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This paper examined female education and employment in Nigeria. The 2018 Nigeria Demographic and Health Survey data (NDHS, 2018) was used. After sorting out for missing data, 28,494 women’s individual data were used. Data were analyzed using descriptive statistics and Multinomial logit regression. Only 0.3% of women in Nigeria are unemployed while 99.7% are employed in skilled and unskilled jobs. However, only 13.4% of the women are engaged in skilled employment; 8.5% are in professional/technical/managerial jobs while 4.9% are involved in skilled manual. The majority (86.3%) are in the unskilled manual employment category; 1.6% in clerical, 49.4% in sales, 9.5% in services, 0.1% in unskilled manual and 25.7% in Agriculture. The likelihood of being involved in professional/technical/managerial employment by women in Nigeria increases with age (0.06), region {North West (1.18), South West (1.87}, educational level {secondary (0.68), tertiary (1.64)}, wealth index{richer (0.90), richest(0.95)}. On the other hand, the likelihood of being engaged in professional/technical/managerial employment type reduces with large household size >10persons (-0.71). Engagement of women in skilled employment types are driven by education while education discourages them in engaging in unskilled employment types. However, because the highest proportion of the women have secondary education, they are found more in the unskilled employment types. Also, engagement in skilled employment types is driven by wealth index while age drives skilled and unskilled employment types. Nigerian women are not much involved in skilled employment, the right policy should be put in place to educate girls beyond the secondary education level and enlighten them on the need to be involved in skilled employment.

Background: Ghana was one of the few countries commended to have halved extreme poverty after the MDG era yet the under-five mortality rate (U5MR) was dire. Ghana's U5MR is still above the national and global SDG target. As a result, the government has over the years implemented other complementary social and policy interventions to improve the socioeconomic status of households to ensure better child health outcomes. Yet key gaps exist and threaten child health outcome sustainability, and child health-related SDG targets. In this regard, we hypothesize that household wealth should therefore not influence under-five child deaths significantly. Methods: The paper first reports the under-five mortality trend over the past 30 years in Ghana. It uniquely analyses the levels and trends in wealth as measured by the Gross National Income per capita at purchasing power parity (ln GNI/p, ppp) as a proxy of the mean Comparative Wealth Index (CWI) against under-five child deaths in Ghana. Using data from the 2014 Ghana Demographic and Health Survey and employing the logistic regression estimation technique, the paper further estimates the effect of household wealth and other key covariates on under-five child deaths. Implemented government poverty-alleviating policies and intervention programs to reduce childhood mortality in Ghana were reviewed to identify risk gaps to child deaths. Results: The 30 year trend analysis from 1990 to 2020 shows that the under-five mortality rate in Ghana is still high, falling short of the rate of decline that is expected toward achieving the 2030 SDG target for U5MR of 25 deaths per 1000 live births. Our empirical estimations show that household wealth still has a negative and significant relationship with under-five child deaths despite the government's existing poverty-alleviating and pro-poor health policies. In addition, the results show that regional differences, maternal age, the number of children alive, and attendance to postnatal healthcare services are crucial for child survival. Conclusion: The results imply that the government should consolidate universal programmes with intensified targeted interventions toward improving household wealth, especially in the Northern Savannah regions. A new and dynamic child health policy is imminent to reflect strategies towards achieving the SDG target on U5MR. Additionally, intensive education on active maternal participation in postnatal care should be given critical consideration to improve child survival. [ABSTRACT FROM AUTHOR]

Dietary diversity is an indicator of nutrition that has been found positively associated with diet quality, micronutrient adequacy, and improved maternal health and child growth. Due to the cultural responsibility of women in providing food at the household level, their status is very important to perform this role. Hence, this study has been conducted on the status of dietary diversity of the mother and child to understand how it relates to various factors of women in urban settings. Data were obtained from 1978 mother–child pairs living in different cities in Bangladesh. The foods taken by the women and children were categorized into 10 and 7 groups to measure women's dietary diversity (WDD) and children's dietary diversity (CDD), respectively. The study found that more than three‐fourths of the mothers and half of the children had low dietary diversity. The household wealth holdings and access to resources by the women were found inadequate, while two‐thirds of them had the lowest to medium level of nutritional knowledge. The binomial logistic regression model was used to measure the factors influencing WDD and CDD. The findings also indicated that children's dietary diversity was influenced by the mother's age, education, supportive attitude and behavior of husband, and access to and control over resources. While the household wealth index can enhance both child and mother's dietary variety, nutrition knowledge, dietary counseling, and access to and control over resources can improve maternal dietary diversity. This study recommends improving women's socioeconomic status by increasing their wealth and access to resources and enhancing their nutrition knowledge by providing food and nutrition counseling. [ABSTRACT FROM AUTHOR]

This study investigates the socio-economic and demographic determinants of household fertility decisions in Nigeria. Using the family system model as a framework, a cross-sectional survey design in a retrospective study was adopted. Quantitative data were purposively obtained from the 2018 Nigeria Demographic and Health Survey (NDHS) household recode dataset. Data were analysed using descriptive, bivariate statistics and Logistic Regressions at P<0.05. The mean age at first birth of respondents was 18.8±4.0 years. The mean of children ever born (CEB) was 5.9±2.8. The CEB was highest in the North West region (36.7%), while the South East had the lowest (12.6%) sum of CEB in the six regions. The relationship between CEB and the age at first birth is statistically significant (2= 8334.4, p=<0.001). Women with all children living are 2.0 times (OR=2.071, CI=1.987-2.158) more likely to increase their CEB than women who have experienced the loss of a child. Women who have no formal education are 5.8 times (OR=5.835, CI=5.504-6.186) more likely to increase their CEB than women with tertiary education. Women who used the folkloric method of contraceptives were 5.5 times more likely to increase their CEB than women using modern contraceptives. Based on the findings, it is recommended that fertility controls must be prioritized, specifically by encouraging girl child education across the nation. [ABSTRACT FROM AUTHOR]

Background: Maternal health service utilization decreases maternal morbidity and mortality. However, the existing evidence is inadequate to design effective intervention strategies in Ethiopia. Objectives: This study aimed to examine the utilization of maternal health service and identify its determinants among women of reproductive age in southern Ethiopia. Design: A community-based cross-sectional study was conducted from October 21 to November 11, 2022 on a sample of 1140 women selected randomly from the Northern Zone of the Sidama region. Methods: Data were collected using the Open Data Kit mobile application and exported to Stata version 15 for analysis. We used a multilevel mixed-effects modified Poisson regression with robust standard error to identify determinants of maternal health service utilization. Results: Utilization of antenatal care, health facility delivery, and postnatal care was 52.0% (95% confidence interval: 49.0%, 55.0%), 48.5% (95% confidence interval: 45.6%, 51.4%), and 26.0% (95% confidence interval: 23.0%, 29.0%), respectively. Antenatal care use was associated with receiving model family training (adjusted prevalence ratio: 1.19; 95% confidence interval: 1.06, 1.35), knowledge of antenatal care (adjusted prevalence ratio: 1.54; 95% confidence interval: 1.31, 1.81), perceived quality of antenatal care (adjusted prevalence ratio: 1.02; 95% confidence interval: 1.01, 1.03), and having birth preparedness plan (adjusted prevalence ratio: 1.13; 95% confidence interval: 1.02, 1.25). The identified determinants of health facility delivery use were middle wealth rank (adjusted prevalence ratio: 1.35; 95% confidence interval: 1.03, 1.77), perceived quality of health facility delivery (adjusted prevalence ratio: 1.02; 95% confidence interval: 1.01, 1.03), antenatal care (adjusted prevalence ratio: 1.76; 95% confidence interval: 1.36, 2.26), and high community-level women literacy (adjusted prevalence ratio: 1.55; 95% confidence interval: 1.10, 2.19). Postnatal care use was associated with facing health problems during postpartum period (adjusted prevalence ratio: 1.79; 95% confidence interval: 1.18, 2.72), urban residence (adjusted prevalence ratio: 3.52; 95% confidence interval: 2.15, 5.78), knowledge of postnatal care (adjusted prevalence ratio: 1.11; 95% confidence interval: 1.04, 1.19), and low community-level poverty (adjusted prevalence ratio: 0.43; 95% confidence interval: 0.25, 0.73). Conclusion: Maternal health service use was low in the study area and was influenced by individual- and community-level determinants. Any intervention strategies must consider multi-sectorial collaboration to address determinants at different levels. The programs should focus on the provision of model family training, the needs of women who have a poor perception, and knowledge of maternal health service at the individual level. [ABSTRACT FROM AUTHOR]

Abstract Background The per capita health expenditure (HE) and share of gross domestic product (GDP) spending on elderly healthcare are expected to increase. The gap between health needs and available resources for elderly healthcare is widening in many developing countries, like Tanzania, leaving the elderly in poor health. These conditions lead to catastrophic HEs for the elderly. This study aimed to analyse the association between measures of health, wealth, and medical expenditure in rural residents aged 60 years and above in Tanzania. Methods The data of this study were collected through a cross-sectional household survey to residents aged 60 years and above living in Nzega and Igunga districts using a standardised World Health Organization (WHO) Study on Global Ageing and Adult Health (SAGE) and European Quality of Life Five Dimension (EQ-5D) questionnaires. The quality of life (QoL) was estimated using EQ-5D weights. The wealth index was generated from principal component analysis (PCA). The linear regression analyses (outpatient/inpatient) were performed to analyse the association between measures of health, wealth, medical expenditure, and socio-demographic variables. Results This study found a negative and statistically significant association between QoL and HE, whereby HE increases with the decrease of QoL. We could not find any significant relationship between HE and social gradients. In addition, age influences HE such that as age increases, the HE for both outpatient and inpatient care also increases. Conclusion The health system in these districts allocate resources mainly according to needs, and social position is not important. We thus conclude that the elderly of lower socio-economic status (SES) was subjected to similar health expenditure as those of higher socio-economic status. Health, not wealth, determines the use of medical expenditures.

Background: Little is known whether physical activity (PA)-promoting environments are equally accessible to children with divergent socioeconomic status (SES) in low-/middle-income countries. The authors, therefore, examined whether South African children from poorer versus wealthier families living in marginalized communities differed in moderate to vigorous PA and cardiorespiratory fitness. We also tested associations between family car ownership and PA/cardiorespiratory fitness. Methods: Parents/guardians of 908 children (49% girls, mean age = 8.3 [1.4] y) completed a survey on household SES. PA was assessed via 7-day accelerometry, parental and child self-reports, and cardiorespiratory fitness with the 20-m shuttle run test. Results: Based on accelerometry, most children met current moderate to vigorous PA recommendations (≥60 min/d). About 73% of the children did not engage in structured physical education lessons. Whereas children of the lowest SES quintile accumulated higher levels of device-based moderate to vigorous PA, peers from the highest SES quintile engaged in more sedentary behaviors, but self-reported higher engagement in sports, dance, and moving games after school. Families' car ownership was associated with higher parent/self-reported leisure-time PA. Conclusions: A deeper understanding is needed about why wealthier children are more sedentary, but simultaneously engage in more leisure-time PA. The fact that access to structural physical education is denied to most children is critical and needs to be addressed. [ABSTRACT FROM AUTHOR]

Abstract Background Low birth weight is a key indicator for child health, especially a concern in low-middle-income countries. However, health and medically-related reforms are being actively implemented in some middle-income countries like India. Identifying low birth weight (LBW) babies with their determinants across the whole country is essential to formulate regional and area-specific interventions. The objective of this study was to find out the burden and determinants of LBW on the regional and residential (rural–urban) divisions of India. Methods The present study was based on the NFHS-5 dataset (2019–21), a nationally representative survey in India. A total of 209,223 births were included in this study. A newborn weighing less than 2500 g was considered as LBW. According to the objectives, we used frequency distribution, chi-square test and binary logistic regression analysis for analysing the data. Results About 18.24% of the babies were LBW in India, significantly higher in rural areas than in urban areas (18.58% vs 17.36%). Regionally prevalence was more frequent in western (20.63%) and central (20.16%) rural areas. Regarding maternal concerns, in the eastern and southern regions of India, mothers aged 25–34 were less likely to have LBW children than mothers aged 35–49 years. It was found that the risk of LBW was more likely among the children born out of unintended pregnancies in almost all regions except for eastern part. In rural India, women who delivered children at home were more likely to have LBW children in India (AOR = 1.19, CI: 1.12–1.28, p

The study was conducted during 2022-23 to assess the level of food insecurity and income status among farm households. Data from 474 farmers through personal interview method were collected. Agriculture was the primary occupation for most households followed by off-farm activities. Average per capita annual income (Rs. 1,00,073) was lower than the national average. The per capita annual income was Rs. 73,303, Rs. 93,256 and Rs. 1,44,456 for marginal, small, and medium farmers, respectively. About 47 per cent of the expenditure was made on consumption. A comparison of calorie intake to recommended calorie intake indicated that food insecurity was prevailing among 26 percent of the farmers. The major contribution to calorie intake was from cereals, the consumption of vegetables and fruits was low. A decision tree model using machine learning algorithms was used to identify the factors influencing food security. Per capita income, family size, consumption expenditure, social participation, and land holdings had significant importance in classifying the households as food secure and insecure. Diversifying farm activities and creating additional opportunities in rural areas, teaching households about balanced diets, promoting home gardening, and institutional policies to improve food security may be the strategic points. [ABSTRACT FROM AUTHOR]

Background: The per capita health expenditure (HE) and share of gross domestic product (GDP) spending on elderly healthcare are expected to increase. The gap between health needs and available resources for elderly healthcare is widening in many developing countries, like Tanzania, leaving the elderly in poor health. These conditions lead to catastrophic HEs for the elderly. This study aimed to analyse the association between measures of health, wealth, and medical expenditure in rural residents aged 60 years and above in Tanzania. Methods: The data of this study were collected through a cross-sectional household survey to residents aged 60 years and above living in Nzega and Igunga districts using a standardised World Health Organization (WHO) Study on Global Ageing and Adult Health (SAGE) and European Quality of Life Five Dimension (EQ-5D) questionnaires. The quality of life (QoL) was estimated using EQ-5D weights. The wealth index was generated from principal component analysis (PCA). The linear regression analyses (outpatient/inpatient) were performed to analyse the association between measures of health, wealth, medical expenditure, and socio-demographic variables. Results: This study found a negative and statistically significant association between QoL and HE, whereby HE increases with the decrease of QoL. We could not find any significant relationship between HE and social gradients. In addition, age influences HE such that as age increases, the HE for both outpatient and inpatient care also increases. Conclusion: The health system in these districts allocate resources mainly according to needs, and social position is not important. We thus conclude that the elderly of lower socio-economic status (SES) was subjected to similar health expenditure as those of higher socio-economic status. Health, not wealth, determines the use of medical expenditures. [ABSTRACT FROM AUTHOR]

Background: Low birth weight is a key indicator for child health, especially a concern in low-middle-income countries. However, health and medically-related reforms are being actively implemented in some middle-income countries like India. Identifying low birth weight (LBW) babies with their determinants across the whole country is essential to formulate regional and area-specific interventions. The objective of this study was to find out the burden and determinants of LBW on the regional and residential (rural–urban) divisions of India. Methods: The present study was based on the NFHS-5 dataset (2019–21), a nationally representative survey in India. A total of 209,223 births were included in this study. A newborn weighing less than 2500 g was considered as LBW. According to the objectives, we used frequency distribution, chi-square test and binary logistic regression analysis for analysing the data. Results: About 18.24% of the babies were LBW in India, significantly higher in rural areas than in urban areas (18.58% vs 17.36%). Regionally prevalence was more frequent in western (20.63%) and central (20.16%) rural areas. Regarding maternal concerns, in the eastern and southern regions of India, mothers aged 25–34 were less likely to have LBW children than mothers aged 35–49 years. It was found that the risk of LBW was more likely among the children born out of unintended pregnancies in almost all regions except for eastern part. In rural India, women who delivered children at home were more likely to have LBW children in India (AOR = 1.19, CI: 1.12–1.28, p < 0.001) and its central, northern, and southern regions than those who gave birth in institutions. The study indicates that LBW coexists with lower maternal education levels and poor household wealth index across all regions. About 58% and 57% of cumulative effects of independent variables on LBW can be distinguished in urban and rural India, respectively. Conclusions: Targeted-specific strategies need to be undertaken as per region and geographical variations. Then only India should be able to decline LBW as proposed by National Health Policy. [ABSTRACT FROM AUTHOR]

This study analyzed the 2017-2018 Jordan Demographic and Health Survey (DHS) database to determine the prev- alence of domestic violence (DV) against women in Jordan and its associated sociodemographic factors. The findings revealed that among Jordanian women, the lifetime prevalence of DV by husbands was 25.9%, with emotional (20.6%), physical (17.5%), and sexual (5.1%) violence being prominently reported. DV against women was signifi- cantly associated with the age, region, and educational status of women, as well as the wealth index, but not their hus- bands. While the results suggest a potential reduction in DV estimates compared to the last decade, DV still represents a public health issue in Jordan. The study highlights the direct association of DV with socio-demographic characteris- tics and provides a gateway to identifying high-risk women and implementing appropriate interventions to reduce DV. [ABSTRACT FROM AUTHOR]

Indonesia is one of the countries with high nutritional problems caused by inadequate feeding practices. A minimum acceptable diet (MAD) is used to assess feeding practices in children with low achievement (53,6%) aged 6-23 months. This study aimed to determine the factors influencing MAD in children aged 6-23 months in Indonesia. This study uses a cross-sectional study design to use secondary data from the 2017 IDHS. The subjects in this study were 4.783 children aged 6-23 months. Data were collected using the 2017 IDHS and WHO UNICEF 2010 questionnaires in assessing feeding practices. Statistical tests used were Chi-square, Spearman, and Multiple logistic regression. This study showed that the prevalence of MAD was 53.7%. Factors influencing MAD were the location of residence (p= 0,001), wealth index (p

Introduction: Bone fracture is a cause of 5 million annual injuries globally. It contributes to profound physical impairment, a reduction in quality of life, long hospitalization time, and reduced institutional care. The socioeconomical impact of bone fracture will be high in the next 50 years in developing countries, including Ethiopia. This study aimed to assess the factors associated with the early phase of fracture healing among fractured adult patients at the University of Gondar Specialized hospital, Northwest Ethiopia. Methods: A secondary data analysis was done from the previous institution-based prospective follow-up study from March to June 2015. An interviewer-administered pretested and structured questionnaire was used to collect the data. Early ossification of fractured bone was defined when the bone was ossified/calcified within 1 month of the fracture using X-ray findings. Data were entered into EpiInfo version 3.5.3 software and exported to SPSS version 20 for Windows for further analysis. Binary logistic regression analysis was employed to find factors associated with early ossification of a fractured bone. In the multivariable model, variables that had a p–value of < 0.05 were considered statistically significant. Also, a 95% CI for odds ratios was calculated to see the degree of association. Results: In total, 118 participants with a bone fracture participated in this study. Of all, 36.4% of them had ossified bone during the early phase of bone healing. Dietary diversity score (DDS) [AOR = 18.6, 95% CI (4.10–84.34)], the type of fractured bone [AOR: = 0.13, 95% CI (0.03–0.50)], and household wealth index [AOR = 8.6, 95% CI (1.51–49.05)] were independently associated with the early phase of fractured bone healing/ossification. Conclusion: Bone ossification during the first month of fracture was low. Dietary diversity score, type of fractured bone, and household wealth index were the factors associated with the early phase of bone ossification. So, improving dietary practice after the incident is essential. Also, health care providers will have to consider the fractured bone type and household assets during the clinical intervention for fractured bone. [ABSTRACT FROM AUTHOR]

Background: Although Antenatal Care has long been a concern for social scientists and public health experts, most research has focused on the poor and migrants as discrete categories. Another worry is whether poorer and migrant women have double obstacles in obtaining Antenatal Care (ANC). This study aims to look into the factors that influence ANC utilization among migrant and poor women in India. Methods: This study used the National Family Health Survey (NFHS-4) data conducted during 2015–16. Descriptive statistics and multiple logistic regression were used to investigate the association between ANC utilization and wealth and the migration status of women. Results: About 10.2% of migrant and poorer women had received full ANC, compared to 30.3% of non-poorer non-migrant women. We found a significant difference in full ANC utilization across wealth and migrant groups. Non-poorer and non-migrant women had a significantly 1.31 times higher likelihood of using full ANC compared to poorer and migrant women, and 1.84 times higher likelihood of accessing four or more ANC visits. Analyses show that women's age, literacy, husband literacy, birth order, social group, religion, and type of residence were significantly associated with the gap in full ANC utilization across migrant and wealth groups. Conclusion: This study found disparities in ANC utilization across wealth and migrant groups.Poorer migrant women were at higher risk of receiving inadequate care. Therefore, policymakers should make an extra effort to provide ANC to these women to reduce the ANC utilization gap.

Census data for Zambia was used to estimate the distribution of wealth in Zambia by constructing the Wealth Index as a measure of socioeconomic status using Principal Component Analysis. The reliability of the index is observed from three fronts; coherence, robustness and validity in representing household socioeconomic status. Classifying the households across all quartiles is highly consistent and robust. The index’s performance in predicting the welfare distribution is analogous to established and most widely used methods from Demographic Health Surveys, as evidenced by similarities in the statistical distributions. Unlike other survey estimates, the index has been produced at the subnational level, such as district, enabling the classification of Zambia’s districts according to their socioeconomic status. The index can be used to predict other socioeconomic outcomes, such as education and health, via Small Area Estimation techniques and determine district-level resource allocation by the central government.

China's government subsidies on the demand side-such as subsidizing medical insurance premiums-have accelerated progress towards universal health coverage. We examined whether the increased government subsidies had benefited the population, especially the poor. We conducted two rounds of household surveys and collected the annual claims reports of a rural medical insurance scheme in Ningxia (a relatively underdeveloped region in Western China). We used benefit incidence analysis to evaluate the distribution of benefits for different health services received by individuals with different living standards, as measured by the household wealth index. From 2009 to 2015, the benefit received per capita tripled from 101 to 332 CNY, most (>94%) of which was received for inpatient care. The overall distribution of benefits improved and became pro-poor in 2015 [the concentration index (CI) changed from -0.017 to -0.092], mainly driven by inpatient care. The poorer groups benefited disproportionately more from inpatient care from 2009 to 2015 (the CI changed from -0.013 to -0.093). County and higher-level inpatient care had the greatest improvements towards a pro-poor distribution. The distribution of subsidies for outpatient services significantly favoured the poorer groups in 2009, but less so in 2015 (CI changed from -0.093 to -0.068), and it became less pro-poor in village clinics (CI changed from -0.209 to -0.020). The increased government subsidies for the rural medical insurance scheme mainly contributed to inpatient care and allowed the poor to use more services at county and higher-level hospitals. China's government subsidies on the demand side have contributed to equity in benefit incidence, yet there is a noticeable increasing trend in utilizing services at higher levels of providers. Our findings also indicate that outpatient services need more coverage from rural medical insurance schemes to improve equity. [ABSTRACT FROM AUTHOR]

Abstract Background Unmet need for family planning (FP) is a core concept in designing FP programmes and reduction of unmet need for FP can improve reproductive and maternal health services. Bangladesh is still away from achieving the target regarding unmet need for FP. This study aimed to explore the composite effect of economic status and place of residence on unmet need for FP among currently married women of reproductive age in Bangladesh after controlling the effect of other selected covariates. Methods The study used the data extracted from the Bangladesh Demographic and Health Survey (BDHS) 2017–2018, which is a nationally representative survey implemented using a stratified two-stage cluster sample design. A total of 13,031 currently married women of reproductive age were included in the final analysis. Binary logistic regression model has been employed to identify the factors influencing the unmet need for FP. Model-I investigated the effect of composite variable place-wealth on unmet need for FP and Model-II examined the effect of place-wealth on unmet need for FP after adjusting for the effect of other selected covariates. The Odds Ratios with p-values were reported to identify significant covariates. Results The rate of unmet need for FP was 15.48%. The composite factor of economic status and place of residence had significant influence on unmet need for FP in both models. Generally, rural women were significantly more likely to have unmet need for FP than their urban counterparts. In particular, women from rural areas and belong to rich families had the highest likelihoods of unmet need for FP. The other selected covariates also had significant influence on unmet need for FP. Conclusion This study shows that rural women had higher odds of unmet need for FP than urban women. The healthcare providers and stakeholders should take necessary actions to motivate women to use contraceptive specially the women who are residing in the rural areas.

Abstract Background Malnutrition is considered a major public health challenge and is associated with a range of health issues, including childhood stunting. Stunting is a reliable and well-recognized indicator of chronic childhood malnutrition. The objective of this study is to determine the risk factors associated with stunting among 17,490 children below five years of age in Bangladesh. Methods Correlates of child stunting were examined using data generated by a cross-sectional cluster survey conducted in Bangladesh in 2019. The data includes a total of 17,490 children (aged

Tracing the patterns of wealth consumption within and between burial communities can reveal different aspects of the sociopolitical and economic abilities of and relations between individuals, groups, and whole communities. For a cross-cultural comparison, burial communities of the cultural groups of the Hungarian Middle Bronze Age Vatya and Füzesabony pottery styles in the Carpathian Basin were chosen. Special emphasis is put on the development of the wealth consumption during the late phase of the Middle Bronze Age. It could be shown that Vatya and Füzesabony communities exhibit very similar patterns of wealth consumption and seemingly sociopolitical organization. In the cemetery of Dunaújváros-Duna-dűlő, a dynamic competition and cooperation between different social segments can be witnessed, representing an arena in which signaling the individual’s and groups’ ability to participate in sociopolitical organization of the burial community took place. The wealth consumption over the whole considered geographical space, and beyond, changes during the late Middle Bronze Age. It can be assumed that during the times of change, cultural convergence increases, as changes in burial rites and wealth consumption suggest. This development is possible because Vatya and Füzesabony shared a very similar sociopolitical organization as well as the perception of wealth and how it should be consumed.

Background Hypertension remains a problem of public health across various socioeconomic groups, despite its high prevalence. However, few studies account for geographical variation in examining socioeconomic inequalities and hypertension in Indonesia. Objective To investigate the burden of hypertension in Indonesia based on prevalence, awareness, treatment, and control of hypertension among adults; and assess whether or not the burdens vary according to geographical variation and socioeconomic status Methods In Wave 5 of the Indonesian Family Life Survey in 2015, 32,034 individuals aged 15 and over participated in the study. Concentration Curves (CC) and Concentration Indexes (CI) were used to analyse socioeconomic inequality. We used multilevel logistic regression to assess biological, geographical variation, and socioeconomic factors associated with the burden of hypertension, adjusting for potential covariates. Results The prevalence of hypertension in Indonesia was 26.1%, and only 26.9% of those with hypertension were aware of their condition. Approximately 22.5% of hypertensive patients received treatment, but only 28.2% had controlled blood pressure and reached the therapeutic goal. Low socioeconomic groups were more prone to hypertension (CI = −0.047 in urban and CI = −0.075 in rural). In contrast, awareness, treatment, and control of hypertension were more concentrated in higher socioeconomic groups. Conclusions The high prevalence of hypertension, low awareness of the condition, poor compliance with treatment, and poor control of the condition, as well as the existing socioeconomic inequality, make this a significant determinant of public health issue in Indonesia. There is a need for effective programs for the prevention of hypertension and better management of hypertensive patients.

In this article, the several factors have been investigated relating to the poor mental health of the children in Punjab, Pakistan. Using the data of the survey conducted by the Punjab Bureau of Statistics, different determinants of child malnutrition and poverty were diagnosed based upon sufficient information of the children under 5 year of age. Logistic regression analysis methodology has been applied for screening the most influential factors of the study. It has been observed that the rise in poverty has prejudiced the nutritional position of the children, the mother's education, and the fitness of the youth. It has also been observed that male children are more at risk to poor mental health than female children. A number of policy issues came to light from the findings of the study. The wealth index of all three anthropometric measures, the child malnutrition status of uneducated mothers, and the child diarrhea menace are the significant areas. [ABSTRACT FROM AUTHOR]

We document the contribution of skin color toward quantifying inequality of opportunity over a proxy indicator of wealth. Our Ferreira-Gignoux estimates of inequality of opportunity as a share of total wealth inequality show that once parental wealth is included as a circumstance variable, the share of inequality of opportunity rises above 40%, overall and for every age cohort. By contrast, the contribution of skin tone to total inequality of opportunity remains minor throughout. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study is to examine the trends in geographical inequality of opportunity in maternal health services in India considering the Every Newborn Action Plan (ENAP) 2025 coverage targets., Setting: India., Participants: Women in the National Family Health Survey (NFHS)-NFHS-4 (2014-2015) and NFHS-5 (2019-2021)., Primary and Secondary Measures: District-level coverages of 4+antenatal care (ANC) visits, institutional delivery with skilled birth attendant, postnatal care (PNC) services within 48 hours of delivery, continuum of care (CoC) services for women with most recent live births were considered. Human Opportunity Index (HOI) documented the opportunities for equitable access to these services, ranging from 0 (high inequality) to 100 (universal access). HOI was compared between the survey rounds and wealth index (WI) quintiles that the women belonged to., Results: Coverages of 4+ANC visits, institutional delivery, PNC and CoC in India increased by 22.8% (95% CI 22.1% to 23.5%), 12.6% (95% CI 12.2% to 12.9%), 28.5% (95% CI 28.0% to 29.0%) and 38.6% (95% CI 37.6% to 39.6%) between NFHS-4 and NFHS-5, respectively. The HOI for 4+ANC visits was 48.4 in NFHS-5, ranging from 11.3 to 92.4 in states and from 31.1 to 70.5 for WI I-V. The HOI for institutional delivery was 80.4 in NFHS-5, ranging from 37.4 to 99.7 in the states and from 21.0 to 100 for WI I-V. The HOI for PNC services was 73.5 in NFHS-5, ranging from 37.5 to 95.6 in the states and from 61.2 to 88.3 for WI I-V. The HOI for CoC was 37.1, ranging from 6.5 to 88.8 in the states and from 19.8 to 62.7 for WI I-V for CoC in NFHS-5., Conclusion: Though significant improvements in the geographical inequity of maternal health services have been made in India, the geographical inequity for 4+ANC visits coverage lags significantly behind resulting in CoC coverage inequity to achieve the ENAP targets for these services., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Abstract Background The global impact of Zika virus in Latin America has drawn renewed attention to circulating mosquito-borne viruses in this region, such as dengue and chikungunya. Our objective was to assess socio-ecological factors associated with Aedes mosquito vector density as a measure of arbovirus transmission risk in three cities of potentially recent Zika virus introduction: Ibagué, Colombia; Manta, Ecuador; and Posadas, Argentina, in order to inform disease mitigation strategies. Methods We sampled Aedes mosquito populations in a total of 1086 households, using indoor and peridomestic mosquito collection methods, including light traps, resting traps, traps equipped with chemical attractant and aspirators. For each sampled household, we collected socio-economic data using structured questionnaires and data on microenvironmental conditions using iButton data loggers. Results A total of 3230 female Aedes mosquitoes were collected, of which 99.8% were Aedes aegypti and 0.2% were Aedes albopictus. Mean female Aedes mosquito density per household was 1.71 (standard deviation: 2.84). We used mixed-effects generalized linear Poisson regression analyses to identify predictors of Aedes density, using month, neighborhood and country as random-effects variables. Across study sites, the number of household occupants [incidence rate ratio (IRR): 1.08, 95% confidence interval (CI): 1.01–1.14], presence of entry points for mosquitoes into the household (IRR: 1.51, 95% CI: 1.30–1.76) and presence of decorative vegetation (IRR: 1.52, 95% CI: 1.22–1.88) were associated with higher Aedes density; while being in the highest wealth tertile of household wealth (IRR: 0.78, 95% CI: 0.66–0.92), knowledge of how arboviruses are transmitted (IRR: 0.94, 95% CI: 0.89–1.00) and regular emptying of water containers by occupants (IRR: 0.79, 95% CI: 0.67–0.92) were associated with lower Aedes density. Conclusions Our study addresses the complexities of arbovirus vectors of global significance at the interface between human and mosquito populations. Our results point to several predictors of Aedes mosquito vector density in countries with co-circulation of multiple Aedes-borne viruses, and point to modifiable risk factors that may be useful for disease prevention and control. Graphical Abstract

BackgroundMalnutrition of under-five children has adverse effects on child's health and development, such as growth failure and muscle wasting. The household wealth index has a direct contribution to child malnutrition despite little attention being given to its indirect effect through other factors. This study aimed to identify the potential mediators of the link between wealth index and malnutrition.MethodsIn this study, a cross-sectional study design was implemented based on the data obtained from the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS), which consists of a total of 3,918 under-five children. Mediation analysis of structural equation (SEM) was implemented to determine and estimate the effects of potential mediators of the link between wealth index and under-five children malnutrition.ResultsAmong 3,918 under-five children involved in this study, 51.4% were male children and 20.2% were from urban areas. The place of delivery of the majority of mothers (56.1%) was at home, and the majority of children were from the poorest household (36.4%). The estimated effects of height-for-age of female children were higher (1.31:95% CI = 0.45, 0.200), indicating that female children had a lower likelihood of stunting than males. As compared to children in an urban area, children from rural areas were more likely to be stunted (−0.269; 95%CI = −0.388, −0.135). The estimated total indirect effects of wealth index on stunting and underweight was 0.69 (95% = 0.045, 0.094) and 0.036 (95% = 0.013, 0.054), respectively, and significant (p-value of

The wealth index based on household assets and amenities is been increasingly used to explain economic variations of health outcomes in the developing countries. While the variables used to compute the wealth index are easy to collect and time- and cost-effective, the wealth index tends to have an urban bias, uses arbitrary weighting, does not provide per capita measures and is a poor measure of inequality. We used micro data from two of the large-scale population-based surveys, the Longitudinal Ageing Study in India, 2017–18 and the India Human Development Survey, 2011–12 that covered over 42,000 households each and collected data on household consumption, assets and amenities in India. We examined the variations and inequality in health estimates by consumption per capita and asset-based measures in India. Descriptive statistics, logistic regression model, concentration index, and concentration curve were used in the analyses.We found a weak association between monthly per capita consumption expenditure (MPCE) and wealth index in both the surveys. Some of the health conditions such as hypertension, cataract, refractive error, and diabetes tended to be underestimated in the bottom 40% of the population when economic well-being was measured using the wealth index compared to consumption. Socio-economic inequality in health outcome, inpatient and outpatient health services were underestimated when measured using the wealth index than when measured using MPCE.We conclude that economic gradients of health by consumption and wealth index are inconsistent and that per capita consumption predicts health estimates better than the wealth index. It is recommended that public health research using population-based surveys that provide data on consumption and wealth index use per capita consumption to explain economic variations in health and health care utilization. We also suggest that the future rounds of the health surveys of National Sample Survey and the National Family and Health Surveys include an abridged version of the consumption schedule to predict better economic variations in health and health care utilization in India.

Objectives: The present study examined the prevalence and patterns of non-communicable disease multimorbidity by wealth quintile among adults in South Africa.Methods: The South African National Income Dynamics Study Wave 5 was conducted in 2017 to examine the livelihoods of individuals and households. We analysed data in people aged 15 years and older (N = 27,042), including self-reported diagnosis of diabetes, stroke, heart disease and anthropometric measurements. Logistic regression and latent class analysis were used to analyse factors associated with multimorbidity and common disease patterns.Results: Multimorbidity was present in 2.7% of participants. Multimorbidity was associated with increasing age, belonging to the wealthiest quintile group, increasing body mass index and being a current smoker. Having secondary education was protective against multimorbidity. Three disease classes of multimorbidity were identified: Diabetes and Hypertension; Heart Disease and Hypertension; and Stroke and Hypertension.Conclusion: Urgent reforms are required to improve health systems responsiveness to mitigate inequity in multimorbidity patterns in the adult population of South Africa as a result of income inequality.

Abstract Background Adolescence is a particularly vulnerable stages of life in which malnutrition inhibits academic performance through poor growth and development, mental retardation, poor overall cognitive function and poor health status. However, there is a dearth of evidence regarding the association between nutritional status and academic performance among adolescent students. Therefore, this study aimed to determine the association of nutritional status and academic performance among adolescent secondary school students in Wolaita Sodo town, Southern Ethiopia. Methods A facility-based cross-sectional study was conducted among 670 systematically selected adolescents in secondary schools of Wolaita Sodo town from April to June 2019. The academic performance of the adolescents was measured using the mean mark score of two consecutive semesters’ results of all subjects. Data were analyzed using Stata software Version 15. Descriptive statistics, binary and multiple linear regression analysis were done. Statistical association of dependent and independent variables was declared at p-value

Intimate partner violence (IPV) is a significant challenge that has a profound impact on women, and a contributing factor to its high prevalence is the justification of IPV. Various research works have shown that women’s socioeconomic status (SES) is connected to IPV justification. The major objective of this study is to investigate the socioeconomic disparities in justification of IPV by women in Nigeria. The study involved an analysis of the 2018 Nigeria Demographic and Health Survey data using a sample comprising 116,958 women. The study utilized chi-square tests and logistic regression as the classical test, and the Bayesian Regression Model in Stan for its analysis. The results were presented using odds ratios along with the 95% confidence limits. The study found that the occurrence of IPV justification by women in Nigeria stood at 32.9%. Additionally, it shows a significant but weak relationship between women’s age and the justification of IPV. Controlling for covariates, women who lacked formal education possess a higher likelihood of justifying IPV with a 54% increase in odds in comparison to women with a higher education level. The study also found that women in the poorest wealth category had a 17% increase in odds of justifying IPV compared to women in the middle-class category, indicating a concerning trend of tolerance toward domestic violence among women with lower SES. IPV has detrimental effects on women and their children. To combat this issue, programs aimed at contextualizing IPV, improving women’s SES, advocating for the end of IPV, and empowering women are highly important. Ultimately, IPV is unjustifiable, regardless of the rationale behind it, and action is needed to reduce the victimization of women within our societies. [ABSTRACT FROM AUTHOR]

Background: Unmet need for family planning (FP) is a core concept in designing FP programmes and reduction of unmet need for FP can improve reproductive and maternal health services. Bangladesh is still away from achieving the target regarding unmet need for FP. This study aimed to explore the composite effect of economic status and place of residence on unmet need for FP among currently married women of reproductive age in Bangladesh after controlling the effect of other selected covariates.Methods: The study used the data extracted from the Bangladesh Demographic and Health Survey (BDHS) 2017-2018, which is a nationally representative survey implemented using a stratified two-stage cluster sample design. A total of 13,031 currently married women of reproductive age were included in the final analysis. Binary logistic regression model has been employed to identify the factors influencing the unmet need for FP. Model-I investigated the effect of composite variable place-wealth on unmet need for FP and Model-II examined the effect of place-wealth on unmet need for FP after adjusting for the effect of other selected covariates. The Odds Ratios with p-values were reported to identify significant covariates.Results: The rate of unmet need for FP was 15.48%. The composite factor of economic status and place of residence had significant influence on unmet need for FP in both models. Generally, rural women were significantly more likely to have unmet need for FP than their urban counterparts. In particular, women from rural areas and belong to rich families had the highest likelihoods of unmet need for FP. The other selected covariates also had significant influence on unmet need for FP.Conclusion: This study shows that rural women had higher odds of unmet need for FP than urban women. The healthcare providers and stakeholders should take necessary actions to motivate women to use contraceptive specially the women who are residing in the rural areas. [ABSTRACT FROM AUTHOR]

Background: Malnutrition is considered a major public health challenge and is associated with a range of health issues, including childhood stunting. Stunting is a reliable and well-recognized indicator of chronic childhood malnutrition. The objective of this study is to determine the risk factors associated with stunting among 17,490 children below five years of age in Bangladesh. Methods: Correlates of child stunting were examined using data generated by a cross-sectional cluster survey conducted in Bangladesh in 2019. The data includes a total of 17,490 children (aged < 5 years) from 64,400 households. Multiple logistic regressions were used to determine the risk factors associated with child stunting and severe stunting. Results: The prevalence of stunting and severe stunting for children was 25.96% and 7.97%, respectively. Children aged 24 to < 36 months [Odds Ratio (OR) = 2.65, 95% CI: 2.30, 3.05] and aged 36 to < 48 months [OR = 2.33, 95% CI: 2.02, 2.69] had more risk of stunting compared to the children aged < 6 months. Children from Sylhet division had the greatest risk of stunting of all the eight divisions [OR = 1.26, 95% CI: 1.09, 1.46]. Children of secondary complete or higher educated mothers were less likely to develop stunting [OR = 0.66, 95% CI: 0.56, 0.79] compared with children of mothers having no education at all. Similarly, children of secondary complete or higher educated father [OR = 0.74, 95% CI: 0.63, 0.87] were found to have lower risk of stunting compared with children whose father hadn't any education. Substantially lower risk of stunting was observed among children whose mother and father both completed secondary education or above [OR = 0.59, 95% CI: 0.52, 0.69]. Children from the richest households [OR = 0.49, 95% CI: 0.41, 0.58] had 51% lower odds of stunting compared to children from the poorest households. Conclusions: After controlling for socioeconomic and demographic factors, parental education and household position in the wealth index were found to be the most important determinants of child stunting in Bangladesh. [ABSTRACT FROM AUTHOR]

This paper examines the effects of socio-economic determinants on child malnutrition in Uttar Pradesh- the most populous and malnourished state of India. Using data from NFHS-4, this study highlights district-wide variations in nutritional status of children less than five years in the state. The percentage of stunted, wasted, and underweight have been taken as dependent variables, while main explanatory variables of child malnutrition were female education, maternal malnutrition (BMI), breastfeeding practices, children's place of residence, father’s education, wealth index of household, family planning, sex of the child, sex of the household and age cohort of mother. Logistic regression models have been applied in order to observe the association between explanatory variables and malnutrition. The findings revealed a high incidence of less stunted, wasted, and underweight infants in case of an educated parents, particularly educational level of mother. Wealth index representing the possession of assets by the household found to be an important indicator in the sense that children born to households with richer and richest quintiles showing better-nourished children aged under-5. The modern method of using contraceptive, breastfeeding practices, maternal malnutrition were also important indicators influencing the rate of malnutrition in children. The study suggested that imparting education to females, breastfeeding practices, economic status, and contraceptive use can play an important role in reducing nutritional status of children.   [ABSTRACT FROM AUTHOR]

Abstract Background Smartphones have rapidly become an important marker of wealth in low- and middle-income countries, but international household surveys do not regularly gather data on smartphone ownership and these data are rarely used to calculate wealth indices. Methods We developed a cross-sectional survey module delivered to 3028 households in rural northwest Burkina Faso to measure the effects of this absence. Wealth indices were calculated using both principal components analysis (PCA) and polychoric PCA for a base model using only ownership of any cell phone, and a full model using data on smartphone ownership, the number of cell phones, and the purchase of mobile data. Four outcomes (household expenditure, education level, and prevalence of frailty and diabetes) were used to evaluate changes in the composition of wealth index quintiles using ordinary least squares and logistic regressions and Wald tests. Results Households that own smartphones have higher monthly expenditures and own a greater quantity and quality of household assets. Expenditure and education levels are significantly higher at the fifth (richest) socioeconomic status (SES) quintile of full model wealth indices as compared to base models. Similarly, diabetes prevalence is significantly higher at the fifth SES quintile using PCA wealth index full models, but this is not observed for frailty prevalence, which is more prevalent among lower SES households. These effects are not present when using polychoric PCA, suggesting that this method provides additional robustness to missing asset data to measure underlying latent SES by proxy. Conclusions The lack of smartphone data can skew PCA-based wealth index performance in a low-income context for the top of the socioeconomic spectrum. While some PCA variants may be robust to the omission of smartphone ownership, eliciting smartphone ownership data in household surveys is likely to substantially improve the validity and utility of wealth estimates.

Hypertension remains a problem of public health across various socioeconomic groups, despite its high prevalence. However, few studies account for geographical variation in examining socioeconomic inequalities and hypertension in Indonesia. To investigate the burden of hypertension in Indonesia based on prevalence, awareness, treatment, and control of hypertension among adults; and assess whether or not the burdens vary according to geographical variation and socioeconomic status In Wave 5 of the Indonesian Family Life Survey in 2015, 32,034 individuals aged 15 and over participated in the study. Concentration Curves (CC) and Concentration Indexes (CI) were used to analyse socioeconomic inequality. We used multilevel logistic regression to assess biological, geographical variation, and socioeconomic factors associated with the burden of hypertension, adjusting for potential covariates. The prevalence of hypertension in Indonesia was 26.1%, and only 26.9% of those with hypertension were aware of their condition. Approximately 22.5% of hypertensive patients received treatment, but only 28.2% had controlled blood pressure and reached the therapeutic goal. Low socioeconomic groups were more prone to hypertension (CI = −0.047 in urban and CI = −0.075 in rural). In contrast, awareness, treatment, and control of hypertension were more concentrated in higher socioeconomic groups. The high prevalence of hypertension, low awareness of the condition, poor compliance with treatment, and poor control of the condition, as well as the existing socioeconomic inequality, make this a significant determinant of public health issue in Indonesia. There is a need for effective programs for the prevention of hypertension and better management of hypertensive patients. [ABSTRACT FROM AUTHOR]

This research carried out in Delta State, Nigeria, focuses on the empirical application of Principal Component Analysis (PCA), an asset based measure of wellbeing which can be used to assess level of poverty among households in rural areas of developing countries. The study employed questionnaire-based household survey data collection methods. The final wealth index was derived using data collected from 430 artisanal fishing households in riverine Delta State communities. Data on 16 variables measuring multiple aspects of household wealth status were used to extract the set of principal components utilized in the construction of the index. Two key statistical tests, the KMO and Bartlett's tests, showed the appropriateness of the data for PCA. Results revealed that five major factors influence the wealth status and hence the wellbeing of households: home infrastructure, energy sources, durable home assets, water sources and mobility. Therefore, it is suggested that any efforts to improve the wellbeing of farm households in the study area as well as in other regions with similar socio- economic settings should consider these factors as entry point to poverty alleviation. [ABSTRACT FROM AUTHOR]

Abstract Background In 2004, Ghana implemented a national health insurance scheme (NHIS) as a step towards achieving universal health coverage. In this paper, we assessed the level of enrollment and factors associated with NHIS membership in two predominantly rural districts of northern Ghana after eight years of implementation, with focus on the poor and vulnerable populations. Methods A cross-sectional survey was conducted from July 2012 to December 2012 among 11,175 randomly sampled households with their heads as respondents. Information on NHIS status, category of membership and socio-demographic characteristics of household members was obtained using a structured questionnaire. Principal component analysis was used to compute wealth index from household assets as estimates of socio-economic status (SES). The factors associated with NHIS enrollment were assessed using logistic regression models. The reasons behind enrollment decisions of each household member were further investigated against their SES. Results Approximately half of the sampled population of 39,262 were registered with a valid NHIS card; 53.2% of these were through voluntary subscriptions by payment of premium whilst the remaining (46.8%) comprising of children below the ages of 18 years, elderly 70 years and above, pregnant women and formal sector workers were exempt from premium payment. Despite an exemption policy to ameliorate the poor and vulnerable households against catastrophic health care expenditures, only 0.5% of NHIS membership representing 1.2% of total exemptions granted on accounts of poverty and other social vulnerabilities was applied for the poor. Yet, cost of premium was the main barrier to NHIS registration (92.6%) and non-renewal (78.8%), with members of the lowest SES being worst affected. Children below the ages of 18 years, females, urban residents and those with higher education and SES were significantly more likely to be enrolled with the scheme. Conclusions Despite the introduction of policy exemptions as an equity measure, the poorest of the poor were rarely identified for exemption. The government must urgently resource the Department of Social Welfare to identify the poor for NHIS enrollment.

Background: Temporally-harmonized asset-based measures of wealth can be used to study the association of life-course wealth exposures in the same scale with health outcomes in low- and middle-income countries (LMICs). The within-individual longitudinal stability of asset-based indices of wealth in LMICs is poorly understood. Methods: Using data from five birth cohorts from three continents, we developed temporally-harmonized asset indices over the life course through polychoric principal component analysis of a common set of assets collected consistently over time (18 years in Brazil to 50 years in Guatemala). For each cohort, we compared the harmonized index to cross-sectional indices created using more comprehensive asset measures using rank correlations. We evaluated the rank correlation of the harmonized index in early life and adulthood with maternal schooling and own attained schooling, respectively. Results: Temporally-harmonized asset indices developed from a consistently-collected set of assets (range: 10 in South Africa to 30 in Philippines) suggested that mean wealth improved over time for all birth cohorts. Cross-sectional indices created separately for each study wave were correlated with the harmonized index for all cohorts (Brazil: r = 0.78 to 0.96; Guatemala: r = 0.81 to 0.95; India: 0.75 to 0.93; Philippines: r = 0.92 to 0.99; South Africa: r = 0.84 to 0.96). Maternal schooling (r = 0.15 to 0.56) and attained schooling (r = 0.23 to 0.53) were positively correlated with the harmonized asset index in childhood and adulthood respectively. Conclusions: Temporally-harmonized asset indices displayed coherence with cross-sectional indices as well as construct validity with schooling.

Motivation: A major challenge with poverty measurement is that household consumption (or income) data are often unavailable or not comparable across survey rounds. Furthermore, panel data are even rarer, thus making it difficult—if not impossible—to track the dynamics of these households' movements into or out of poverty in different periods. Purpose: We review imputation methods that have been employed to provide poverty estimates in such data‐scarce contexts. We provide a concise and introductory synthesis, which focuses on intuition and nuanced practical insights rather than technical details. Approach and methods: We start first with each method's motivation, a brief description, some recent application examples, and the remaining challenges. This format offers a self‐contained treatment and facilitates comparison between the various methods and highlight their nuanced differences. Findings: The growing demand for more frequent and accurate poverty estimates is not satisfied by current data availability, at least in the short run. Imputation methods offer a promising solution and have received increasing attention. This review helps remedy the dearth of research analysing how to bridge the gap between typical development practitioners and the latest advances in the field. Policy Implications: Poverty‐imputation methods offer several policy‐relevant advantages, including In the immediate term (when micro‐survey data are unavailable for all countries).Survey costs or implementation pose challenges.Back‐casting consumption from a more recent survey for better comparison with older surveys.Bypassing thorny issues of obtaining appropriate intertemporal/intraregional price deflators. Furthermore, poverty‐imputation methods can also be used in other fields. [ABSTRACT FROM AUTHOR]

• Using a principle component analysis, we created an asset-based wealth index. • Knowledge of marine conservation was positively correlated with one's wealth. • Participation in marine conservation was positively correlated with one's wealth. • Intra-community stratifications matters to management processes and outcomes. • Wealth-based underrepresentation leads to unjust and less effective conservation. Conservation organizations often adopt the normative value of "whole community" participation, predicated on the idea that broad community involvement across categories of identity and social stratification will lead to more successful project outcomes. Analysis of intra-community social stratifications in relation to participation in conservation is important to the pursuit of environmental justice as well as improved efficacy of a given conservation intervention. While a large body of literature broadly examines intra and inter-community dynamics in relation to community-based conservation, few have specifically quantified how wealth influences one's participation in community-based conservation initiatives, especially in the marine realm. To address these questions, we interviewed people living near marine conservation initiatives in Madagascar. Using a principle component analysis, we created an asset-based wealth index and showed that both knowledge of and participation in marine conservation was positively correlated with wealth. Specifically, three of the four participation categories were statistically correlated with wealth, including involvement in any element of the conservation project, involvement in decision-making, and in enforcement. However, wealth was not significantly correlated with participation in monitoring. Ultimately our research highlights the importance of understanding underlying drivers of participation in community-based conservation. If the poorest in a community are underrepresented in local participation, the conservation initiative will not only be unjust, but will also likely be less effective. [ABSTRACT FROM AUTHOR]

Background: The global impact of Zika virus in Latin America has drawn renewed attention to circulating mosquito-borne viruses in this region, such as dengue and chikungunya. Our objective was to assess socio-ecological factors associated with Aedes mosquito vector density as a measure of arbovirus transmission risk in three cities of potentially recent Zika virus introduction: Ibagué, Colombia; Manta, Ecuador; and Posadas, Argentina, in order to inform disease mitigation strategies. Methods: We sampled Aedes mosquito populations in a total of 1086 households, using indoor and peridomestic mosquito collection methods, including light traps, resting traps, traps equipped with chemical attractant and aspirators. For each sampled household, we collected socio-economic data using structured questionnaires and data on microenvironmental conditions using iButton data loggers. Results: A total of 3230 female Aedes mosquitoes were collected, of which 99.8% were Aedes aegypti and 0.2% were Aedes albopictus. Mean female Aedes mosquito density per household was 1.71 (standard deviation: 2.84). We used mixed-effects generalized linear Poisson regression analyses to identify predictors of Aedes density, using month, neighborhood and country as random-effects variables. Across study sites, the number of household occupants [incidence rate ratio (IRR): 1.08, 95% confidence interval (CI): 1.01–1.14], presence of entry points for mosquitoes into the household (IRR: 1.51, 95% CI: 1.30–1.76) and presence of decorative vegetation (IRR: 1.52, 95% CI: 1.22–1.88) were associated with higher Aedes density; while being in the highest wealth tertile of household wealth (IRR: 0.78, 95% CI: 0.66–0.92), knowledge of how arboviruses are transmitted (IRR: 0.94, 95% CI: 0.89–1.00) and regular emptying of water containers by occupants (IRR: 0.79, 95% CI: 0.67–0.92) were associated with lower Aedes density. Conclusions: Our study addresses the complexities of arbovirus vectors of global significance at the interface between human and mosquito populations. Our results point to several predictors of Aedes mosquito vector density in countries with co-circulation of multiple Aedes-borne viruses, and point to modifiable risk factors that may be useful for disease prevention and control. [ABSTRACT FROM AUTHOR]

This study examined wealth trends in a rural Kenyan community between 2011 and 2018. Understanding wealth trends is important for understanding health outcomes and overall well-being of vulnerable communities, and for informing economic and health policy that can improve specific wealth challenges. Information regarding household materials, assets, education, and mortality from 20,370 households in the Kombewa Health and Demographic Surveillance System was used. Three indices were developed and compared to quantify wealth: a principal component analysis of assets, a multiple correspondence analysis of assets, and the multidimensional poverty index. Wealth quintiles and levels of deprivation relating to socioeconomic status were then created and analyzed over time. Wealth measured by the asset-based indices, suggested an increase in wealth during the assessment period with the percentage of households in the wealthiest quintile increasing from 19 to 23%. The multidimensional poverty index, however, suggests no change in socioeconomic status over time. Among other factors, a lack of access to sanitation and improved water seems to be the main justification. Our results indicate that households are accumulating assets, but their increased accumulation is not translating to changes in living conditions known to improve health. Hence, while houses may be getting wealthier, they may not necessarily be getting healthier. [ABSTRACT FROM AUTHOR]

Objectives: To examine the wealth index over a decade utilizing Malawi’s Demographic and Health (DHS) survey data from 2004, 2010, and 2015/16, and to explore factors that predict higher wealth. Study design: This was a retrospective descriptive study. Methods: The study utilized DHS data from 2004, 2010, and 2015/2016. The total number of participants was 77,194. Linear regression models were used to assess the effects of the predictors. All analyses were conducted in Stata version 13. Results: Findings showed no significant increase in wealth between the survey years. However, significant increases in wealth were associated with smaller family size (−0.09[-0.10, −0.08]), age (0.02[0.02,0.02]), having formal education (0.21[0.18, 0.24]), and living in urban areas (−1.84[-1.98, −1.70]). Differences in wealth also existed among the different ethnic and religious groups with the Chewa reporting less wealth than other groups, and people with any form of religion reporting more wealth than people with no religion. Conclusions: Minimal changes in wealth have occurred in Malawi between 2004 and 2015/16, and sociodemographic, socioeconomic, and cultural factors are associated with wealth in this population.

The asset index is often used as a measure of socioeconomic status in empirical research as an explanatory variable or to control confounding. Principal component analysis (PCA) is frequently used to create the asset index. We conducted a simulation study to explore how accurately the principal component based asset index reflects the study subjects' actual poverty level, when the actual poverty level is generated by a simple factor analytic model. In the simulation study using the PC-based asset index, only 1% to 4% of subjects preserved their real position in a quintile scale of assets; between 44% to 82% of subjects were misclassified into the wrong asset quintile. If the PC-based asset index explained less than 30% of the total variance in the component variables, then we consistently observed more than 50% misclassification across quintiles of the index. The frequency of misclassification suggests that the PC-based asset index may not provide a valid measure of poverty level and should be used cautiously as a measure of socioeconomic status.