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  • Author: Harsha Aturupane, Anil B. Deolalikar, Dileni Gunewardena
  • Publication Date: 05-2008
  • Content Type: Working Paper
  • Institution: United Nations University
  • Abstract: Reducing child malnutrition is a key goal of most developing countries. To combat child malnutrition with the right set of interventions, policymakers need to have a better understanding of its economic, social and policy determinants. While there is a large literature that investigates the determinants of child malnutrition, it focuses almost exclusively on mean effects of these determinants. However, socioeconomic background variables and policy interventions may affect child nutrition differently at different points of the conditional nutritional distribution. Using quantile regressions, this paper explores the effect s of variables such as a child's age, sex and birth order; household expenditure per capita; parental schooling; and infrastructure on child weight and height at different points of the conditional distributions of weight and height using data from Sri Lanka's Demographic and Health Survey. Results indicate that OLS estimates can be misleading in predicting the effects of determinants at the lower end of the distributions of weight and height. For example, even though on average Sri Lankan girls are not nutritionally-disadvantaged relative to boys, among children at the highest risk of malnutrition girls are disadvantaged relative to boys. Likewise, although expenditure per capita is associated with strong nutritional improvement on average, it is not a significant determinant of child height or weight at the lower end of the distribution. Similarly, parental education, electricity access, and the availability of piped water have larger effect son child weight and height at the upper quantiles than at the lower quantiles. The policy implication is that general interventions—parental schooling, infrastructure and income growth—are not as effective for children in the lower tail of the conditional weight and height distributions. These children, who are at the highest risk of malnutrition, are likely to need specialized nutritional interventions.
  • Topic: Development, Education, Health
  • Political Geography: Asia, Sri Lanka
  • Author: Julie Subervie, Patrick Guillaumont, Catherine Korachais
  • Publication Date: 05-2008
  • Content Type: Working Paper
  • Institution: United Nations University
  • Abstract: The reduction of child mortality is one of the most universally accepted Millennium Goals. However, there is a significant debate on the means of reaching it and its realism with regard to the situation in most of the least developed countries. The recommendations made for the achievement of this goal are mainly medical ones. However, without underestimating the importance of these measures, in particular vaccinations, it seems increasingly obvious that the rate of reduction of child mortality is mainly determined by the evolution of macroeconomic environment. The influence of per capita income level on mortality is frequently underlined.
  • Topic: Development, Health, Third World
  • Author: Marie-Claude Martin
  • Publication Date: 03-2008
  • Content Type: Working Paper
  • Institution: United Nations University
  • Abstract: The interaction between available individual and collective resources in the determination of health is largely ignored in the literature on the relationship between poverty and health in developing countries. We analyse the role public resources play in the perception that rural women in Morocco have of their health. These resources are taken to contribute directly and indirectly to the improvement of individual health by, on the one hand, providing a health-promoting environment and, on the other, improving the individual's ability to produce health. The empirical results of multilevel models confirm the expected associations between socioeconomic status, individual vulnerability factors and health. Furthermore, the random part of the model suggests that variation in state of health is also associated with the presence of collective resources. However, the higher the level of women's individual wealth, the less the characteristics of the community in which they live seem to be associated with their health, and the less the potential vulnerability factors seem to constrain their ability to maintain or improve health. Our results suggest that collective investments derived from various areas of activity will be more favourable to improving health, insofar as they are adapted to the initial capacity of women to benefit from them.
  • Topic: Gender Issues, Health, Poverty
  • Political Geography: Africa, Morocco
  • Author: Mariano Rojas
  • Publication Date: 05-2008
  • Content Type: Working Paper
  • Institution: United Nations University
  • Abstract: This paper uses a subjective wellbeing approach to study the role of household arrangements on the health satisfaction of an individual. It also studies the impact of household arrangements on health satisfaction across different income groups, by contrasting two main theories of the family: the altruistic/communitarian theory, which emphasizes altruism within the family, implies that the within-the-household allocation of relevant health satisfaction resources leads towards an egalitarian distribution of health satisfaction, and second, the cooperative bargaining theory according to which the family emerges as the cooperative equilibrium outcome from the unilateral interests of each household member. Thus, each household member takes advantage of their bargaining power to attain an equilibrium that favours their personal interests. According to the latter approach, the intra-household allocation of relevant health satisfaction resources leads to a distribution of health satisfaction that closely follows the distribution of bargaining power.
  • Topic: Civil Society, Health
  • Political Geography: Mexico
  • Author: B. Valentine Joseph Gandhi, M. Cynthia Serquiña Bantilan, Devanathan Parthasarathy
  • Publication Date: 04-2008
  • Content Type: Working Paper
  • Institution: United Nations University
  • Abstract: This paper discusses the livelihood dynamics in the fragile landscape of the semi-arid tropics (SAT) of Andhra Pradesh. SAT is home to the poorest of the poor who live in conditions of persistent drought, subsistence agriculture and poor access to markets. This paper is a case study focusing particularly on labour migration, its role in influencing the health risk behaviour of migrants and in the spread of the HIV epidemic among SAT rural households. The most vulnerable population in these drought-prone regions are the migrant labourers, and their vulnerability is influenced by three major factors—the vulnerability and unstable productivity in the degraded and marginal landscape, the caste system that has traditionally kept them backward and vulnerable, and experiences in the external environment to which they migrate. This study—based on a theoretical framework, whereby livelihood risks lead to health risks, particularly HIV infection—outlines the process that causes a further deterioration of the household and the occurrence of cyclical health risk. The paper calls for a multisectoral approach to tackle the issue of migrant vulnerability, and for interventions with a more migrant-need sensitive approach.
  • Topic: Agriculture, Health, Migration
  • Political Geography: Andhra Pradesh
  • Author: Marlene Attzs
  • Publication Date: 06-2008
  • Content Type: Working Paper
  • Institution: United Nations University
  • Abstract: This paper explores the linkages between poverty and disaster vulnerability in the context of remittance flows to households in the Caribbean. Jamaica is used as the case study country. The paper discusses the channels through which natural disasters and remittances affect each other but also reviews the distribution of female-headed households in Jamaica as a percentage of households living below the poverty line and seeks to identify whether flows of remittances alleviate the post-disaster living conditions of such households.
  • Topic: Disaster Relief, Gender Issues, Health, Poverty
  • Political Geography: Caribbean, Jamaica
  • Author: Kavita Sethuraman
  • Publication Date: 02-2008
  • Content Type: Working Paper
  • Institution: United Nations University
  • Abstract: Moderate undernutrition continues to affect 46 per cent of children under 5 years of age and 47 per cent of rural women in India. Women's lack of empowerment is believed to be an important factor in the persistent prevalence of undernutrition. In India, women's empowerment often varies by community, with tribes sometimes being the most progressive. This paper explores the relationship between women's empowerment, domestic violence, maternal nutritional status, and the nutritional status and growth over six months in children aged 6 to 24 months in a rural and tribal community. This longitudinal observational study undertaken in rural Karnataka, India included tribal and rural subjects. Structured interviews with mothers were conducted and anthropometric measurements were obtained for 820 mother-child pairs, the follow-up rate after 6 months was 82 per cent. The data were analyzed by multivariate regression. Some degree of undernutrition was seen in 83.5 per cent of children and 72.4 per cent of mothers in the sample, moreover the prevalence of undernutrition increased among children at follow up. Domestic violence was experienced by 34 per cent of mothers in the sample. In multivariate analysis, biological variables explained most of the variance in nutritional status and child growth, followed by health-care seeking and women's empowerment variables; socio-economic variables explained the least variance. Women's empowerment variables were significantly associated with child nutrition on enrolment and child growth at follow-up. At follow-up, mother's prior lifetime experience of physical violence significantly undermined child growth in terms of weight-for-age, and older age at marriage and high mobility of mothers predicted less stunting in their children. In addition to the known investments needed to reduce undernutrition, improving women's nutrition, promoting gender equality, empowering women, and ending violence against women could further reduce the prevalence of undernutrition in this segment of the Indian population.
  • Topic: Gender Issues, Health
  • Political Geography: India, Asia
  • Author: Karen Macours, Renos Vakis
  • Publication Date: 04-2008
  • Content Type: Working Paper
  • Institution: United Nations University
  • Abstract: This paper provides unique evidence of the positive consequences of seasonal migration for investments in early childhood development. We analyse migration in a poor shockprone border region in rural Nicaragua where it offers one of the main household income diversification and risk coping strategies. IV estimates show, somewhat surprisingly, that mother's migration has a positive effect on early cognitive development. We attribute these findings to changes in income and to the intrahousehold empowerment gains resulting from mother's migration, which offset potential negative ECD effects from temporary lack of parenting. This paper, hence, illustrates how increased opportunities in seasonal migration due to higher South–South mobility might positively affect early childhood development and as such long term poverty reduction.
  • Topic: Health, Migration, Poverty
  • Political Geography: Nicaragua
  • Author: Gilbert Burnham, Brinnon Garrett, Hugh Waters
  • Publication Date: 01-2007
  • Content Type: Working Paper
  • Institution: United Nations University
  • Abstract: Although baseline data for post-conflict situations are frequently unavailable, there is a clear deterioration in the health conditions of populations during and following conflict. Excess mortality and morbidity, displaced populations, and vulnerability to communicable diseases during and following conflict all call for immediate relief and restoration of basic services. As much as possible, short-term relief and assistance programmes should be implemented in a manner compatible with longer term health system rehabilitation.
  • Topic: Conflict Resolution, Development, Health, War
  • Author: Stephen Bach
  • Publication Date: 08-2006
  • Content Type: Working Paper
  • Institution: United Nations University
  • Abstract: The consequences of health professional mobility have become a prominent public policy concern. This paper considers trends in mobility amongst doctors and nurses and the consequences for health systems. Policy responses are shifting from a reactive agenda that focuses on stemming migration towards a more active agenda of managed migration that benefits source and destination countries. Improved working conditions and effective human resource practice are required to encourage retention of health professionals in both source and destination countries.
  • Topic: International Relations, Health, Human Welfare, Migration