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Due to rapid demographic ageing and to sustain its pension system, the Netherlands recently initiated a pension reform that increased the retirement age, with the intention to increase labour force participation among older workers. However, there is little evidence on the preferences of workers concerning their retirement age, and on how these preferences have changed over time. To identify personal and work-related determinants of the preference toward earlier or later retirement, and how these determinants and preferences have changed over time. We use data from three consecutive measurements (waves) of a large Dutch panel. Ordered logit regression is used to investigate the predictors of retirement preferences. Analyses are performed for two groups; all workers and a subsample of workers aged 50 years or older. Furthermore, the analyses are performed for each wave separately and for the combined dataset. A preference for later retirement is primarily related to university education, high job satisfaction, and high income. Age is only positively related to later retirement among older workers. Earlier retirement is preferred by female workers and workers living with a partner. The preference toward an earlier retirement age has increased over time. The preferences toward retirement can be primarily explained by personal characteristics, job satisfaction, and net income. Furthermore, with the increase in the retirement age defined by current legislation, the preference for an earlier retirement age has increased over time.

We use a randomised experiment to study the effect of offering half of 556 freshman students a learning analytics dashboard and a weekly email with a link to their dashboard, on student behaviour in the online environment and final exam performance. The dashboard shows their online progress in the learning management systems, their predicted chance of passing, their predicted grade and their online intermediate performance compared with the total cohort. The email with dashboard access, as well as dashboard use, has positive effects on student behaviour in the online environment, but no effects are found on student performance in the final exam of the programming course. However, we do find differential effects by specialisation and student characteristics.

In the health sector, decentralisation mainly consists of the devolution of administrative functions to local governments. Since 2009, Burkina Faso has engaged in a process to transfer health resources to local governments. This study examines the decision-makers' knowledge, attitudes and practices (KAP) about the decentralisation and health resources transfer to local governments in Burkina Faso. We used a qualitative research method. In-depth semi-structured interviews were conducted with key decision-makers. The data collected went through a directed qualitative content analysis. Findings suggest that all respondents are aware of the rationale of the decentralisation and resources transfer to local governments. The vast majority of respondents have a positive opinion towards decentralisation and the main elements that appear to be motivating their attitude, are the expected outcomes from decentralisation. The practical experience was limited to awareness raising, training, supervision, technical assistance and resources mobilisation. Poor collaboration between health districts and local governments, the control of certain resources by the state and the health districts constrain the implementation of health resources and skills transfer policy at grassroots level. Careful attention should be given to the country's political context and institutional design.

Health insurance can have important effects on self-employment and self-employment transitions. However, there is a literature gap on the relationship between health insurance and self-employment in low- and middle-income countries, especially in the context of the rapid expansion of health insurance in these countries. This article examines this relationship in Vietnam with a focus on a comparison between the voluntary scheme for the informal sector (mostly self-employed workers) and compulsory insurance for the formal sector (mostly wage workers). We employ a Probit model with selection on a panel from the Vietnamese Household Living Standards Surveys 2010-2014 to investigate the association between health insurance and self-employment entry and exit. We show that those with compulsory health insurance in Vietnam, the formal workers, are 10 percentage points less likely to enter self-employment than those having voluntary insurance. Regarding self-employment exit, people with compulsory insurance are more likely to exit self-employment compared with those covered by voluntary insurance. However, the effect size is relatively small.

We examine the effects of HIV-infection on school attendance in Zimbabwe using recent nationally representative data of 11,673 children aged 6–18 years. We employ a non-linear multivariate decomposition approach to examine how HIV affects gender gaps in school attendance. We find gaps in school attendance between HIV-positive boys and girls and between HIV-negative and positive girls. About 44% of the attendance gap in both cohorts is attributed to differences in observable characteristics. About 56% of this gap is attributed to differences in the effects of these characteristics. The results indicate that HIV mainly affects girls’ school attendance.

This study evaluates the effectiveness of an intervention of formative assessments with a clicker-based technology on anxiety and academic performance. We use a randomized experiment in physics education in one school in Dutch secondary education. For treated students the formative assessments are operationalized through quizzing at the end of each physics class, where clickers enable students to respond to questions. Control students do not receive these assessments and do not use clickers, but apart from that the classes they attend are similar. Findings from multilevel regressions indicate that the formative assessments significantly reduce anxiety in physics, and improve academic performance in physics in comparison with a traditional teaching. Furthermore, a mediation effect of anxiety in physics on academic performance is observed. In sum, this implies that an easily to implement technique of formative assessments can make students feel more at ease, which contributes to better educational performance. ispartof: RESEARCH IN SCIENCE EDUCATION vol:51 issue:SUPPL 1 pages:1-20 status: Published online

Objectives: To elicit patients' preferences for pharmacist services that can enhance medication management among people with diabetes in Indonesia. Methods: A discrete choice experiment (DCE) among 833 respondents with diabetes in 57 community health centers (CHCs) and three hospitals in Surabaya, Indonesia. Consultation was the baseline service. Four attributes of consultation and two attributes of additional services were used in the DCE profiles based on literature and expert opinion. The DCE choice sets generated were partially balanced and partially without overlap. Random effect logistic regression was used in the analysis.Results: Respondents preferred a shorter duration of consultation and flexible access to the pharmacist offering the consultation. A private consultation room and lower copayment (fee) for services were also preferred. Respondents with experience in getting medication information from pharmacists, preferred to make an appointment for the consultation. Total monthly income and experience with pharmacist services influenced preferences for copayments. Conclusion: Differences in patients' preferences identified in the study provide information on pharmacist services that meet patients' expectations and contribute to improve medication management among people with diabetes. Practice implication: This study provides insight into evaluating and designing pharmacist services in accordance with the preferences of people with diabetes in Indonesia.(c) 2020 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

In many countries, the quality of (large-scale quantitative) educational research is threatened by data challenges. In this article, we present an innovative data research project from the Netherlands in which many of the challenges that come forward in previous literature are addressed. The Netherlands Cohort Study on Education [in Dutch abbreviated as NCO (Nationaal Cohortonderzoek Onderwijs)] uses longitudinal register data on track placement of cohorts of pupils in primary and secondary education from Statistics Netherlands, which will be combined with school admin data on pupils’ performance and data from the major (inter)national surveys. NCO maps pupils’ pathways and performances through primary and secondary education and their trajectory into tertiary education. NCO so far covers more than 10 complete cohorts and is complemented with the newest data every year. These registers are made available at Statistics Netherlands. A major contribution of NCO is that data from school administrative systems and additional research projects are linked with administrative register data, thereby creating a unique data set that enriches not only research, but also policy and practice. This data brief elaborates on the possibilities of this database by exploring and following one of the cohorts over time.

Summary Background Burkina Faso has undertaken decentralization reforms in the health care sector to improve the performance of the health system. This study aimed to analyze the differences in health outcomes by health district's demographic and economic status, and the distribution of health resources during the period of health care decentralization. Methods A bivariate correlation analysis was conducted using data at the health districts and regions level. Data from the health management information system (HMIS) and national households' surveys were used. Results The results indicate a strong correlation between district's population size and the availability of health resources (P ≤ .05). The health visits per capita and skilled birth attendance are correlated with the economic status of the health district (P ≤ .05). Malnutrition among under‐five and maternal mortality was associated with the availability of health personnel and health infrastructures (P ≤ .05). No correlation was found between financial resources and health outcomes. Conclusion The results indicated disparities in health among the health districts in Burkina Faso. The ways to address this inequality include more transparent resource allocation, as well as policies to address the socio‐economic disparities and financial barriers to health services. Further research is needed to collect relevant data and investigate the effects of decentralization, which was not possible in our study.

We examined levels of financial literacy (knowledge, attitudes, self-efficacy, and self-reported behavior) among 15-year-old high school students in the Netherlands (N= 2025), and investigated which factors are associated with the different financial literacy components. Our findings show lower levels of financial literacy among students in the lowest track in high school, students with low mathematical ability, immigrant students, students with low SES, students with mothers without a university degree, and students who do not discuss financial matters with family and peers. Notably, our findings show a large gap in financial knowledge levels between the lowest and highest high-school tracks in the Netherlands. These findings are useful for designing effective financial education and intervention programs, and for identifying groups that may benefit the most from financial education programs.

Between 2008 and 2013, the Netherlands was confronted by a severe recession. This recession may have affected the job satisfaction of workers. Currently, little is known about how job satisfaction changes during a recession. To investigate the effect of the 2008–2013 recession on job satisfaction in the Netherlands, and to assess how job satisfaction changed over time. Longitudinal data from six waves of a national panel in the Netherlands are used to investigate the effects. These data capture the periods before, during and after the recession. A Blinder–Oaxaca decomposition technique is used to decompose the ordinal outcome variable job satisfaction. Subsequent waves are compared, which results in five comparison groups. Workers who participated in subsequent waves are matched to assess their job satisfaction over time. Cross-sectional associations are analyzed using the entire unmatched dataset. Workers became more satisfied with their job during the recession. After the recession ended, average job satisfaction decreased again. Both unmatched and matched analyses indicated only changes in job level affecting job satisfaction. The coefficient of education had a small effect cross-sectionally. The level of education and industry had a small effect longitudinally. However, these effects were not robust. Job satisfaction decreased before the recession commenced but increased during the recession. After the recession, job satisfaction decreased again. An increase in job satisfaction during the recession may be explained by a change in the composition of workers with respect to job level, instead of by the effect of predictors.

Background Family planning and maternal care services have become increasingly available in West Africa but the level of non-use remains high. This unfavorable outcome may be partly due to the unaffordability of reproductive health care services. Methods Using the Demographic Health Survey data from Burkina Faso, Niger, Nigeria, Ghana, and Senegal, we perform a decomposition analysis to quantify the contribution of socio-demographic characteristics to disparities in exposure to mass media information on family planning, use of modern contraceptives, adequate antenatal care visits, facility-based childbirth and C-section between low-wealth and high-wealth women. Results Our study shows that differences in maternal characteristics between the wealth groups explain at least 40% of the gap in exposure to mass media family planning information, 30% in modern contraceptive use, 24% of adequate antenatal care visits, 47% of the difference in facility-based childbirths, and 62% in C-section. Lack of information on pregnancy complications, living in rural residence, religion, lack of autonomy in health facility seeking decision, need to pay, and distance explains the disparity in reproductive health care use across all countries. In countries with complete fee exemption policies for specific groups in the population, Ghana, Niger, and Senegal, the inequality gaps between wealth groups in having an adequate number of antenatal care visits and facility-based childbirth are smaller than in countries with partial or no exemption policies. But this is not the case for C-section. Conclusions There is evidence that current policies addressing the cost of maternal care services may increase the wealth-based inequality in maternal care use if socio-demographic differences are not addressed. Public health interventions are needed to target socio-demographic disparities and health facility seeking problems that disadvantage women in poor households.

In this paper we study if feedback strategies during formative assessment with polling technology have an impact on learning gains. We conduct a randomized experiment in physics class in upper secondary education with the web-based polling system Socrative comparing three conditions. In the cooperative condition students receive a combination of peer discussion and teacher feedback, while in the individual condition they receive only teacher feedback. In the control condition students do not receive any feedback, from either teacher or peers. To measure what individuals learn from teacher feedback, whether or not combined with peer discussions, students in all three conditions individually answer paired isomorphic multiple-choice questions. Per question, we study the probability to answer the second isomorphic question correct and compare this between conditions The analyses show that teacher feedback, regardless of the peer discussions, positively affects learning gains in question pairs of the treatment conditions in comparison with the control condition. However, the cooperative condition shows that the largest learning gains occur when peer discussion is followed by teacher feedback. The findings provide insights into which feedback strategies affect learning gains in question pairs and are important for teachers when implementing feedback strategies during formative assessments.

Introduction Patient satisfaction is a key indicator of health care quality. We investigated women’s satisfaction with antenatal, natal and immediate postnatal care, as well as the association between women’s satisfaction with the care they received and background characteristics. Methods We conducted a survey in the capital and two regions of Georgia. 400 women, who gave birth to healthy babies during the preceding twelve months before the date of data collection, were the target population. Women’s opinion about the organization of maternal care (tangibility, availability, accessibility) and process characteristics (responsiveness, reliability, empathy, communication and courtesy) were measured. Women satisfaction with antenatal, natal and postnatal services was also measured. Results Women’s satisfaction with antenatal, natal, and immediate postnatal services was high. The respondents’ perception about the tangibility of maternity houses was quite positive, more than three quarters of the respondents agreed or strongly agreed with the statements that maternity houses/units were attractive and medical equipment was up to date. Regression analysis on satisfaction with antenatal, natal, and immediate postnatal showed that those who paid for services were less satisfied than those who did not pay. Women in urban areas were more satisfied with antenatal and natal services than in rural areas. High educated women were less satisfied than women with the lowest education level. Conclusions In general, women are satisfied with maternal care in Georgia. The high level of satisfaction can be due to the improvement in structural factors of maternal health care such as tangibility, availability, and accessibility.

Background Various pharmacist services are available to improve medication adherence, including consultation, brochure, etc. Challenges arise on which services are best implemented in practice. Knowledge about patients’ and pharmacists’ preferences can help to prioritize services. This study explores the pharmacists’ and patients’ perceptions about the importance of pharmacist services to improve medication adherence among patients with diabetes in Indonesia. Methods This questionnaire-based cross-sectional study involved adult outpatients with diabetes type 2 and pharmacists from community health centers (CHCs) and hospitals in Surabaya, Indonesia. Random sampling was used to identify 57 CHCs in the study. In addition, based on convenient sampling, three hospitals participated. All pharmacists working at the CHCs and hospitals, who were willing to participate, were included in the study. For patients, minimum sample size was calculated using Slovin’s formula. Patients and pharmacists were asked to rank five pharmacist service types (consultation, brochure/leaflet, patient group discussion, medication review, and phone call refill reminder) according to their importance to improve medication adherence. A face validity test of the self-developed questionnaire was conducted before the data collection. Rank ordered probit models were estimated (STATA 15th software). Results A total of 457 patients from CHCs, 579 patients from hospitals, and 99 pharmacists from both medical facilities were included. Consultation (CHC patients 56.0% vs hospital patients 39.7% vs pharmacists 75.2%) and brochure (CHC patients 23.2% vs hospital patients 27.5% vs pharmacists 11.9%) were the most preferred pharmacist services. Patients with experience getting medication information from pharmacists valued consultation higher than brochure and patient group discussions. Older patients ranked a brochure higher than other services. Patients without formal education in CHCs had a lower probability of giving a high rank to a brochure to improve medication adherence. There was significant positive correlation between the ranking of phone call refill reminder and medication review (0.6940) for patients in CHCs. Conclusion For both patients and pharmacists, consultation, brochure, and group discussion were the highest-ranked services. Education, age, experience with pharmacist services, and medical facility features need to be considered when evaluating which pharmacist services to implement in Indonesia.

After more than one and a half years of the Covid-19 crisis and the school closures that followed around the world, concerns around decreases in learning growth and exacerbated inequalities are larger than ever. The discussion in this policy paper is based on analyses with unique data that are used to show how one and a half years of Covid-19 crisis has affected learning growth and pre-existing inequalities in student achievement in Dutch primary education. Underlying these analyses is a dataset that includes more than 30% of Dutch primary school students from about 1,900 schools, with standardised test scores for reading, spelling and mathematics, as well as detailed background information about the students and their families. The data show a lower learning growth after one and a half years for reading, maths and spelling in the lower grade levels, compared with similar periods before the Covid-19 crisis. We find a slightly higher learning growth for spelling in the higher grade levels. Furthermore, the data show that the decreases in learning growth are notably larger for students with low parental socioeconomic status or income, and for students from single-parent households

In het afgelopen anderhalf jaar hebben scholen in het primair onderwijs twee keer de deuren moeten sluiten: in de tweede helft van het schooljaar 2019/2020 (half maart t/m half mei) en in de eerste helft van het schooljaar 2020/2021 (half december tot begin februari). Eerder heeft het NCO al gerapporteerd over de effecten van de eerste schoolsluiting voor reguliere basisscholen (zie Factsheet 1) en de effecten van de tweede schoolsluiting (zie Factsheet 5). Toen concludeerden we dat de gevolgen van een heel jaar waarin leerlingen minder mogelijkheden hadden om fysiek les te krijgen groot waren. De leergroei was bij alle drie de onderzochte domeinen vertraagd, vooral bij begrijpend lezen. Inmiddels zijn de resultaten bekend van de eindtoetsen (E-toetsen) die in mei/juni van het schooljaar 2020/2021 zijn afgenomen. Daarmee kunnen we de gevolgen in kaart brengen van anderhalf jaar waarin leerlingen minder mogelijkheden hebben gehad om fysiek les te krijgen. Heeft de vertraging die we na de eerste en tweede schoolsluiting hebben geconstateerd zich voortgezet of zijn scholen en leerlingen erin geslaagd om de vertraging (deels) in te halen?

Deze technische toelichting hoort bij de derde reeks factsheets die het NCO heeft uitgebracht in oktober 2021 over de leergroei in het primair onderwijs (PO) naar aanleiding van de COVID-19-crisis. In deze factsheets is gekeken naar de invloed van anderhalf jaar COVID-19-crisis (met twee perioden van schoolsluitingen naar aanleiding van de COVID-19-crisis) op de groei in vaardigheidsscores van leerlingen op drie domeinen: begrijpend lezen, spelling en rekenen-wiskunde.

In het afgelopen anderhalf jaar hebben scholen in het primair onderwijs twee keer de deuren moeten sluiten: in de tweede helft van het schooljaar 2019/2020 (half maart t/m half mei) en in de eerste helft van het schooljaar 2020/2021 (half december tot begin februari). Eerder heeft het NCO al gerapporteerd over de effecten van de eerste en de tweede schoolsluiting voor reguliere basisscholen op het moment van de middentoetsen (M-toets) van maart 2021 (zie Factsheets 3 en 7). Toen concludeerden we dat de gevolgen groot waren, maar ook dat scholen daarbij sterk verschillen. De vertraging in de leergroei was het sterkst bij scholen met relatief veel leerlingen uit lagere sociaaleconomische milieus, bij scholen die relatief klein zijn en bij scholen die eerder al een lagere leergroei lieten zien. Inmiddels zijn de resultaten bekend van de eindtoetsen (E-toets) die in mei/juni van het schooljaar 2020/2021 zijn afgenomen. Daarmee kunnen we de gevolgen in kaart brengen van anderhalf jaar waarin leerlingen minder mogelijkheden hebben gehad om fysiek les te krijgen. Zijn er nog steeds (grote) verschillen tussen scholen?

While evidence from several developing countries suggests the existence of socio-economic inequalities in the access to safe drinking water, a limited number of studies have been conducted on this topic in informal settlements. This study assessed socio-economic inequalities in the use of drinking water among inhabitants of informal settlements in South Africa. The study used data from “The baseline study for future impact evaluation for informal settlements targeted for upgrading in South Africa.” Households eligible for participation were living in informal settlements targeted for upgrading in all nine provinces of South Africa. Socio-economic inequalities were assessed by means of multinomial logistic regression analyses, concentration indices, and concentration curves. The results showed that the use of a piped tap on the property was disproportionately concentrated among households with higher socio-economic status (concentration index: +0.17), while households with lower socio-economic status were often limited to the use of other inferior (less safe or distant) sources of drinking water (concentration index for nearby public tap: −0.21, distant public tap: −0.17, no-tap water: −0.33). The use of inferior types of drinking water was significantly associated with the age, the marital status, the education status, and the employment status of the household head. Our results demonstrate that reducing these inequalities requires installing new tap water points in informal settlements to assure a more equitable distribution of water points among households. Besides, it is recommended to invest in educational interventions aimed at creating awareness about the potential health risks associated with using unsafe drinking water.

ObjectiveThis study examines the effects of household shocks on access to healthcare services in Kenya. Shocks are adverse events that lead to loss of household income and/or assets.Design and settingThe study used data from the Kenya Integrated Household Budget Survey 2015/2016, a nationally representative cross-sectional survey. A propensity score matching approach was applied for the analysis.ParticipantsThe study sample included 16 297 individuals from households that had experienced shocks (intervention) and those that had not experienced shocks (control) within the last 12 months preceding the survey.Outcome measuresThe outcome of interest was access to healthcare services based on an individual’s perceived need for health intervention.ResultsThe results indicate that shocks reduce access to healthcare services when household members are confronted with an illness. We observed that multiple shocks in a household exacerbate the risk of not accessing healthcare services. Asset shocks had a significant negative effect on access to healthcare services, whereas the effect of income shocks was not statistically significant. This is presumably due to the smoothing out of income shocks through the sale of assets or borrowing. However, considering the time when the shock occurred, we observed mixed results that varied according to the type of shock.ConclusionsThe findings suggest that shocks can limit the capacity of households to invest in healthcare services, emphasising their vulnerability to risks and inability to cope with the consequences. These results provoke a debate on the causal pathway of household economic shocks and health-seeking behaviour. The results suggest a need for social protection programmes to integrate mechanisms that enable households to build resilience to shocks. A more viable approach would be to expedite universal health insurance to cushion households from forgoing needed healthcare when confronted with unanticipated risks.

This PhD research aims to increase knowledge on educational outcomes in low income and lower-middle-income countries by examining the intergenerational correlation of education in multiple dimensions, given the complexity inherent in the concept and the global persistence in the number of early school leavers. The proposition is that in order to combat the high rate of school dropout among the poor, it is necessary to explore the gaps that exist due to inherited limited opportunities from parents and a lack of basic necessities for a comfortable standard of living.The analysis is on two fronts. First, by increasing opportunities educationally, economically, and socially in society so that the independence of children’s education to that of their parents will be enhanced. This may be done through public policies or actions that favour the socioeconomically disadvantaged in the society. Second, by increasing the absolute intergenerational mobility through the easing of deprivations in the households and their consequences, which make that school-aged individuals are more likely to leave school early.

University-industry collaboration (UIC) is increasingly seen as an important driver of economic growth, but knowledge on its implementation mechanisms is still limited especially in developing countries. This constrains the capacity of those countries to design adequate policies and strategies to foster such interactions. This paper provides information about the extent to which academic staff from Tertiary Education Institutions (TEIs) in Rwanda interact with industry. It identifies the factors underlying their propensity to engage in interactions and the barriers or challenges faced. Data were collected from 334 academic staff permanently employed by 17 Higher Education Institutions in Rwanda. Results indicate a low level of interaction except in some informal channels arguably less inclined to foster relational learning and knowledge creation. Regression analyses indicated that the type of institution and the academic grades are significantly associated with the propensity of academic staff to interact with industry. In addition, four main barriers to interaction are identified and they are all linked to poor support from the government and the universities. Therefore, the study recommends the elaboration of explicit policies and strategies at country and institutional levels to set the stage for such indispensable interactions.

This dissertation investigates a number of teacher characteristics (gender, experience, prior training, class composition and teaching methods) that are often related to student performance in Dutch primary education. One of the conclusions is that pupils perform worse in mathematics if their teacher did a vocational training programme before attending teacher training at a university of applied sciences. The study further showed that pupils with same-gender teachers do not perform any better or worse than pupils with a teacher of a different gender. This means there is no evidence that the large proportion of female teachers negatively affects the maths performance of boys. Another conclusion is that teachers do not adjust their teaching methods to different class compositions. Teachers' background characteristics do appear to play a role in their teaching methods. Female teachers and more experienced teachers used less classroom instruct and more small-group or individual teaching methods.

We use data from the 1970 British Cohort Study to measure the effect of adolescent sexual intercourse on female schooling attainment. We emphasize the appropriate use of menarcheal age as an instrumental variable (IV) for early intercourse. Our analysis suggests that developmental trajectories vary with menarcheal age and, therefore, capturing variations in individual cognitive capacities induced by pubertal timing is crucial for the validity of the IV identification strategy. Our empirical results indicate that adolescent sexuality reduces full-time education by approximately one year. Given that 37 percent of females in our data exited virginity in adolescence, the aggregate loss of human capital as measured by average years of female schooling could be up to one-third of a year.

Background Around the world, millions of people are impoverished due to health care spending. The highest catastrophic health expenditures are found in countries in transition. Our study analyzes the extent of financial protection by estimating the incidence of catastrophic health care expenditure in Myanmar and its association with sociodemographic factors. Methods We performed a secondary analysis of data from the household surveys conducted by the Livelihoods and Food Security Trust Fund (LIFT) in 2013 and 2015 in Myanmar. To estimate the magnitude of catastrophic health care expenditure, we applied the definition of catastrophic payment proposed by the World Health Organization (WHO); a household’s out-of-pocket payment for health care is considered catastrophic if it exceeds 40% of the household capacity to pay. We also examined the changes in catastrophic payments at three different threshold levels (20, 30, 40%) with one equation allowing for a negative capacity to pay (modified WHO approach) and another equation with adjusted negative capacity to pay (standard WHO approach). Results In 2013, the incidence of catastrophic expenditure was 21, 13, 7% (standard WHO approach) and 48, 43, 41% (modified WHO approach) at the 20, 30, 40% threshold level respectively, while in 2015, these estimates were 18, 8, 6% (standard WHO approach) and 47, 41, 39% (modified WHO approach) respectively. Geographical location, gender of the household head, total number of household members, number of children under 5, and number of disabled persons in the household were statistically significantly associated with catastrophic health care expenditures in both studied years 2013 and 2015. Education of household head was statistically significantly associated with catastrophic health expenditure in 2013. We found that the incidence of catastrophic expenditures varied by the approach used to estimate expenditures. Conclusions Although the level of catastrophic health care expenditure varies depending on the approach and threshold used, the problem of catastrophic expenditures in Myanmar cannot be denied. The government of Myanmar needs to scale up the current Social Security Scheme (SSS) or establish a new financial protection mechanism for the population. Vulnerable groups, such as households with a household head with a low-level of education, households with children under the age of 5 years or disabled persons, and low-income households should be prioritized by policymakers to improve access to essential health care. Electronic supplementary material The online version of this article (10.1186/s12939-019-1018-y) contains supplementary material, which is available to authorized users.

This study investigates which subjects teachers talk about with parents in parent-teacher conferences and other contact moments, and how they communicate with regard to these subjects. Fifty-five in-depth interviews were carried out with teachers from special education schools, at-risk schools serving low socio-economic status children and mainstream primary education schools in the southern part of the Netherlands. The results illustrate that (1) two-way communication is used the most in at-risk schools, (2) teachers find it difficult to involve parents in the decision-making process concerning special care for the child, and (3) the teachers' attitude towards parents is best when it comes to difficult discussion topics. When situations are really difficult, teachers stand alongside the parents instead of addressing them from their expert role, asking them 'How can we solve this together?'. Teachers should be more aware of this quality, and not be afraid to address difficult subjects or conflicts.

This article offers the first large-scale comparative analysis of pupils’ and teachers’ perspectives on homosexuality using two waves (2013 and 2017) of self-collected data through questionnaires issued in eight European countries: Belgium, the Netherlands, Germany, the UK, Spain, Poland, Hungary and Turkey. Using these unique data, the authors examine to what extent differences prevail across countries, what mechanisms explain the differences, and how the differences change over time. The results indicate significant differences across countries. Moreover, although a positive trend can be observed between the two waves of the survey, in some countries the general climate towards homosexuality is reversing.

The transition from primary to secondary school comes with changes in both the social- and the school context. This study focuses on assessing the concerns, expectations and experiences of 371 dutch children making the transition. Data have been collected during four years. Also the effect of information to the mentor at secondary school on the transition is assessed through a blinded experiment. Results show that some children are more vulnerable for a poor transition such as children at special education schools, anxious children, and to a lesser extent, girls. However the results do not show that children who informed their mentor made a better transition. The intervention only has a small effect on the social context.

The expansion of health insurance in emerging countries raises concerns about the unintended negative effects of health insurance on labour supply. This article examines the labour supply effects of the Health Care Fund for the Poor (HCFP) in Vietnam in terms of the number of work hours per month and labour force participation (the probability of employment). Employing various matching methods combined with a Difference-in-Differences approach on the Vietnam Household Living Standard Surveys 2002–2006, we show that the HCFP, which aims to provide poor people and disadvantaged minority groups with free health insurance, has a negative effect on labour supply. This is manifested in both the average number of hours worked per month and the probability of employment, suggesting the income effect of the HCFP. Interestingly, the effects are mainly driven by the non-poor recipients living in rural areas, raising the question of the targeting strategy of the programme. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

We investigate the importance of contextual variables in explaining the differences in the correlation of education from parents to children in 48 developing countries. The contextual characteristics are internationally comparable macro-economic and institutional indicators. We use measures on GDP and industrial development, public spending, the education system, infrastructure, health outcomes, political stability and accountability. Our results show that contextual characteristics account for 39% of the explained cross-country variation in the education correlation across generations. The quality of the education system is the most important explanation of the variation of the intergenerational education correlation in the developing countries.

This paper provides a systematic review of studies on the effects of human capital interventions on entrepreneurial performance in industrialized countries. We identify 21 experimental and quasi‐experimental studies published before September 2018. These studies examine the effects of business training, formal education, and entrepreneurship education. Their performance outcomes include firm profits, firm size, and entrepreneurial earnings. The main finding across these studies is that these interventions do not have statistically significant effects. Formal education is the only exception, showing positive effects on firm profits and entrepreneurial earnings, yet these effects are small in magnitude. Evidence is inconclusive regarding effect duration. These findings stand in stark contrast to correlational studies, which tend to find large positive correlations between human capital interventions and entrepreneurial performance. We therefore conclude that correlational studies tend to overestimate the benefits of human capital interventions. Moreover, our estimates show that the interventions are associated with moderately low additionality.

Introduction Latvia has a high maternal mortality ratio compared to other European countries, as well as major inequities in accessing adequate maternal care. Adequacy refers to the extent to which services are safe, effective, timely, efficient, equitable and people-centred. This study aims to explore stakeholder views on access to adequate maternal care in Latvia and the extent to which there was consensus. Methods This mixed-method study is based on an online survey among women who recently gave birth, as well as interviews with healthcare providers and decision-makers. The data were analysed using the method of directed qualitative content analysis. The extent of stakeholder consensus was determined by studying five access-related aspects of maternal care: availability, adequacy, affordability, approachability and acceptability. Findings Our study identified barriers to accessing adequate maternal care related to availability (i.e. shortage of human resources, geographical distance) and appropriateness (i.e. inequalities in provider knowledge, care provision and use of clinical guidelines). Other challenges were related to providers’ approaches towards women (i.e. communication) and, to a lesser extent, maternal care acceptance by women (i.e. health literacy). Conclusions The barriers identified in our study highlight areas that should be addressed in future reforms of maternal care. These barriers also indicate the need for micro-level indicators that can facilitate a comprehensive evaluation of maternal care in Latvia and elsewhere.

This case study explores the coping strategies of oncology patients and their family members in Ukraine. These coping strategies are seen as an individual-level response to the organizational and financial failures of the Ukrainian health care system. Based on semistructured interviews with medical doctors, patients, representatives of charitable foundations, and policy makers, we identify a variety of coping strategies, including personal connections and informal payments. Unequal access to diagnostic and treatment services is observed: coping strategies are developed by patients and their families taking into account the available financial and social capital. Importantly, we could not identify a typical path for cancer patients as cancer patients act in an environment of great uncertainty-in terms of their prognosis and in terms of the cost of treatment. With a weak state and financial uncertainty, patients and physicians perceive coping strategies rather positively as it may contribute to the chance of life.

We investigate the relationship between parent’s education and children’s education in the presence of deprivation in developing countries. The aim is to contribute to the evidence on the important factors in the intergenerational transmission of education. The deprivation index constructed comprises of child mortality, school attendance, cooking fuel, sanitation, drinking water, electricity, housing, and assets. Our findings show a strong relationship between being deprived and the intergenerational correlation of education. This relationship is a little stronger for women as compared to the men. ispartof: International Journal Of Educational Research vol:109 pages:1-17 status: Published online

In een recente brief aan het onderwijsveld stelt het Nationaal Programma Onderwijs (NPO) dat alle scholen in het basis- en voortgezet onderwijs een zomerprogramma moeten aanbieden aan hun leerlingen. Scholen kunnen dit zelfstandig of in onderlinge samenwerking verzorgen, maar er kunnen ook externe partners worden ingezet. In dit advies zetten we op een rij wat bekend is uit onderzoek naar de effectiviteit van zomerscholen en welke lessen hieruit getrokken kunnen worden. Dit advies is bedoeld voor schoolbesturen, schoolleiders en docenten die een zomerschool willen organiseren. Wat is tot nu toe bekend over de werking van zomerscholen?

Gedurende de tweede helft van het schooljaar 2019/20 is er een (gedeeltelijke) schoolsluiting geweest in het primair onderwijs vanwege de COVID-19-crisis. Wat is het gevolg geweest voor de leergroei bij leerlingen in het reguliere basisonderwijs? In dit factsheet belichten we enkele van de landelijke gevonden verschillen tussen scholen.

Gedurende de tweede helft van het schooljaar 2019/20 is er een (gedeeltelijke) schoolsluiting geweest in het primair onderwijs vanwege de COVID-19-crisis. Wat is hiervan het gevolg geweest voor de leergroei bij leerlingen in het reguliere basisonderwijs? In dit factsheet kijken we naar de landelijke gevolgen van de schoolsluiting voor verschillende groepen leerlingen.

Gedurende de tweede helft van het schooljaar 2019/20 is er een (gedeeltelijke) schoolsluiting geweest in het primair onderwijs vanwege de COVID-19-crisis. Dit heeft flinke gevolgen gehad voor de leergroei voor leerlingen in het reguliere basisonderwijs. Eerder1 lieten we zien dat de vertraging in leergroei bij leerlingen met een lage sociaaleconomische status (SES) ongeveer anderhalf keer zo hoog is als bij leerlingen met een hoge SES. Ook lieten we zien dat de vertraging in leergroei voor laagpresterende leerlingen ongeveer twee keer zo groot is als voor hoogpresterende leerlingen. In dit factsheet kijken we of de gevolgen van de schoolsluiting voor deze twee groepen leerlingen versterkt worden als ze ook op een school zitten met relatief veel lage-SES-leerlingen of relatief veel laagpresteerders. Voor de overzichtelijkheid kijken we daarbij uitsluitend naar de leergroei in de Cito-vaardigheidsscores bij rekenen-wiskunde

Hoe is de informatie in de factsheets opgebouwd? Hoe groot is de steekproef? Welke berekeningen en welke keuzes zijn gemaakt? Welke schattingsmethoden zijn gebruikt en welke robuustheidsanalyses zijn toegepast? En wanneer zijn bepaalde gegevens niet gebruikt? Dit vindt u allemaal uitgelegd in de technische toelichting

Little is known about pharmacists' preferences for services to improve medication adherence in patients with diabetes in Indonesia. Identification of such preferences can provide valuable insights on suitable services from a pharmacist's perspective. This study elicits pharmacists' preferences for services to improve medication adherence among their patients. A discrete choice experiment (DCE) method was used to survey pharmacists in all community health centres and three hospitals in Surabaya, Indonesia. Four attributes of consultation, namely duration of consultation, place of consultation, access to a pharmacist and patient copayment, and two attributes on additional services (educational and behavioural-based services) were included. The 16 profiles generated for DCE were partially balanced and partially without overlap. A random-effect logistic regression was used in the analysis. In total, 99 pharmacists completed the questionnaire, but only 80 were included in the study based on a consistency check. All attributes were found to determine preferences for a pharmacist service package. Pharmacists preferred a consultation with a shorter duration accompanied by flexible access to the pharmacist as well as a private consultation room and a lower patient copayment. Providing the patient with a brochure/leaflet was the most preferred additional service to help improve medication adherence. Patient group discussion and medication review were also preferred in combination with a consultation. Pharmacists' socio-demographic background characteristics influence preferences. These findings can be considered in evaluating current practice and designing pharmacist services to help improve medication adherence among patients with diabetes.

Since 2013, the Netherlands has gradually increased the statutory retirement age. We use a regression discontinuity design to analyse the effect of the increase in retirement age on overall job satisfaction and satisfaction with the organisation's personnel policy. Date of birth was used as a sharp cut-off to assign workers to the intervention or comparison group. The increase had no effect on overall job satisfaction. An effect was only observed for satisfaction with the personnel policy in one of the groups analysed. Further, there was only a significant effect if the statutory retirement age was increased by seven months, but this relation was no longer significant when controlling for the difference in days between the date of birth and the cut-off.

Burkina Faso has undertaken major reforms, the cornerstone of which has been the decentralization of the health system to increase access to primary healthcare and to increase the effectiveness, efficiency, financial viability and equity of health services. This study aims to analyze the socio-demographic determinants of households' access to healthcare in Burkina Faso.We used data from a national household survey conducted in 2014 in Burkina Faso. We carried out binary logistic and linear regression analysis using data from a national household survey. The statistical analysis explored the associations between socio-demographic characteristics on the one side, and the use of health services, satisfaction with health services and expenditures on health services, on the other side.The findings indicate an association between age, education, income and use of services (p 0.0005). The results show that healthcare users' satisfaction is influenced by age, the association is stronger with the age group under 24 (p 0.0005) than the age group of 25-39 (p 0.005). An association was found between the age group under 15 (p 0.005), the type of health facility used (p 0.0005), the distance traveled to health facilities (p 0.005) and households' individuals' health expenditure.Specific policies are needed to enhance geographical access to healthcare, financial access to and satisfaction with healthcare in moving towards universal health coverage (UHC).RéSUMé: INTRODUCTION: Le Burkina Faso a entrepris des réformes majeures dans le domaine de la santé dont l’une des pierres angulaires a été la décentralisation du système de santé en vue d’accroître l’accès aux soins de santé primaire et d’améliorer l’efficience, l’efficacité, la viabilité financière et l’équité des services de santé. La présente étude vise à analyser les déterminants de l’accès des ménages aux services de santé au Burkina Faso. MéTHODE: Pour notre analyse, nous avons utilisé les données secondaires d’une enquête nationale réalisée en 2014 au Burkina Faso sur le profil de pauvreté et d’inégalités des ménages. Une régression logistique binaire et linéaire a été réalisée pour analyser l’association entre les caractéristiques sociodémographiques et l’utilisation des services de santé d’une part, le niveau de satisfaction des utilisateurs envers les services de santé et les dépenses de santé d’autre part. RéSULTATS: Les résultats indiquent une association entre l’âge, l’éducation, le revenu et l’utilisation des services de santé (p 0.0005). Les résultats montrent que la satisfaction des utilisateurs des services de santé est. influencée par l’âge, la corrélation est. plus forte avec le groupe d’âge de moins de 24 ans (p 0.0005) que le groupe d’âge de 25–39 (p 0.005). Une corrélation a été mise en évidence entre le groupe d’âge de moins de 15 ans (p 0.005), le type de structure de santé utilisé (p 0.0005), la distance parcourue pour le recours aux soins (p 0.005) et les dépenses de santé des ménages. CONCLUSION: Des politiques spécifiques sont nécessaires pour améliorer l’accès géographique et financier des populations aux services de santé, ainsi que le niveau de satisfaction des utilisateurs des services de santé dans la perspective de la couverture sanitaire universelle.

Although widely used in policy debates, the literature on children’s outcomes when raised by same-sex parents mostly relies on small selective samples or samples based on cross-sectional survey data. This has led to a lack of statistical power and the inability to distinguish children born to same-sex parents from children of separated parents. We address these issues by using unique administrative longitudinal data from the Netherlands, which was the first country to legalize same-sex marriage. These data include 2,971 children with same-sex parents (2,786 lesbian couples and 185 gay male couples) and over a million children with different-sex parents followed from birth. The results indicate that children raised by same-sex parents from birth perform better than children raised by different-sex parents in both primary and secondary education. Our findings are robust to use of cousin fixed effects and coarsened exact matching to improve covariate balance and to reduce model dependence. Further analyses using a novel bounding estimator suggest the selection on unobserved characteristics would have to be more than three times higher than the selection on observed characteristics to reduce the positive estimates to zero. ispartof: American Sociological Review vol:85 issue:5 pages:830-856 status: published

The neonatal early onset sepsis (EOS) calculator is a novel tool for antibiotic stewardship in newborns, associated with a reduction of empiric antibiotic treatment for suspected EOS. We studied if implementation of the EOS calculator results in less healthcare utilization and lower financial costs of suspected EOS. For this, we compared two single-year cohorts of hospitalizations within 3 days after birth in a Dutch nonacademic teaching hospital, before and after implementation of the EOS calculator. All admitted newborns born at or after 35 weeks of gestation were eligible for inclusion. We analyzed data from 881 newborns pre-implementation and 827 newborns post-implementation. We found significant reductions in EOS-related laboratory tests performed and antibiotic days, associated with implementation of the EOS calculator. Mean length of hospital stay was shorter, and EOS-related financial costs were lower after implementation among term, but not among preterm newborns.Conclusion: In addition to the well-known positive impact on antibiotic stewardship, implementation of the EOS calculator is also clearly associated with reductions in healthcare utilization related to suspected EOS in late preterm and term newborns and with a reduction in associated financial costs among those born term.What is Known:• The early-onset sepsis (EOS) calculator is a novel tool for antibiotic stewardship in newborns, associated with a reduction in empiric antibiotic treatment for suspected EOS.What is New:• In newborns at risk for EOS, EOS calculator implementation is associated with a significant reduction in laboratory investigations related to suspected EOS and significantly shorter stay in those born term.• EOS calculator implementation in term newborns is associated with a mean reduction of €207 in costs for EOS-related care per admitted newborn.