Household Access Research Articles

Prevalence of undernutrition and associated factors among adolescent pregnant women in Dolo-Ado town, Somali region, Ethiopia.

Maternal malnutrition, particularly among adolescent pregnant women, is a significant public health issue globally, with far-reaching consequences for both maternal and fetal health. It increases the risk of complications such as stillbirth, low birth weight,preterm birth, uterine bleeding, and other pregnancy-related issues. This study aimed to assess the prevalence of undernutrition and associated factors among adolescent pregnant women (aged < 20years) in the Dolo-Ado town, Somali region, Ethiopia. A cross-sectional study was conducted from January 1-30, 2022, involving 380 pregnant adolescents randomly selected from the Dolo-Ado town. A structured, pretested questionnaire was used to gather data on socio-demographics, maternal nutrition, and obstetric characteristics. Nutritional status was assessed using mid-upper arm circumference (MUAC), with undernutrition defined as MUAC ≤ 22cm. Data were collected via home visits, and the accuracy of anthropometric measurements was standardized through training and pretesting. Descriptive statistics were used for data description, and binary logistic regression was performed to explore the associations between independent and dependent variables. A total of 380 pregnant adolescents participated, achieving a 100% response rate. The mean age of the participants was 17.7 (± 0.78) years. Approximately 32.1% of the participants experienced food insecurity, and only 3% met the minimum dietary diversity score. The prevalence of undernutrition was 21% (79/380), as indicated by a MUAC of < 22cm. The high prevalence of undernutrition among pregnant adolescent women in Dolo-Ado poses a significant public health concern. Key factors associated with undernutrition include maternal education [AOR] of 3.9; 95% Confidence Interval [CI]: 1.9-8.0), rural residence (AOR of 12; 95% CI: 3.5-42.9), low family income (AOR of 2.6; 95% CI: 1.2-5.4), food insecurity (AOR of 6.2; 95% CI: 2.8-13.9), iron-folic acid supplementation (AOR of 3.6; 95% CI: 1.7-7.5), and low dietary diversity intake (AOR of 13.1; 95% CI: 2.2-77.3). Therefore, targeted efforts to address family income, household food insecurity, dietary diversity, and access to iron-folic acid supplementation should be prioritized by both government and non-governmental organizations for pregnant adolescents.

Socioeconomic disparities in child malnutrition: trends, determinants, and policy implications from the Kenya demographic and health survey (2014 - 2022)

BackgroundChild malnutrition remains a critical public health problem, with socioeconomic factors playing a significant role. Socioeconomic factors include household income, parental education, and access to healthcare, which influence a child’s nutritional status. Despite overall progress in reducing under-five child malnutrition in Kenya, disparities persist. This paper analyzes changes, and determinants of child malnutrition, contributions of these determinants to health inequality, and their potential use in the screening for chronic malnutrition in children under five years.MethodsWe use data from the Kenyan Demographic and Health Survey (KDHS 2014 and 2022) and analyze malnutrition using three indicators: Stunting, underweight, and wasting. The determinants of malnutrition are analyzed using multivariate logistic regression. Trends in socioeconomic inequality are analyzed using concentration indices and visualized using concentration curves. Wagstaff decomposition is used to explore the contributions of determinants to inequality in child malnutrition. We investigate diagnostic utility using sensitivity, specificity, predictive values, and area under the ROC curve.ResultsSocioeconomic inequality in under-five child malnutrition increased between 2014 and 2022, with children from the poorest socioeconomic quintiles being disproportionately affected. A child’s age (in months) (Adjusted Odds Ratio [AOR] = 1.01; 95% Confidence Interval [CI]: 1.01 – 1.02), being born to a household in the poorest socioeconomic quintile (AOR = 2.67; 95%CI: 1.92 - 3.72), and sex (male) (AOR = 1.50; 95%CI: 1.35 – 1.67) were associated with an increased risk of stunting. The mother’s age, sex of the child (male), and household socioeconomic status (poorest) was associated with an increased risk of being underweight and wasted, whereas residence was associated with an increased risk of wasting alone after adjusting for potential confounders. A household’s socioeconomic status was the largest contributing factor to health inequality. Sensitivity, specificity, and AUC values were 67.4% (95% CI: 66.4% – 68.4%), 50.6% (95%CI: 50.0% - 51.1%), and 0.59 (95%CI: 0.58 – 0.60), respectively, when using socioeconomic status as a screening tool for stunting.ConclusionSocioeconomic disparities are a major barrier to reducing child malnutrition in Kenya, with children from lower socioeconomic quintiles at a greater risk of stunting, underweight, or wasting. This study identifies a child’s sex, age, and household socioeconomic status as key predictors of malnutrition, highlighting the need to include these factors in public health interventions. Addressing these disparities with targeted strategies considering immediate health risks and underlying socioeconomic challenges is essential for equitably improving child health outcomes.

Associations Between Coparenting Quality, the Home Food Environment, and Child's Body Mass Index.

Background: Although positive coparenting, or how parents relate during childrearing, is known to support children's socioemotional development, the role of coparenting in supporting children's healthy eating and growth is poorly understood. This study examined associations between coparenting quality, the home food environment, and young children's body mass index (BMI). Methods: Cross-sectional data were obtained from 290 mothers and their 3-year-old children who participated in the Sprout study. Mothers who indicated they had a coparent in their household completed surveys to assess coparenting quality, food parenting practices, family mealtime routines and structure, and home food availability. Mothers also reported the foods served at two typical meals, and a healthy meal index (HMI) score was calculated to assess the nutritional quality of meals. Children's height and weight were measured and used to calculate BMI z-scores (BMIz). Results: Mothers who reported more positive coparenting also reported providing children more guidance for healthy eating (β = 0.15, p < 0.001), less use of food to control children's emotions (β = -0.15, p < 0.01), less use of food as a reward (β = -0.27, p < 0.01), more structured mealtimes (β = 0.22, p < 0.001), and more household availability of fruits and vegetables (β = 0.11, p < 0.01). Mothers who reported greater coparent agreement on childrearing also had children with lower BMIz (β = -0.11, p = 0.03). Mothers who reported greater endorsement of their partner's childrearing competency had a higher mean HMI score (β = 1.82, p < 0.01). Conclusion: Among dual-parent, highly resourced families with young children, stronger coparenting practices were associated with several food-related parenting practices that support healthy eating and weight among young children.

Household Dietary Diversity and Its Influence on Preschoolers' Nutritional Status in Tamale Metropolis, Ghana

Introduction: Household dietary diversity serves as a simple indicator of various parameters that affect the nutrition of people. Food security has three important aspects (availability, access, and utilization). Household accessibility to food has also been shown to be affected by demographic and socioeconomic factors, accounting for variations in diet quality. This study aimed to determine the relationship between preschoolers’ household dietary diversity and their nutritional status in the Tamale Metropolis. Methods: A cross-sectional survey was used to obtain data from 357 caregiver-preschooler pairs from three randomly selected communities in Tamale Metropolis. Structured questionnaires were used to collect data on the demographic and nutritional status of the preschoolers. Dietary data for preschoolers and households were obtained using a single 24-hour recall method. Height and weight measurements of preschoolers were collected on anthropometric indices (weight-for-height, weight-for-age, and height-for-age). The relationships between the independent variables (household dietary diversity) and dependent variables (weight-for-age, weight-for-height, and height-for-age) were examined using the statistical analysis test to assess the strength of the relationship. The data were collected between December 2022 and January 2023. Results: The results indicated that preschoolers consumed more starchy staples than other food groups. Dairy, egg, and meat products were the least consumed. Households had a mean household dietary diversity of 6.7059 ± 1.23 out of 12 food groups, and about 84.3% of the households had minimum dietary diversity. The finding from this study showed 22.1% stunting, 7.8% wasting and 14.3% underweight. No significant relationship was found between dietary diversity and height-for-age and weight-for-height nutritional status. However, there was a significant relationship between the age of the child and being stunted (P = .00) and underweight (P = .00). Conclusion: These results show no significant relationship between household dietary diversity and preschoolers’ nutritional status. Therefore, there should be improvements in household food security, maternal knowledge of balance, and hygienic food practices.

Effectiveness of home water treatment for the control of diarrhea in children under five years: an intervention study in a rural health zone of Tshopo in the Democratic Republic of Congo

ABSTRACT Villages that were once certified as ‘sanitized’ have lost their status and now have high rates of diarrheal diseases. The goal of this study was to evaluate the effectiveness of water treatment and safe management in reducing diarrheal diseases in children aged 0–59 months. An intervention study with non-randomized allocation of subjects was conducted from 1 September 2023 to 29 February 2024 in two villages in Tshopo province. The control village was the one selected in the similar context in terms of water supply, hygiene and sanitation. The incidence of diarrhea was calculated in each village per 100 person-weeks. Systematic water treatment combined with hygienic storage and reduction of storage time to 24 h reduced the prevalence of diarrhea from 49.6 to 9% in children aged 0–59 months. Village category (IRR = 1.89, 95% CI: 1.8–1.98), education level (IRR = 1.101, 95% CI: 1.05–1.5), marital status of household head (IRR = 1.13, 95% CI: 1.02–1.24) and household size (IRR = 1.08, 95% CI: 1.07–1.08) were associated with diarrhea. Water treatment and safe management are effective measures to reduce diarrheal morbidity and should be recommended in the context of poor household access to improved water sources.

Urban inequality, the housing crisis and deteriorating water access in US cities

The housing unaffordability and cost-of-living crisis is affecting millions of people in US cities, yet the implications for urban dwellers’ well-being and social reproduction remain less clear. This Article presents a longitudinal analysis of household access to running water—a vital component of social infrastructure—in the 50 largest US cities since 1970. The results indicate that water access has worsened in an increasing number and typology of US cities since the 2008 global financial crash, disproportionately affecting households of color in 12 of the 15 largest cities. We provide evidence to suggest that a ‘reproductive squeeze’—systemic, compounding pressures on households’ capacity to reproduce themselves on a daily and societal basis—is forcing urban households into more precarious living arrangements, including housing without running water. We analyze the case study of Portland (Oregon) to illustrate the racialized nature of the reproductive squeeze under a housing crisis. Our insights reveal that plumbing poverty—a lack of household running water—is expanding in scope and severity to a broader array of US cities, raising doubts about equitable progress towards Sustainable Development Goals for clean water and sanitation for all (SDG 6) and sustainable cities (SDG 11) in an increasingly urbanized United States.

Determining household out of pocket payments, incidence of catastrophic expenditures and impoverishment among patients with malaria in Zambia's path towards Universal Health Coverage.

The World Health Organisation (WHO) estimates that about 3.2 billion people which is nearly half of the world's population are at risk of malaria. Annually about 216 million cases and 445,000 deaths of malaria occur globally. Africa accounted for 90% and 91% of the malaria cases and deaths respectively. Zambia has earmarked malaria elimination on its path to Universal Health Coverage (UHC). This paper aims to determine the incidence of Out-of-Pocket Payments (OOP) and Catastrophic Health Expenditures (CHE) and impoverishment among households with malaria patients in Zambia. The paper focusses on the incidence of OOP and impoverishment for malaria in a setting without user fees for accessing primary malaria health care services and virtually no user fees at all levels of care if referred through the referral system. The results of this study will also serve as a baseline for tracking Zambia's path towards achieving malaria financial access on its path towards UHC among patient with malaria. The study uses a nationally representative cross-sectional survey of households in both rural and urban areas of Zambia. The study employed probability sampling procedures. A two-stage stratified cluster sample design was used. We analyse a total of 2,005 households that had at least one member suffering from malaria with a recall period of four weeks for out-patients and six months for the in-patient respectively. A logistic regression model was estimated with a Categorical Dependent variable being CHE (CHE = = 1, or otherwise = = 0). A household is considered impoverished if it fell below the poverty line due to OOP. All data was analyzed using Stata version 2013. The results show that although the country has a free malaria policy at primary care level and virtually at all levels if referred through the health system process, households are still incurring costs in accessing health care services. Incidence of CHE and impoverishment were reflected at all levels. In terms of CHE, the poorest contributed almost 30% while the wealthier quintile contributed about 10%. Similarly, impoverishment effects of OOPs are more pronounced in the poorest quintile. The OOP composed mainly of transport, followed by diagnosis and medicines and was lowest for Insecticide-treated bed nets (ITNs) payments. The high costs of transport that the households had to incur when accessing health services could be due to the long distance that the households have to face as they travel to the health facilities as most of the facilities in Zambia are still outside the 5 km radius. The drug expenditure could be explained by the drugs running out of stock. Low expenditure on ITNs could be due to the country's strategy of mass distribution working to give the country's universal financial protection on ITNs for malaria. This study sought to address gaps in OOP and the associated incidence of CHE and impoverishment for malaria, distribution of OOP among Social Economic Status (SES) setting and determinants of OOP in Country that has earmarked malaria elimination in the UHC agenda. Understanding household's costs related to malaria will enable targeting intervention to accelerate Zambia's path towards elimination of malaria and therefore contribute to attainment of the Sustainable Development Goals of household's financial access to UHC. Thus, the study will also serve as a baseline for tracking UHC for household financial access to malaria care that the country has embarked on.

Development and Validation of the South African Diet Quality Index for Pregnancy: The NuEMI Study.

Diet quality indexes (DQIs) consist of combinations of foods and/or nutrient components that represent adherence to dietary guidelines. A high-quality diet during pregnancy contributes to optimal birth outcomes. We developed and validated the first DQI for pregnancy for South African women. The South African Food Based Dietary Guidelines and pregnancy dietary guidelines were used as theoretical basis for the a priori development of the South African Diet Quality Index for Pregnancy (SA-DQI-P). To validate the SA-DQI-P, we applied it to data collected for the Nutritional status of Expectant Mothers and their newborn Infants (NuEMI) study (N = 682). We determined the associations between SA-DQI-P scores in tertiles with nutrient intakes, sociodemographic factors, household food security level, and biochemical values. A lower household density ratio, household access to a toilet, refrigerator, and microwave, a higher educational level, being employed and being food secure were significantly associated with a higher score. After correcting for energy intake, higher scores were significantly associated with higher intakes of protein, total fat, saturated fat, cholesterol, calcium, vitamin A, vitamin E, folic acid, vitamin B12, and vitamin C. Significantly more participants who were vitamin A deficient scored in the lowest tertile than those in higher tertiles. The SA-DQI-P is the first DQI developed for a South African population and has proven to be valid in ranking diet quality in pregnant women in our sample. Information regarding diet quality of this vulnerable group can assist with planning nutrition intervention programs to improve nutritional status.

The Impact of Using Clean Fuel on the Risk of Stunting in Children Aged 0-59 Months

Stunting is a critical global health challenge, particularly in developing nations, affecting children's physical, cognitive, and socioeconomic outcomes. This study investigates the impact of clean cooking fuel use on stunting risk among children aged 0–59 months in Indonesia, employing cross-sectional data from the 2014 Indonesian Family Life Survey (IFLS) and the Propensity Score Matching (PSM) method. The results reveal that households using clean cooking fuels, such as liquefied petroleum gas (LPG), significantly improve children's Height-for-Age Z-scores, reducing stunting risk. Factors including higher household education, income levels, and access to urban areas positively influence clean fuel adoption. The study underscores the importance of clean energy policies and increased awareness, particularly in rural areas, to mitigate health disparities and improve childhood growth outcomes. These findings contribute to the growing evidence linking clean energy transitions with enhanced public health and child development indicators.

Impact of the COVID-19 pandemic on intra-household gender disparities in the Middle East and North Africa region: A scoping review protocol.

The Middle East and North Africa (MENA) is a global outlier both for its low female labor force participation and investment in early childhood development services, and consistently ranks lowest on global rankings of gender parity. While the impact of the COVID-19 pandemic on global gender inequity has been acknowledged, specific challenges faced by partnered-women in MENA are underexplored. Additionally, with over half of the region affected by conflict and displacement, exploring these impacts sheds light on understudied gender disparities in humanitarian contexts during the pandemic. This scoping review aims to examine intra-household gender disparities during the COVID-19 pandemic, adding to a more comprehensive understanding of this particular public health emergency's worldwide ramifications. The hypothesis is that the pandemic has exacerbated women's pre-existing constraints in the MENA region, worsening gender inequities in economic empowerment, healthcare access, and general well-being. This review will explore intra-household gender disparities in decision-making, household labor division, economic independence, health, and access to resources and services during the COVID-19 pandemic that have been reported to have been affected by COVID-19 globally. Following PRISMA guidelines for Scoping Reviews, a comprehensive search will be conducted in APA PsycINFO, Arab World Research Source: Al Masdar, EconLit, Global Health, MEDLINE, Scopus, and Web of Science Core Collection, in consultation with an information specialist. Studies in English, French and Arabic from January 2020 to August 2024 will be included. Four independent reviewers will screen studies, and data will be charted, coded, and narratively synthesized. This review is expected to shed light on gender disparities in healthcare accessibility, mobility, and decision-making during the COVID-19 pandemic across low- and middle-income countries in the MENA region, adding to the global literature.

Strengthening resilience: the role of institutions in facilitating local agricultural adaptation to the impact of climate change in Tanzania

Building resilience in areas susceptible to climatic hazards is widely recognised as a critical strategy. This article offers valuable insights into the contribution of institutions to supporting smallholder farmers in building resilience against the effects of climate change. Data for this article was collected from Manzase and Haneti villages in Chamwino district in Dodoma region, Tanzania. The study adopted a qualitative approach and deployed key informant interviews and focus group discussions for data collection. The result showed that institutions that operate in the villages under study which include agricultural extension agencies, Non-Governmental organisations, private companies and village governments, have played such roles as providing drought-resistant seeds, disseminating seasonal weather forecast information and supporting the establishment of income diversification activities to farmers. Furthermore, the institution facilitated agroforestry farming through natural tree regeneration and ensured access to crop markets and loans for farm inputs. These roles have contributed to reducing crop loss due to drought and rainfall unreliability, enhanced household income, and allowed households access to food during drought-induced crop failure. The study also revealed that institutional linkages are crucial in comprehensively addressing challenges faced by smallholder farmers, thereby building their livelihood resilience. This paper argues that strong institutional support is essential for farmers to build resilience against climate change.

Sustainable Livelihood Approach for Supporting Aquaculture Households Amid Structural Shifts in Sidoarjo Regency

This study examines the role of the Sustainable Livelihood Approach (SLA) in supporting aquaculture households in Sidoarjo Regency as they adapt to structural shifts driven by industrialization and urbanization. The research analyzes how sustainable livelihood strategies enhance the economic stability of pond-based households impacted by land-use change. Using a quantitative approach with descriptive analysis, the study employs Structural Equation Modeling Partial Least Squares (SEM-PLS) to evaluate the influence of key variables. Conducted in Kalisogo Pond Village, the study uses purposive sampling based on criteria such as economic reliance on aquaculture and sector experience. Data were gathered through questionnaires and analyzed for model validity and reliability. Findings indicate that the SLA significantly bolsters pond households’ adaptive capacity to structural shifts. Income diversification through non-aquaculture activities enhances economic stability and reduces dependence on pond farming. Social capital further supports households by strengthening local community networks. The study underscores the importance of institutional backing and microcredit access for aquaculture households. Policymakers and financial institutions are encouraged to support sustainable adaptation measures. These findings offer valuable insights into the SLA’s application amid structural changes in industrialized coastal regions.

Burden of acute malnutrition in the conflict-affected urban communities of Tigray, Northern Ethiopia: a cross-sectional study

BackgroundMalnutrition impedes the growth, development, and survival of children. Conflict has severely affected the livelihoods of families and caused an alarming increase in food insecurity, population displacements, and extreme poverty in Tigray. Therefore, this study aimed to assess the prevalence and factors associated with acute malnutrition among 6- to 23-month-old children in the armed conflict-affected urban areas of Tigray.MethodsThe study population were randomly selected children aged 6 to 23 months. A cross-sectional study design was used. Data was collected from July 13 to 28, 2022 in Tigray region, Northern Ethiopia. A systematic random sampling technique was used to select the participants. Sociodemographic, lifestyle, anthropometric, and clinical variables were collected using a structured questionnaire. The data were analyzed using SPSS version 24 and presented using descriptive and analytical statistics. Binary logistic regression was used to identify independent predictors of acute malnutrition. All variables were declared statistically significant at a p-value of < 0.05.ResultsA total of 368 participants aged 6–23 months were included in the study. Half (50.5%) and around three-fourths (72.6%) of the participants were females and 12 to 23 months old children, respectively, with a mean (SD) age of 15.2 (5.1) months. The overall proxy global acute malnutrition rate was 44.3%, with 34.5% and 9.8% being moderate acute malnutrition and severe acute malnutrition, respectively. In the multivariable logistic regression model, three variables (consumption of legumes, maternal nutritional status, and household access to clean water) were identified as significant predictors of proxy global acute malnutrition. Children who didn’t eat legumes (AOR (95%CI): 2.39 (1.44, 3.97)), children of acutely malnourished mothers (AOR (95%CI): 1.60 (1.02, 2.51)), and children from households with insufficient water supply (AOR (95%CI): 1.99 (1.20, 3.31)) were significantly associated with an increased likelihood of acute malnutrition as compared with their counterparts.ConclusionsChildren from the armed conflict areas of Tigray are disproportionally impacted by acute malnutrition. Nearly half of the children were acutely malnourished, with one in ten suffering from the more serious severe acute malnutrition. Hence, urgent action is needed to prevent their permanent mental and physical deterioration and death by improving consumption of high protein foods, nutritional status of mothers, and access to clean water.

How to Enhance Resilience Against the Adverse Effects of Climate Change: Evidence from Boro Rice Farmers in Northeast Bangladesh

ABSTRACTBoro rice cultivation in the Haor (wetland) environment of northeastern Bangladesh is extremely vulnerable to flash floods. This study examines how flash floods in the Haor region affect crop income and household food consumption. For this research, household‐level data were generated from the “Bangladesh Integrated Household Survey (BIHS) 2018‐19,” which is a nationwide dataset of 5604 households across 64 districts of the country. However, this paper represents a sample of 428 farm households in six Haor‐concentrated districts (Sunamganj, Sylhet, Habiganj, Maulvibazar, Kishoreganj, and Netrakona) of northeastern Bangladesh. These districts were selected based on the climate shock data (damaged Boro land due to flash floods) from the “Yearbook of Agricultural Statistics‐2018.” Descriptive results uncover that in 2017, flash floods inundated about one‐third of the standing Boro rice lands of Haor farmers. This study employed simultaneous quantile regression, which reveals flash floods extensively decrease crop income. Nevertheless, a male‐headed and educated family, a larger farm, and livestock asset availability in the household are the pivotal determinants that protect crop income. Moreover, flash floods negatively impact the consumption of home‐produced food, but the consumption of purchased food remains unaffected. Notably, possession of farmlands and livestock assets encourages food consumption from own production, while household access to credit enhances consumption of purchased food. Livestock‐raising households could increase their consumption of self‐produced food, increase their agricultural income, and be more resilient to climatic shocks. Hence, this study emphasizes the policy intervention that prioritizes the upbringing of livestock assets in farm households. In addition, policy‐enhancing farmers' credit access is crucial for smoothing their purchased food consumption and mitigating the adverse effects of climatic events. Therefore, livestock assets and credit availability in farm households are profoundly resilient against the adverse effects of climatic shocks in northeastern Bangladesh.

Changes in urbanicity and household availability of and proximity to food vendors from 2004 to 2020 in a rural district of northwestern Bangladesh

BackgroundThe nutrition transition underway in South Asia is likely mediated by changes to the food environment. Yet, few studies have been conducted in rural areas of South Asia to describe how the food environment has changed. ObjectiveThis analysis assessed changes in household availability of and proximity to markets, grocery shops, and tea shops over a 16-year time period in Gaibandha, Bangladesh. MethodsWe analyzed household demographic and geospatial data collected at 3 time points from 2004 to 2020 in a contiguous rural area (435 km2). We defined availability as number of food vendors within 400- and 1600-m radius of households and proximity as distance to nearest vendor. We used linear and Poisson models to estimate associations between household socioeconomic status (SES) and food vendor availability and proximity. We used multi-level models to conduct similar analyses for community-level urbanicity. ResultsFrom 2004 to 2020, the numbers of markets, grocery shops and tea shops increased by 21%, 66% and 270%, respectively. Food vendor proximity did not change by household SES, but less urban households witnessed larger increases in proximity to markets (p for interaction<0.001) and tea shops (p for interaction<0.001) over time. Grocery shop and tea shop availability was initially higher and increased more over time for households in higher urbanicity areas (p for interaction<0.001). ConclusionOver a 16-year period, this rural area of Bangladesh became more urbanized, increasing the availability of and proximity to markets, grocery shops, and tea shops. Further research is needed to see how these changes impact rural residents’ intake and nutritional status.

Out-of-pocket health expenditure, social protection, and life expectancy of female-headed households in China.

This study explores the relationship between out-of-pocket health expenditure, social protection interventions, and life expectancy of female-headed households in China. The study was based on data extracted from the World Bank (2021) Global Financial Inclusion Index (Global Findex) and applied the descriptive statistics and the Ordinary Least Squares Regression (OLS). The results show that there is a significant positive coefficient for social protection in total households, females, and males, indicating a beneficial link between social protection programs and life expectancy in female-headed households in China. Conversely, negative coefficients for out-of-pocket health expenditure suggest that higher healthcare costs are associated with lower life expectancy, highlighting the financial strain on these households. These submissions justify the necessity for social protection interventions in improving health outcomes and addressing financial barriers to healthcare access for female-headed households in China.

Negligible impact of supermarkets on food security (so far) in low-income neighborhoods of Accra, Ghana

In recent years, African policymakers have embraced supermarket development as a form of food system modernization, but the impacts of the proximity of supermarkets on low-income households in a developing African city are largely unexplored. Using a sample of 680 households in seven of Accra’s poorer neighborhoods, we examine the dimensions and level of food security, household-level determinants, and what impact, if any, the arrival of supermarkets has had on local food security. Using two internationally accepted food-security metrics, (Food Consumption Score and Household Food Insecurity Access Scale), two economic measures (income equivalence and asset ownership), and satellite imagery of supermarket locations, we find that physical proximity to supermarkets is not significantly associated with household food security in low-income areas of Accra. The majority of poor households in Accra are currently food secure, but asset ownership is a much stronger predictor of food security than income. The relatively high degree of food security in Accra is likely related to credit-based relationships that households have with local food vendors. Further, given that supermarkets can compete with these so-called “informal” vendors for access to public space, these credit-based relationships will suffer with new supermarket development. Our study highlights the need for nuanced understanding regarding the role of consumer-retailer and retailer-retailer relationship in ensuring food access for low-income households in urban Africa.

Adoption of clean energy cooking technologies in rural households: the role of women

Abstract Ensuring energy access for rural households is crucial for global sustainable development. Technologies like liquefied petroleum gas, biogas, and efficient cookers are touted as solutions, yet their adoption remains limited despite their potential health, economic, and environmental benefits. We conducted a meta-analysis of 50 studies in developing countries, integrating contextual factors to explore gender and other determinants impacting rural energy transition. Our findings underscore socioeconomic status, social capital, environmental concerns, and gender dynamics as pivotal factors. Notably, women's involvement boosts adoption rates by 7.90 per cent, yet cultural barriers often sideline them from these processes. Thus, our recommendations stress addressing women's roles as energy technology users to foster inclusive energy transitions.

Predictors of Food Insecurity and Food Assistance Program Usage Among Puerto Ricans Before and During the COVID-19 Pandemic in Holyoke, Massachusetts.

Puerto Rican households often face elevated rates of food insecurity. Frequently, households experiencing food insecurity turn to federal and emergency nutrition assistance for urgent or prolonged aid. This study analyzes factors influencing food insecurity and food assistance program involvement among Puerto Ricans in Holyoke, Massachusetts, amidst the COVID-19 pandemic. Using a combination of community-based participatory recruitment, purposive sampling, and web-based tools, we collected 284 survey responses. Our paper employed Pearson's chi-square, logistic regression, and hierarchical linear models to assess relationships between demographic and household attributes and food access outcomes. Variables such as having children in the household and age significantly influenced food relief participation and food insecurity outcomes. Puerto Rican heritage and low educational attainment were strong predictors of obtaining federal food aid. Low-income participants disproportionately faced food shortages and depended on emergency food initiatives. Our findings indicate that demographic and household factors significantly influence food insecurity and accessibility. Our study demonstrates that the pandemic made it challenging for households to obtain consistent, safe, and affordable nourishment. The impacts were unequally spread; hence, Puerto Rican communities and low-income groups were most affected.

The distributional effects of rural electrification on household welfare: Evidence from Senegal

This study uses a cross-sectional dataset of 3215 rural Senegalese households from the 2018/19 Harmonized Survey on Households Living Standards to assess the distributional household welfare effects of electricity access. The paper conducts separate analyses for both on-grid and off-grid electricity access and uses an array of empirical strategies to compute the relevant effects. We find that household access to grid electricity is associated with increased food and non-food expenditures, while off-grid solar electricity is only associated with increased levels of the latter. In addition, access to grid electricity appears to impact household expenditures more than solar electricity, with the off-grid effect not detected at the top end of the non-food expenditure distribution. In contrast, on-grid electricity has a greater welfare impact on higher-income households. The results further suggest that access to solar electricity can reduce inequality in total non-food household expenditures more than on-grid electricity. The findings encourage consideration of policies designed to extend solar energy to the more remote rural areas to reduce inequality.