time in Ethiopia, India, Peru, or Vietnam. [ABSTRACT FROM AUTHOR]

There is limited information on the feeding practices of 9.42 million children living within institution‐based care (IBC) worldwide. Poor feeding practices can predispose or exacerbate malnutrition, illness and disability. Here we describe the feeding practices of children living within IBC based on a retrospective analysis of records from 3335 children, 0–18 years old, participating in Holt International's Child Nutrition Program (CNP), from 36 sites in six countries. Data analysed included demographic information on age, sex, feeding practices, disabilities and feeding difficulties. Descriptive statistics were produced. A generalised linear model explored associations between feeding difficulties and disability and 2 × 2 tables examined feeding difficulties over time. An additional set of feeding observations with qualitative and quantitative data was analysed. At baseline, the median age of children was 16 months (0.66–68 months) with 1650/3335 (49.5%) females. There were 757/3335 (22.7%) children with disabilities; 550/984 (55.9%) were low birth weight; 311/784 (39.7%) were premature; 447/3113 (14.4%) had low body mass index and 378/3335 (11.3%) had feeding difficulties. The adjusted risk of having a feeding difficulty was 5.08 ([95% confidence interval: 2.65–9.7], p ≤ 0.001) times greater in children with disabilities than those without. Many children saw their feeding difficulties resolve after 1‐year in CNP, 54/163 (33.1%) for children with disabilities and 57/106 (53.8%) for those without disabilities. Suboptimal hygiene, dietary and feeding practices were reported. In conclusion, feeding difficulties were common in IBC, especially among children with disabilities. Supporting safe interactive mealtimes for children living within IBC should be prioritised, to ensure overall health and development. Key points: Feeding difficulties are common among children living in institution‐based care (IBC), particularly but not exclusively among those children with disabilities.Suboptimal feeding practices were common in IBC and encompassed inadequate hygiene, limited support for self‐feeding, reading children's feeding cues (especially around pacing and satiety), addressing feeding difficulties, such as difficulty chewing or swallowing. These should be prioritised in training and supervision for caregivers.Addressing the needs of this vulnerable group should include support for safe feeding techniques. These should be prioritised to help ease the transition into eventual family‐based care if we are to move towards deinstitutionalizing children and strengthening families. [ABSTRACT FROM AUTHOR]

Background: Understanding the context of a health programme is important in interpreting evaluation findings and in considering the external validity for other settings. Public health researchers can be imprecise and inconsistent in their usage of the word “context” and its application to their work. This paper presents an approach to defining context, to capturing relevant contextual information and to using such information to help interpret findings from the perspective of a research group evaluating the effect of diverse innovations on coverage of evidence-based, life-saving interventions for maternal and newborn health in Ethiopia, Nigeria, and India. Methods: We define “context” as the background environment or setting of any program, and “contextual factors” as those elements of context that could affect implementation of a programme. Through a structured, consultative process, contextual factors were identified while trying to strike a balance between comprehensiveness and feasibility. Thematic areas included demographics and socio-economics, epidemiological profile, health systems and service uptake, infrastructure, education, environment, politics, policy and governance. We outline an approach for capturing and using contextual factors while maximizing use of existing data. Methods include desk reviews, secondary data extraction and key informant interviews. Outputs include databases of contextual factors and summaries of existing maternal and newborn health policies and their implementation. Use of contextual data will be qualitative in nature and may assist in interpreting findings in both quantitative and qualitative aspects of programme evaluation. Discussion: Applying this approach was more resource intensive than expected, in part because routinely available information was not consistently available across settings and more primary data collection was required than anticipated. Data was used only minimally, partly due to a lack of evaluation results that needed further explanation, but also because contextual data was not available for the precise units of analysis or time periods of interest. We would advise others to consider integrating contextual factors within other data collection activities, and to conduct regular reviews of maternal and newborn health policies. This approach and the learnings from its application could help inform the development of guidelines for the collection and use of contextual factors in public health evaluation. [ABSTRACT FROM AUTHOR]

This supplement outlines the development and piloting of district mental healthcare plans from five low- and middle-income countries, together with the methods for their design, evaluation and costing. In this editorial we consider the challenges that these programmes face, highlight their innovations and draw conclusions. [ABSTRACT FROM AUTHOR]

Learning is a fundamental human right, the basis of developing human capital and the foundation of human development. Basic skills provide individuals, their families and communities with the foundations needed to participate in society and to achieve better life chances. The shift in focus from mass access to mass learning has drawn attention to the question of who is and is not attaining these skills, and why. Opportunities to learn depend on access to schooling, but also the effectiveness of that schooling. There is considerable evidence of learning inequalities, both across and within countries. However, less is known about whether these patterns of inequality are rooted in variations in school effectiveness. In this paper we use evidence from Young Lives school surveys in Ethiopia, India and Vietnam to consider differences in girls' and boys' learning outcomes and progress and investigate how these patterns relate to school effectiveness. We explore whether girls or boys are 'sorted' into more or less effective schools and whether the same schools are differentially effective for boys and girls. Findings from India are perhaps closest to the 'typical' story that is often heard, in which girls, particularly those in rural areas, have lower attainment and attend less effective schools. In comparison, in Vietnam, girls have higher test scores and attend more effective schools on average, with this pattern driven by the higher performance of girls in rural areas. In Ethiopia, the divide between urban and rural areas is predominant in this context, over and above other areas of inequality including gender. Comparing results from these different areas of analysis and from three very different countries reveals the complexities of understanding how gender relates to educational outcomes. It demonstrates the importance of understanding gendered outcomes and school effectiveness in context. • Educational outcomes depend on access to education and the quality of that education. • Cross-country analysis reveals the complexities of how gender and school effectiveness relate to educational outcomes. • In India, where there is greatest school choice, girls have lower attainment and attend less effective schools than boys. • In Vietnam, the opposite is true - girls perform better and attend more effective schools. • In Ethiopia, the divide between urban and rural areas is predominant, over other axes of inequality including gender. [ABSTRACT FROM AUTHOR]

Background: Headache disorders are disabling, with major consequences for productivity, yet the literature is silent on the relationship between headache-attributed disability and lost productivity, often erroneously regarding the two as synonymous. We evaluated the relationship empirically, having earlier found that investment in structured headache services would be cost saving, not merely cost-effective, if reductions in headache-attributed disability led to > 20% pro rata recovery of lost productivity. Methods: We used individual participant data from Global Campaign population-based studies conducted in China, Ethiopia, India, Nepal, Pakistan and Russia, and from Eurolight in Lithuania, Luxembourg and Spain. We assessed relationships in migraine and probable medication-overuse headache (pMOH), the most disabling common headache disorders. Available symptom data included headache frequency, usual duration and usual intensity. We used frequency and duration to estimate proportion of time in ictal state (pTIS). Disability, in the sense used by the Global Burden of Disease study, was measured as the product of pTIS and disability weight for the ictal state. Impairment was measured as pTIS * intensity. Lost productivity was measured as lost days (absence or < 50% productivity) from paid work and corresponding losses from household work over the preceding 3 months. We used Spearman correlation and linear regression analyses. Results: For migraine, in a linear model, we found positive associations with lost paid worktime, significant (p < 0.05) in many countries and highly significant (p < 0.001) in some despite low values of R2 (0–0.16) due to high variance. With lost household worktime and total lost productivity (paid + household), associations were highly significant in almost all countries, although still with low R2 (0.04–0.22). Applying the regression equations for each country to the population mean migraine-attributed disability, we found pro rata recoveries of lost productivity in the range 16–56% (> 20% in all countries but Pakistan). Analysing impairment rather than disability increased variability. For pMOH, with smaller numbers, associations were generally weaker, occasionally negative and mostly not significant. Conclusion: Relief of disability through effective treatment of migraine is expected, in most countries, to recover > 20% pro rata of lost productivity, above the threshold for investment in structured headache services to be cost saving. [ABSTRACT FROM AUTHOR]

Contact tracing is an important tool for reducing the spread of infectious diseases. Its goal is to reduce a disease's effective reproductive number (R) by identifying people who have been exposed to the virus through an infected person and contacting them to provide early detection, tailored guidance, and timely treatment. By stopping virus transmission chains, contact tracing helps "flatten the curve" and reduces the peak burden of a disease on the health-care system. Contact tracing forms an essential part of Ethiopia and India response to the COVID-19 pandemic. This proposed technical specification for a new privacy-preserving Bluetooth protocol is used to support Contact Tracing and makes it possible to combat the spread of the COVID-19 virus by alerting participants of possible exposure to someone who they have recently been in contact with, and who has subsequently been positively diagnosed as having the virus. The Contact Detection Service is the medium for contact tracking and uses the Bluetooth LE (Low Energy) for nearby smart-phone proximity detection and data sharing mechanisms. Technology (BLE), which has been available in today's smart phones for many years, has proven to be the only way to determine the proximity to other smart phones. In our proposed model, firstly we developed the tracing cloud function and android app which is a privacy-preserving protocol for community-driven contact tracing across borders. It allows participating devices to log Bluetooth encounters with each other, in order to facilitate epidemiological contact tracing while protecting users' personal data and privacy, finally We developed Tracing calibration data and trial methodologies for testing implementations of Bluetrace protocol. [ABSTRACT FROM AUTHOR]

This paper summarises experiences of efforts made by twenty individuals when implementing small-scale ICT development projects in their organizations located in seven developing countries. The main focus of these projects was the use of ICT in educational settings. Challenges encountered and the contributing factors for implementation success of the projects are systematically investigated using interviews and follow up surveys. Results show that the typical limitations of technology and infrastructure were the key obstacles. The commitment of individual project managers in the role of "change agents" and organizational support in the were the strengths behind the success of the projects. Based on the outcome of this study, professional development of the change agents is a key factor for the success of projects. IT and infrastructure limitations contributed to the failure of the majority of the ICT related projects.

Vertical disease control programmes have enormous potential to benefit or weaken health systems, and it is critical to understand how programmes' design and implementation impact the health systems and communities in which they operate. We use the Develop-Distort Dilemma (DDD) framework to understand how the Global Polio Eradication Initiative (GPEI) distorted or developed local health systems. We include document review and 176 interviews with respondents at the global level and across seven focus countries (Afghanistan, Bangladesh, Democratic Republic of Congo, Ethiopia, India, Indonesia and Nigeria). We use DDD domains, contextual factors and transition planning to analyse interactions between the broader context, local health systems and the GPEI to identify changes. Our analysis confirms earlier research including improved health worker, laboratory and surveillance capacity, monitoring and accountability, and efforts to reach vulnerable populations, whereas distortions include shifting attention from routine health services and distorting local payment and incentives structures. New findings highlight how global-level governance structures evolved and affected national actors; issues of country ownership, including for data systems, where the polio programme is not indigenously financed; how expectations of success have affected implementation at programme and community level; and unresolved tensions around transition planning. The decoupling of polio eradication from routine immunization, in particular, plays an outsize role in these issues as it removed attention from system strengthening. In addition to drawing lessons from the GPEI experience for other efforts, we also reflect on the use of the DDD framework for assessing programmes and their system-level impacts. Future eradication efforts should be approached carefully, and new initiatives of any kind should leverage the existing health system while considering equity, inclusion and transition from the start. [ABSTRACT FROM AUTHOR]

The barriers and facilitators of conducting knowledge translation (KT) activities are well-established but less is known about the institutional forces that drive these barriers, particularly in low resource settings. Understanding organizational readiness has been used to assess and address such barriers but the employment of readiness assessments has largely been done in high-income countries. We conducted a qualitative study to describe the institutional needs and barriers in KT specific to academic institutions in low- and middle-income countries. We conducted a review of the grey and published literature to identify country health priorities and established barriers and facilitators for KT. Key-informant interviews (KII) were conducted to elicit perceptions of institutional readiness to conduct KT, including experiences with KT, and views on motivation and capacity building. Participants included representatives from academic institutions and Ministries of Health in six countries (Bangladesh, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria). We conducted 18 KIIs, 11 with members of academic institutions and 7 with policymakers. KIIs were analysed using a deductive and inductive coding approach. Our findings support many well-documented barriers including lack of time, skills and institutional support to conduct KT. Three additional institutional drivers emerged around soft skills and the complexity of the policy process, alignment of incentives and institutional missions, and the role of networks. Participants reflected on often-lacking soft-skills needed by researchers to engage policy makers. Continuous engagement was viewed as a challenge given competing demands for time (both researchers and policy makers) and lack of institutional incentives to conduct KT. Strong networks, both within the institution and between institutions, were described as important for conducting KT but difficult to establish and maintain. Attention to the cross-cutting themes representing barriers and facilitators for both individuals and institutions can inform the development of capacity building strategies that meet readiness needs. [ABSTRACT FROM AUTHOR]

Background: With the outbreak of COVID-19 pandemic across the world, people have suffered an unexpected setback to their mental health. As psychological support is being provided to patients and healthcare workers, the general population and university students go unnoticed. This review aims to present existing literature that reports the effects of COVID-19 on psychological outcomes of the general population and university students in different countries. Methods: A manual search was conducted on PubMed, Google Scholar and Mendeley from inception to 31st January 2021. Articles were selected based on the predetermined eligibility criteria. Results: During COVID-19 pandemic, relatively high rates of depression (4.5% to 72.3%), anxiety (12.7% to 85.7%) and stress (5% to 90.1%) were reported in the general population as well as in university students, depression (3% to 70.5%), anxiety (9% to 63.3%) and stress (61.5% to 25%) in India, Nepal, Pakistan, China, Spain, US, UK, France, Egypt, Ethiopia, Bangladesh, Nigeria and Saudi Arabia. Risk factors associated include female gender, younger age group (≤40 years), unemployment, student status, and frequent exposure to social media/news concerning COVID-19. Conclusions: The COVID-19 pandemic is associated with highly significant levels of psychological disorders such as depression, anxiety and stress. Alleviating the hazardous effects of COVID-19 on mental health should be given due attention internationally. [ABSTRACT FROM AUTHOR]

Background: Lower limb deformities include conditions such as leg length discrepancy, lower limb deficiency and associated angular and rotational deformities of the hips, knees, ankles and feet. Children with lower limb deformities often have physical limitations due to gait irregularities and pain. The differences in the appearance and function of their lower limbs can discourage participation in social, recreational and leisure activities, which may result in behavioural, emotional, psychological and social adjustment problems. The health-related quality of life (HRQL) of these children is often impacted due to the factors discussed above, as well as by the complex surgical procedures. Surgical treatment options for limb deformities in children vary from limb lengthening and reconstruction to amputation. The lack of evidence demonstrating superiority of either treatment options and their effect on HRQL limits the ability of healthcare providers to counsel families on the best evidence-based treatment option for them. This manuscript describes the international qualitative study which guided the development of a new patient-reported outcome measure (PROM). Individual semi-structured face-to-face interviews with children with lower limb deformities and their parents were conducted at five sites: Canada (2 sites), Ethiopia, India and the USA. Results: Seventy-nine interviews were conducted at five international sites. Five main themes emerged from the qualitative interviews and formed the basis of the conceptual framework. These themes were: 1) appearance, 2) physical health, 3) psychological health 4) school and 5) social health. Conclusions: Lower limb deformities have a substantial impact on the HRQL of children. The concepts of interest identified in our study were similar across children from all countries. The conceptual framework guided the development of outcome scales specific to these patients. The information about the impact of various treatment options on the HRQL of children with lower limb deformities, collected using this new PROM, could be used to inform parents and children about outcomes (physical, social, psychological) associated with specific treatment options. This information could supplement other objective outcome information (e.g., complication rates, how the leg will look, etc.) to help families to come to a more informed decision on a child's course of treatment. [ABSTRACT FROM AUTHOR]

This study analyzes the trends and determinants of FDI inflow to Ethiopia from India and China. It is based on panel data of 2 decades (1997–2016). It employs a gravity model approach and fixed effects estimation technique to identify factors governing the flow of FDI to Ethiopia. Factors affecting the flow of Indian FDI to Ethiopia include Ethiopia's trade with India, India's population size, GDP of Ethiopia, GDP PC of India, real interest rate, credit access and FDI openness in Ethiopia. Similarly, factors governing Chinese FDI flow to Ethiopia include Ethiopia's GDP growth, Ethiopia's trade with China, FDI openness and secondary school enrolment. Government expenditure in the host country reduces China's and India's FDI inflow. The traditional explanatory variable, a resource rent, is not found significant in explaining FDI in flow from China and India. The FDI inflow from India and China showed an increasing trend with an average rate of 82% and 202%, respectively, during the two-decade period. But the overall trend for both partner countries showed fluctuation across years. We can conclude that FDI from India is responsive to macroeconomic variables such as OER, real interest rate and liberalization measures such as trade openness in Ethiopia. FDI and trade flows from China are positively related to one another and cheap labour is an important attraction factor for Chinese FDI inflow. Policy makers in Ethiopia can focus on macroeconomic reform in case of the country's relation with India whereas they focus on maintaining cheap labour cost, GDP growth and trade transactions with China. [ABSTRACT FROM AUTHOR]

Despite strong advocacy, the UN Decade of Action for Road Safety (2011-2020) is ending with most low- and middle-income countries (LMICs) no closer to the Sustainable Development Goals target of reducing traffic mortality by half. In contrast, most high-income countries (HICs) have seen large benefits in recent decades from large-scale safety interventions. We aimed to assess how much LMICs would benefit from interventions that address six key risk factors related to helmet use, seatbelt use, speed control, drink driving, and vehicle design for safety of occupants and pedestrians. We use a comparative risk assessment framework to estimate mortality and health loss (disability adjusted life years lost, DALYs) that would be averted if these risks were reduced through intervention. We estimate effects for six countries that span all developing regions: China, Colombia, Ethiopia, India, Iran, and Russia. We find relatively large benefits (27% reductions in road traffic deaths and DALYs) from speed control in all countries, and about 5%-20% reductions due to other interventions depending on who is at risk in each country. To achieve larger gains, LMICs would need to move beyond simply learning from HICs and undertake new research to address risk factors particularly relevant to their context. [ABSTRACT FROM AUTHOR]

The main objective of the present study is to identify, assess and compare the operational risk management practices in commercial banks of India and Ethiopia. Though Operational risk is not a new for commercial banks and practically not possible to zero down the risk, it has to manage effectively which will influence the profitable and financial position of the organization. Even the main objective of Basel Accord II is to improve stability and soundness of internal and external banking system, which is not successfully implemented by most of the banks. The present study is descriptive in nature and used primary and secondary data, primary data was collected through questionnaire and secondary data was collected through different journal, official documents, and financial statements of the commercial banks. In order to identify the frequency of different risk factors and to collect the relevant data from the selected sample unit's, researcher developed structured questionnaire and determined the sample size by using purposive sampling technique. Multiple linear regression model used to analyze the data statistically, paired T Test to test the Hypotheses and interpreted the data using tables and graphs. At the end point researched identified that, comparatively operation risk management practices are good in commercial banks of India and moderate in Ethiopian commercial banks. [ABSTRACT FROM AUTHOR]

This paper provides evidence on the predicted benefits of maternal education, in terms of reduced child malnutrition at ages 1 and 5, focusing specifically on the complementarities with early life interventions across contexts. Using data from the Young Lives Longitudinal Study for Ethiopia, India, Peru and Vietnam, results show the expected association of maternal education with reduced likelihood of malnutrition both at ages 1 and 5. However, the benefits of maternal education via access to an early life intervention (antenatal care), are found only in some countries and for some levels of maternal education. Inequalities in the risk of malnutrition between those with the highest endowments of maternal education and access to antenatal services, and those without these, are significant within countries. We conclude that programmes which aim to reduce the risks of malnutrition should consider local knowledge and realities in order to understand more fully the expected benefits.

Many interventions focus on preventing stunting in the first 1,000 days of life. We take a broader perspective on childhood growth to assess the proportions of children who suffer persistent stunting, recover, and falter and become newly stunted between birth and adolescence. We use longitudinal data collected on 7,128 children in Ethiopia, India, Peru, and Vietnam. Data were collected in five survey waves between the ages of 1 to 15 years. We use descriptive and graphical approaches to compare the trajectories of children first stunted by age 1, first stunted by age 5, and those remained not stunted until age 5. On average, 29.6% of children were first stunted by age 1, 12.9% of children were first stunted by the age 5, and 68.7% of children were not stunted at either age 1 or age 5. A larger percentage of children stunted by age 1 remained stunted at age 15 (40.7%) compared with those who were first stunted by age 5 (32.3%); 33.7% of children first stunted by age 1 and 31.1% of children first stunted by age 5 go on to recover, but then falter during later childhood. 13.1% of children who were not stunted at age 1 or age 5 become newly stunted between the ages of 8 and 15. Our results show that children both become stunted and recover from stunting into adolescence. More attention should be paid to interventions to support healthy growth throughout childhood. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Development Research is the property of Palgrave Macmillan Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article investigates the household determinants of teen marriage in Ethiopia, India, Peru, and Vietnam using data from the international Young Lives study tracking a cohort of children from the ages of 8-19 over a 15-year period. First, we offer a descriptive and comparative overview of the prevalence of teen marriage among girls in geographically selected areas of the four countries, together with their sociodemographic determinants. Second, we place a specific focus on the role of gender and sibling sex-composition in shaping the probability of getting married by age 19. Drawing on the significant cross-country heterogeneity in household context, direction of marriage payments, and prevalence of arranged marriage, we test hypotheses relating to the availability of economic resources within the household and cultural norms surrounding the order and timing of marriage. We show that in Ethiopia, India, and Vietnam, presence and number of older sisters in the household are associated with a 30-50 percent lower likelihood of teen marriage, while the association is null in Peru. Also, we show that having a girl as next-youngest sibling does not significantly affect girls' likelihood of experiencing teen marriage, except in Ethiopia. Our results combined support theories of family-level resource constraints over sibling rivalry hypotheses. Our findings enrich and complement existing evidence on the role of sibling sex-composition on adolescent outcomes in low- and middle-income countries. [ABSTRACT FROM AUTHOR]