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The aim of the study was to assess the effects of the maternal and child health (MCH) system strengthening through multilevel governmental collaboration in Nujiang Prefecture, China. A case study design was applied. Guided by the logical framework of the Nujiang MCH Comprehensive Intervention Project, national, provincial, and prefecture government sectors jointly implemented comprehensive health system strengthening (HSS) interventions in Nujiang Prefecture. In this case study, we conducted the end point surveys (November 2015 and January 2016) with 33 local MCH facilities. We also interviewed 35 MCH providers, government officials, leaders of MCH facilities, and project specialists. The thematic framework method was used to analyze the interview data, and descriptive analysis was performed to analyze the survey data. The three levels of governmental collaboration contributed to increased government investment in the local MCH system and ensured the successful implementation of the project. Participatory training methods and appropriate HSS interventions tailored to the local context were crucial to improve MCH providers' knowledge and skills, with the proportion of qualified MCH providers increasing from 70% in 2011 to 96% in 2015. Owing to this increase in knowledge and the increase in needed equipment, more MCH hospitals could provide inpatient obstetric services, and more town health clinics were capable of providing basic MCH services. The development of a reimbursement policy tailored to the local context promoted in-hospital delivery. At the conclusion of the project, percentages of antenatal care, in-hospital delivery, and newborn screening increased by 20.71%, 18.12%, and 278.62%, respectively. Growth monitoring coverage for children younger than three years remained stable at around 90%. However, the MCH system was negatively impacted by the workforce shortage. Those shortages were caused by a lack of positive recruitment and retention and incentive policies. Implementation of comprehensive HSS interventions through multilevel governmental collaboration improves the MCH system in remote and low-income areas. • Multilevel governmental collaboration improves the Maternal and Child Health (MCH) system in remote and low-income areas. • Participatory training methods contributes to the positive effects of health system strengthening interventions. • The MCH system is negatively impacted by the workforce shortages and inadequate incentives for health providers. [ABSTRACT FROM AUTHOR]

Poverty and poverty reduction in mainland China are the main concerns of development discourse and policy. Among poor individuals, children are the most vulnerable. This study aimed to investigate how multidimensional child poverty influenced children's academic achievement in poor rural areas in China. This study examined how this effect might be mediated by the stock of social relationships. Data were obtained from a questionnaire survey of 775 children (grades 4 to 9) living in the most underdeveloped rural areas in southwest China (Eryuan County). Results showed that multidimensional child poverty was negatively related to children's academic achievement. Social relationships played a significant role in mediating the effects of multidimensional child poverty on children's academic achievement. These findings provided valuable insights into the multidimensions of poverty and the underlying mechanisms from poverty to children's academic achievement. Implications in theory, social work practice, and social policy were discussed. Social work intervention and prevention were also developed in terms of fostering the growth of social relationships. • Poverty and poverty reduction in mainland China are currently the central concerns of development discourse and policy. • Multidimensional child poverty was negatively related to children's academic achievement. • Social relationships significantly mediated the effects of multidimensional child poverty on children's academic achievement. [ABSTRACT FROM AUTHOR]

The effects of late-life subjective poverty on brain health are understudied. We aimed to investigate the association between duration of subjective poverty after age 64 and subsequent cognitive function and decline in China. Data were from 4118 adults aged ≥64 at baseline in the population-based China Longitudinal Healthy Longevity Survey (CLHLS), 2005–2018. The duration of subjective poverty was measured from self-rated economic status relative to neighbors in 2005, 2008, and 2011 (never; one time point; two or three time points). Cognitive function was assessed by the Chinese Mini-Mental State Exam (CMMSE; range: 0–30) in 2011, 2014, and 2018. We fitted attrition-weighted, multivariable mixed-effects Tobit regression models to examine the relationship between duration of subjective poverty from 2005 to 2011 and subsequent cognitive function and decline from 2011 to 2018. A total of 2675 (64.96%) participants never reported subjective poverty over the period 2005–2011, 930 (22.58%) participants reported subjective poverty at one time point, and 513 (12.46%) reported subjective poverty at two or three time points. Compared to those who never reported subjective poverty, participants experiencing subjective poverty at one time point (β = −0.95, 95% CI: −1.48 to −0.41) and two or three time points (β = −2.01; 95% CI: −2.73 to −1.29) had lower CMMSE scores in 2011, indicating a dose-response relationship. Individuals with a longer duration of subjective poverty had a slower rate of decline in CMMSE scores than those never in subjective poverty (β = 1.44; 95% CI: 0.20 to 2.68 for 2018 X Two or three time points). Subjective poverty in late life may have unique and cumulative contributions to cognitive aging among older adults in China. The lower level of initial cognitive function but slower rate of cognitive decline observed for those with greater subjective poverty is consistent with theories of cognitive reserve and empirical evidence from Western settings on other socioeconomic markers. • One of the first longitudinal studies of subjective poverty and cognitive aging. • This study focuses on the middle-old and oldest-old adults in China. • A longer subjective poverty duration was associated with worse cognitive function. • However, a longer subjective poverty duration may lead to slower cognitive decline. [ABSTRACT FROM AUTHOR]

• Employing resilience framework to examine the poverty effect under multisystems. • Constructing Multidimensional Poverty Index to measure household poverty. • Identifying promotive factors in mitigating poverty risk posed on child development. By employing the resilience framework, this study investigates how poverty would impact children's educational and behavioral performance in China. Considering the nested structure of the data, we employed multilevel structural equation modeling. The results suggest that, at the household level, personal agency and family resources completely mediate the effect of poverty on educational performance while partially mediating its effect on behavioral performance. At the community level, the two mediators partially mediate both educational and behavioral performance. Taking both mediators into account, poverty has a negative effect on cognitive ability at the community level, but positive impacts on behavioral performance at both the household and community levels. This study offers a new lens for social service practitioners who seek to promote poverty resilience among poor children. [ABSTRACT FROM AUTHOR]

• Poverty has a direct negative effect on adolescents' psychological well-being but not on their psychological distress. • Relational victimization, not overt victimization, mediates the association between poverty and adolescents' mental health. • Poverty and relational victimization negatively predict self-esteem, which in turn, jeopardizes adolescents' mental health. Poverty is negatively linked to adolescents' mental health. However, little is known about the underlying process that mediates this relationship. This study aims to examine the association among poverty, peer victimization, self-esteem, and mental health of adolescents. Data are collected through a multistage cluster random sampling in Hebei, China (N = 1280; mean age = 15.68; 47.4% male). Structural equation modeling is adopted to examine the hypothetical model using AMOS 24.0. Results reveal that the mechanisms linking poverty to adolescent mental health differ in terms of victimization types (overt or relational). Relational victimization and self-esteem partially mediate the relationship between poverty and psychological well-being and fully mediate the relationship between poverty and psychological distress after gender, age, hukou status, and family socioeconomic status are controlled. However, the mediating effect of overt victimization is not significant. The overall model accounts for 27% and 24.8% of the variance in psychological well-being and distress, respectively. This study contributes to an improved understanding of the mediating mechanisms underlying poverty and mental health. The implications of the present findings for social work interventions and social policies are also discussed. [ABSTRACT FROM AUTHOR]