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Supplemental material, sj-pdf-1-hsr-10.1177_13558196211012732 for Challenges of using asthma admission rates as a measure of primary care quality in children: An international comparison by Irina Lut, Kate Lewis, Linda Wijlaars, Ruth Gilbert, Tiffany Fitzpatrick, Hong Lu, Astrid Guttmann, Sharon Goldfield, Shaoke Lei, Geir Gunnlaugsson, Stefán Hrafn Jónsson, Reli Mechtler, Mika Gissler, Anders Hjern and Pia Hardelid in Journal of Health Services Research & Policy

Supplemental material, sj-pdf-1-hsr-10.1177_13558196211012732 for Challenges of using asthma admission rates as a measure of primary care quality in children: An international comparison by Irina Lut, Kate Lewis, Linda Wijlaars, Ruth Gilbert, Tiffany Fitzpatrick, Hong Lu, Astrid Guttmann, Sharon Goldfield, Shaoke Lei, Geir Gunnlaugsson, Stefán Hrafn Jónsson, Reli Mechtler, Mika Gissler, Anders Hjern and Pia Hardelid in Journal of Health Services Research & Policy

Additional file 1.

BackgroundCOVID-19 is mainly a disease of adults but can affect vulnerable children indirectly through social containment measures. The study aimed to explore the impact of the pandemic on the lives of Quranic schoolboys, almudos, who beg on behalf of their teachers, chernos, in Guinea-Bissau.MethodsData were collected in July 2020 during a state of emergency. Data rest on semistructured interviews with 14 almudos and observations. The almudos, aged 12–16 years, were identified in the capital Bissau and the regional centre Gabú.ResultsFour interconnected themes were found. The first, hardship, was brought by the COVID-19 pandemic and caused by lockdown and police threats, resulting in a decrease in alms and hunger. The second, circumvention of calamity, included preventive measures the boys undertook and concerns with crowdedness impeding social distancing. Relations with others is the third theme. These had changed with sharply reduced contacts with neighbours and other providers of alms. The parents had more frequent telephone contact with their sons, and encouraged them to continue their studies. At the same time, the chernos and almudos passed more time together, and they dedicated more time than earlier to the studies and prayers. The fourth theme has to do with the boys’ concerns about their long-term aspirations—to complete their studies and become respected chernos, for which begging was seen as an integral part.ConclusionThe almudos suffered from decreased alms, resulting in hunger. COVID-19 was only an additional burden to the boys, who are used to facing challenges while begging to complete their religious education. According to the Convention on the Rights of the Child, children have a right to develop their capabilities in line with their future aspirations. Governments and child rights organisations need to address the specific needs of almudos in respectful collaboration with them, their parents, the chernos and their communities.

Publisher's version (útgefin grein), Objective To assess whether the level of austerity implemented by national governments was associated with adverse trends in perinatal outcomes and the social determinants of children's health (SDCH) in rich countries Design Longitudinal ecological study of country-level time trends in perinatal outcomes and SDCH and from 2005 to 2015. Setting and participants 16 European countries using available data from the International Monetary Fund, the Organisation for Economic Co-operation and Development and Eurostat. Main outcome measures Trends in perinatal outcomes (low birth weight (LBW); infant mortality) and the SDCH: child poverty rates; severe material deprivation in families with primary education; preschool investment in three time periods: 2005-2007, 2008-2010 and 2012-2015. Outcomes were compared according to the cyclically adjusted primary balance (CAPB, differences between 2013 and 2009) as a measure of austerity, stratified in tertiles. Generalised estimating equation models of repeated measures were used to assess time trend differences in three periods. Results Countries with higher levels of austerity had worse outcomes, mainly at the last study period. Material deprivation increased during the period 2012-2015 in those countries with higher CAPB (interaction CAPB-period 2012-2015, B: 5.62: p, Funding DT-R is funded by the MRC on a Clinician Scientist Fellowship (MR/ P008577/1). The study was not externally financed.