Household Residents Research Articles

Legal regulation of tourism activities in Russia and the CIS countries

The tourism and hospitality industry produces many social benefits. More specifically tourism creates employment opportunities, contributes to the growth of local and regional economies by improving both the living standards of resident households and the incomes of local firms and represents “a tool for poverty alleviation” especially in developing countries. Nowadays tourism is the biggest industry globally. In particular according to the World Tourism Organization and Organization of American States, “data indicates that the sector contributes to more than 10 % of global gross domestic product and provides for one in ten jobs in the world”.

The Differential Effects of Caregiving Intensity on Overnight Hospitalization in the Previous 2 Years

Caregiving for a spouse is considered a major stressor many Americans will encounter during their lifetimes. Although most studies indicate caregiving is associated with experiencing diminished health outcomes, little is known about how this role affects caregivers’ use of acute health services. To understand how spousal caregiving affects the use of acute health services, we use data from the Health and Retirement Study. We apply fixed effects (FE) logistic regression models to examine odds of experiencing an overnight hospitalization in the previous two years according to caregiving status, intensity, and changes in caregiving status and intensity. Models controlled for caregiver gender, age, race, ethnicity, educational attainment, health insurance status, the number of household residents, and self-assessed health. Overall, caregivers were no more likely to experience an overnight hospitalization compared to non-caregivers (OR 0.92; CI 0.84 to 1.00; p-value=0.057). However, effects varied according to the intensity of caregiving and the time spent in this role. Compared to non-caregivers, for example, spouses who provided care to someone with no need for assistance with activities of daily living had lower odds of experiencing a hospitalization (OR 0.77; CI 0.66 to 0.89). In contrast, caregivers who provided care to someone with dementia for 4 to <6 years had 3.29 times the odds of experiencing an overnight hospitalization (CI 1.04 to 10.38; p-value=0.042). Findings indicate that, although caregivers overall appear to use acute health services about as much as non-caregivers, large differences exist between caregivers. Results emphasize the importance of recognizing diversity within caregiving experiences.

Non-adherence to long-lasting insecticide treated bednet use following successful malaria control in Tororo, Uganda.

Indoor residual spraying (IRS) and long-lasting insecticide-treated bednets (LLINs) are common tools for reducing malaria transmission. We studied a cohort in Uganda with universal access to LLINs after 5 years of sustained IRS to explore LLIN adherence when malaria transmission has been greatly reduced. Eighty households and 526 individuals in Nagongera, Uganda were followed from October 2017 -October 2019. Every two weeks, mosquitoes were collected from sleeping rooms and LLIN adherence the prior night assessed. Episodes of malaria were diagnosed using passive surveillance. Risk factors for LLIN non-adherence were evaluated using multi-level mixed logistic regression. An age-matched case-control design was used to measure the association between LLIN non-adherence and malaria. Across all time periods, and particularly in the last 6 months, non-adherence was higher among both children <5 years (OR 3.31, 95% CI: 2.30-4.75; p<0.001) and school-aged children 5-17 years (OR 6.88, 95% CI: 5.01-9.45; p<0.001) compared to adults. In the first 18 months, collection of fewer mosquitoes was associated with non-adherence (OR 3.25, 95% CI: 2.92-3.63; p<0.001), and, in the last 6 months, residents of poorer households were less adherent (OR 5.1, 95% CI: 1.17-22.2; p = 0.03). Any reported non-adherence over the prior two months was associated with a 15-fold increase in the odds of having malaria (OR 15.0, 95% CI: 1.95 to 114.9; p = 0.009). Knowledge about LLIN use was high, and the most frequently reported barriers to use included heat and low perceived risk of malaria. Children, particularly school-aged, participants exposed to fewer mosquitoes, and those from poorer households, were less likely to use LLINs. Non-adherence to LLINs was associated with an increased risk of malaria. Strategies, such as behavior change communications, should be prioritized to ensure consistent LLIN use even when malaria transmission has been greatly reduced.

Early marriage and early childbearing in South Asia: trends, inequalities, and drivers from 2005 to 2018.

Early marriage (EM) and early childbearing (ECB) have far‐reaching consequences. This study describes the prevalence, trends, inequalities, and drivers of EM and ECB in South Asia using eight rounds of Demographic and Health Survey data across 13 years. We report the percentage of ever‐married women aged 20–24 years (n = 105,150) married before 18 years (EM) and with a live birth before 20 years (ECB). Relative trends were examined using average annual rate of reduction (AARR). Inequalities were examined by geography, marital household wealth, residence, and education. Sociodemographic drivers of changes for EM were assessed using regression decomposition analyses. We find that EM/ECB are still common in Bangladesh (69%/69%), Nepal (52%/51%), India (41%/39%), and Pakistan (37%/38%), with large subnational variation in most countries. EM has declined fastest in India (AARR of –3.8%/year), Pakistan (–2.8%/year), and Bangladesh (–1.5%/year), but EM elimination by 2030 will not occur at these rates. Equity analyses show that poor, uneducated women in rural areas are disproportionately burdened. Regression decomposition analysis shows that improvements in wealth and education explained 44% (India) to 96% (Nepal) of the actual EM reduction. Investments across multiple sectors are required to understand and address EM and ECB, which are pervasive social determinants of maternal and child wellbeing.

The Household Financial Losses Triggered by an Immigration Arrest, and How State and Local Government Can Most Effectively Protect Their Constituents

Through a survey of 125 long-term resident households in Pima County, Arizona, this study finds that an immigration arrest costs each household an average of more than $24,000. These costs accumulate through the value of assets seized and not recovered, out-of-pocket costs for hiring an attorney, immigration bond, and other expenses involved in supporting an immediate family member as they navigate the immigration court system. But they also include lost income due to disruptions to employment resulting from the arrest, and a physical inability to work while in detention, appearing in court, and immediately following deportation. In this article, we discuss how, when measured at the scale of the household, these financial costs fail to discriminate according to immigration or citizenship status, and accumulate to affect issues of poverty, education, housing security, health and development, and generational wealth inequality — all matters of sustained interest to state and local government. In the second half of the article, we draw on our research findings to evaluate various policies that states, counties, and municipalities can implement to mitigate these financial burdens while promoting the overall well-being of their constituents. Policies considered include: The “Immigrant Welcoming City” paradigm The limitation of routine cooperation and custody transfer between local and federal law enforcement Expanding access to permissible forms of identification Universal representation for immigration defendants The cultivation of community bond funds The promotion of worker-owned cooperativesAlthough these kinds of state or local initiatives cannot replace meaningful federal action on immigration reform, they can do much to provide relief and promote economic security for established immigrant and mixed-status families living in the United States, while contributing to overall community well-being and economic vitality.

Childhood maltreatment and lead levels in middle adulthood: A prospective examination of the roles of individual socio-economic and neighborhood characteristics.

BackgroundLead is a common environmental hazard because of its past use as an additive to gasoline and household paint. Some evidence suggests that children with histories of child abuse and neglect are at elevated risk for residence in communities and households with less desirable characteristics and high levels of exposure to environmental hazards and toxins.ObjectivesTo understand whether childhood maltreatment leads to higher levels of household dust lead and blood lead in adulthood and the extent to which characteristics of a person’s physical environment or individual level socio-economic status (SES) (based on unemployment, poverty, and receipt of public assistance) contribute to understanding the relationship.MethodsA large prospective cohort design study in which abused and neglected children (ages 0–11) were matched with non-maltreated children and assessed in adulthood. Objective and subjective neighborhood characteristics were assessed at approximate age 40 and household dust lead (cleaned and less often cleaned) and blood lead levels were measured at age 41. Blood was collected through venipuncture by a registered nurse as part of a medical status exam.ResultsChildhood maltreatment predicted higher levels of dust lead in less often cleaned household places, residence in worse neighborhoods defined by objective (census tract data) and subjective (reports of physical disorder and lack of social cohesion and control), and higher levels of poverty, receiving public assistance, and unemployment. Only objective neighborhood characteristics mediated the relationship between childhood maltreatment and dust lead level in adulthood. There were also significant paths from objective neighborhood disadvantage and individual level SES to higher levels of blood lead.DiscussionThirty years after their childhood experiences, individuals with documented histories of childhood maltreatment are at higher risk for living in environments as adults with elevated lead levels that may impact other aspects of their lives and compromise their health.

Cycles of violence in England and Wales: the contribution of childhood abuse to risk of violence revictimisation in adulthood

BackgroundInterpersonal violence is a leading cause of death and disability globally, has immediate and long-term impacts on individuals’ health and wellbeing, and impacts global health care expenditures and national economies. A public health approach to violence prevention is crucial, and addressing risk factors is a key priority. Global research has demonstrated that childhood adversity increases risk of a range of poor outcomes across the lifecourse. This study examined the association between being a victim of child abuse and the risk of physical assault (PA), intimate partner violence (IPV), and sexual violence (SV) victimisation in adulthood.MethodsData from a nationally representative survey of household residents (adults aged 16 to 59 years; n = 21,845) was analysed. Types of child abuse examined included physical, sexual, and psychological abuse and witnessing domestic violence. Logistic regressions examined the independent relationships between child abuse types, experiencing multiple types, and adulthood violence outcomes.ResultsMost individual types of child abuse were significantly associated with each adulthood violence outcome, after controlling for sociodemographics and other abuse types. Compared to individuals who experienced no abuse in childhood, those who experienced one form of abuse were over twice as likely to experience PA in the past year and three times as likely to have experienced IPV and/or SV since age 16 years, whilst individuals who experienced multiple types were three, six, and seven times more likely to experience PA, IPV, and SV, respectively. After controlling for sociodemographics and multi-type childhood victimisation, the type or combination of types which remained significant differed by violence outcome; child psychological and physical abuse were significantly associated with IPV; psychological and sexual abuse with SV; and psychological abuse with PA.ConclusionsPrevention of child abuse is an important goal, and evidence from the current study suggests such efforts will have a downstream effect on preventing interpersonal violence across the lifecourse. With adulthood victimisation likely to compound the already detrimental effects of childhood abuse, and given that many associated outcomes also represent adversities for the next generation, breaking the cycle of violence should be a public health priority.

Public Attribution of Responsibility for Disaster Preparedness across Three Levels of Government and the Public: Lessons from a Survey of Residents of the U.S. South Atlantic and Gulf Coast

AbstractUsing survey data collected from residents of counties along the South Atlantic and Gulf Coasts of the United States, we use innovative compositional data analysis techniques to examine individuals’ assignment of responsibility for hurricane preparedness across federal, state, and local officials as well as among household residents and their community. We find that the public assigns limited responsibility for hurricane preparedness to governments. Rather, respondents, especially conservatives and those with low trust in government, view individuals themselves as responsible for preparedness. Our results emphasize the role of ideology and the individualistic culture of American politics. These results also have implications for scholars who study individual attribution responsibility in multi-level systems and who may assume that individuals will assign responsibility to one of the various levels of government; however, focusing on disaster preparation in particular, our study shows that a significant number of individuals may not assign responsibility to government at any level.

Quantifying Plasmodium falciparum infections clustering within households to inform household-based intervention strategies for malaria control programs: An observational study and meta-analysis from 41 malaria-endemic countries.

Reactive malaria strategies are predicated on the assumption that individuals infected with malaria are clustered within households or neighbourhoods. Despite the widespread programmatic implementation of reactive strategies, little empirical evidence exists as to whether such strategies are appropriate and, if so, how they should be most effectively implemented. We collated 2 different datasets to assess clustering of malaria infections within households: (i) demographic health survey (DHS) data, integrating household information and patent malaria infection, recent fever, and recent treatment status in children; and (ii) data from cross-sectional and reactive detection studies containing information on the household and malaria infection status (patent and subpatent) of all-aged individuals. Both datasets were used to assess the odds of infections clustering within index households, where index households were defined based on whether they contained infections detectable through one of 3 programmatic strategies: (a) Reactive Case Detection (RACD) classifed by confirmed clinical cases, (b) Mass Screen and Treat (MSAT) classifed by febrile, symptomatic infections, and (c) Mass Test and Treat (MTAT) classifed by infections detectable using routine diagnostics. Data included 59,050 infections in 208,140 children under 7 years old (median age = 2 years, minimum = 2, maximum = 7) by microscopy/rapid diagnostic test (RDT) from 57 DHSs conducted between November 2006 and December 2018 from 23 African countries. Data representing 11,349 infections across all ages (median age = 22 years, minimum = 0.5, maximum = 100) detected by molecular tools in 132,590 individuals in 43 studies published between April 2006 and May 2019 in 20 African, American, Asian, and Middle Eastern countries were obtained from the published literature. Extensive clustering was observed-overall, there was a 20.40 greater (95% credible interval [CrI] 0.35-20.45; P < 0.001) odds of patent infections (according to the DHS data) and 5.13 greater odds (95% CI 3.85-6.84; P < 0.001) of molecularly detected infections (from the published literature) detected within households in which a programmatically detectable infection resides. The strongest degree of clustering identified by polymerase chain reaction (PCR)/ loop mediated isothermal amplification (LAMP) was observed using the MTAT strategy (odds ratio [OR] = 6.79, 95% CI 4.42-10.43) but was not significantly different when compared to MSAT (OR = 5.2, 95% CI 3.22-8.37; P-difference = 0.883) and RACD (OR = 4.08, 95% CI 2.55-6.53; P-difference = 0.29). Across both datasets, clustering became more prominent when transmission was low. However, limitations to our analysis include not accounting for any malaria control interventions in place, malaria seasonality, or the likely heterogeneity of transmission within study sites. Clustering may thus have been underestimated. In areas where malaria transmission is peri-domestic, there are programmatic options for identifying households where residual infections are likely to be found. Combining these detection strategies with presumptively treating residents of index households over a sustained time period could contribute to malaria elimination efforts.

How much does it cost to measure immunity? A costing analysis of a measles and rubella serosurvey in southern Zambia.

Serosurveys are a valuable surveillance tool because they provide a more direct measure of population immunity to infectious diseases, such as measles and rubella, than vaccination coverage estimates. However, there is concern that serological surveys are costly. We adapted a framework to capture the costs associated with conducting a serosurvey in Zambia. We costed a nested serosurvey in Southern Province, Zambia that collected dried blood spots from household residents in a post-campaign vaccine coverage survey. The financial costs were estimated using an ingredients-based costing approach. Inputs included personnel, transportation, field consumable items, social mobilization, laboratory supplies, and capital items, and were classified by serosurvey function (survey preparation, data collection, biospecimen collection, laboratory testing, and coordination). Inputs were stratified by whether they were applicable to surveys in general or attributable specifically to serosurveys. Finally, we calculated the average cost per cluster and participant. We estimated the total nested serosurvey cost was US $68,558 to collect dried blood spots from 658 participants in one province in Zambia. A breakdown of the cost by serosurvey phase showed data collection accounted for almost one third of the total serosurvey cost (32%), followed by survey preparation (25%) and biospecimen collection (20%). Analysis by input categories indicated personnel costs were the largest contributing input to overall serosurvey costs (51%), transportation was second (23%), and field consumables were third (9%). By combining the serosurvey with a vaccination coverage survey, there was a savings of $43,957. We estimated it cost $4,285 per average cluster and $104 per average participant sampled. Adding serological specimen collection to a planned vaccination coverage survey provided a more direct measurement of population immunity among a wide age group but increased the cost by approximately one-third. Future serosurveys could consider ways to leverage existing surveys conducted for other purposes to minimize costs.

Spatial patterns and associated factors of HIV Seropositivity among adults in Ethiopia from EDHS 2016: a spatial and multilevel analysis

BackgroundHIV is a major public health issue, especially in developing countries. It is important to track and design successful intervention programs to explore the spatial pattern, distribution, and associated factors of HIV Seropositivity. This study therefore showed the spatial variation of HIV Seropositivity and related factors in Ethiopia.MethodsA total sample of 25,774 individual data collected from the 2016 EDHS data were primarily HIV biomarkers, IR, MR, and GPS. Spatial heterogeneity analysis was used with methods such as Morans I, Interpolation, and Kulldorff ‘s scan statistic. Spatial analysis was conducted using open source tools (QGIS, GeoDa, SaTScan). Multilevel logistic regression analysis was performed using Stata14 to identify HIV-associated factors. Finally, the AOR with a 95% confidence interval was used to report the mixed-effect logistic regression result in the full model.ResultThe prevalence of HIV / AIDS at national level was 0.93%. The highest prevalence regions were Gambela, Addis Abeba, Harari and Diredawa, accounting for 4.79, 3.36, 2.65 and 2.6%, respectively. Higher HIV seropositive spatial clusters have been established in the Gambela and Addis Ababa regions. Multilevel analysis at the individual level being married [AOR = 2.19 95% CI: (1.11–4.31)] and previously married [AOR = 6.45, 95% CI: (3.06–13.59)], female [AOR = 1.8, 95% CI: (1.19–2.72)], first-sex at age ≤15 [AOR = 4.39, 95% CI: (1.70–11.34)], 18—19 [AOR = 2.67 95% CI: (1.05–6.8)], middle age group (25-34) [AOR = 6.53, 95% CI: (3.67–11.75)], older age group (>34) [AOR = 2.67 95% CI: (1.05–6.8)], primary school [AOR = 3.03, 95% CI: (1.92–4.79)], secondary school [AOR = 3.37, 95% CI: (1.92–5.92) were significantly associated with serropositivity. Regarding household level, place of residence [urban: AOR = 6.13 CI: (3.12, 12.06)], female-headed households (AOR = 2.24 95% CI: (1.57–3.73), media exposure [low exposure (AOR = 0.53 95% CI: (0.33–0.86), no exposure AOR = 0.39 95% CI: (0.23–0.65)] and increased household size [AOR = 0.72 95% CI: (0.65–0.8)] were associated with HIV Seropositivity.ConclusionHigh cluster HIV cases were found in Gambela, Addis Abeba, Harari, and Diredawa. Having a history of married, start sex at a younger age, female-headed household, urban residence, and lower household size is more affected by HIV/AIDS. So any concerned body work around this risk group and area can be effective in the reduction of transmission.

Prevalence and risk factors for low birth weight in Jordan and its association with under-five mortality: a population-based analysis.

Low birth weight (< 2.5 kg) is an important indicator of health and development of infants throughout their life. This study aimed to determine the prevalence and risk factors for low birth weight in Jordan and its association with under-5 mortality. In this secondary analysis, data were extracted from the 2012 Jordan Population and Family Health Survey for 9734 live births born in the 5 years preceding the survey and for which birth weight was reported. Data were collected on child and maternal characteristics. Multivariable regression analysis was used to determine the significant risk factors for low birth weight and mortality. Of the 9734 births analysed, 13.8% were low birth weight and 1.3% were very low birth weight. Mother's age (< 30 and ≥ 35 years), education (less than higher education), birth interval (< 24 months and first birth), unplanned pregnancy, household wealth status (poorest and richest), consanguinity, residence (central and south regions of Jordan), female sex, birth order (1 and ≥ 6), twin birth and maternal smoking during pregnancy were significant risk factors for low birth weight. The risk of death under 5 years of age was 4.8 times higher in children with low birth weight than children with normal birth weight. The high rate of low birth weight and its increasing rate in Jordan is a challenge for public health. Preventing low birth weight neonates and increasing their survival need to be prioritized in the national health strategy. Special care needs to be taken for the high-risk groups identified in this study.

Treatment of Particulate Matter Pollution: People’s Attitude and Readiness to Act

Abstract The paper displays results of the questionnaire called “Particulate matter pollution in air”, which serves as a tool to determine level of public awareness of the health risks related to pollution from small capacity heating equipment in households. Barriers for installation of the innovative flue gas treatment technology called a fog unit in households and possible mechanisms to decrease or prevent these barriers were defined. The first part of the questionnaire included overall information about participants: age, gender, education level, place of residence, activities to protect the environment and motives behind performing these activities. The remaining questions were divided in four groups: “Environmental views”, “Knowledge on air pollution”, “Willingness to pay”, “Choice of flue gas treatment technologies”. The results of questionnaire correspond with raised problem situations. Over 80 % of respondents lack information on pollution and possible consequences deriving from it, and on potential solutions to prevent pollution. Residents of households are willing to pay for installation of flue gas treatment equipment (capital investments).

Examination of daily water consumption behaviors of individuals living in a semi-rural area

Abstract Background The aim of this study is to investigate water consumption behaviors and related factors in the summer period of the population over the age of 15 who apply to family health centers in the semi-rural region. Methods The universe of this cross-sectional study consisted of adult patients who applied to community health centers of a region in Malatya. A questionnaire was applied to random 303 individuals about sociodemographic information and water and other fluid consumption and water use behavior.And also Chrobach alpha coefficient of 0.83, the validity adopted in Turkey Likert type consisting of 16 questions Water Consumption Behavior Scale-16 (WCBS) was used for data collection. Scale score height is considered good. In the analysis of the data; Mann Whitney-U and Kruskal-Wallis tests were used. P &amp;lt; 0.05 was chosen as the level of error. Results 49.8% of the participants were male and 64.4% were married. The median daily drinking water consumption of the individuals was 2000 ml (320 ml-1000 ml) and the median daily liquid consumption was 3300 ml (718ml-17001ml). There was no significant difference between age groups, marital status and education level and daily water and other fluid consumptions (p &amp;gt; 0,05). 48.8% of individuals stated that they saved water and the most important reason for this was the high level of water consumption prices.In our study, there was no significant difference between gender, place of residence and number of households and total WCBS scale score.(p &amp;gt; 0,05). But the married individuals' scale score were significantly higher than the single individuals (p &amp;lt; 0,05) Conclusions Water and fluid consumption of individuals are at moderate levels in the region. Marital status was most important factor influencing the water consumption behaviors has been found in this study.When the most important factors in saving water are examined, the high price water bills were noteworthy. Key messages In order to ensure correct water consumption the society should be informed, the necessary sensitivity should be performed to behavioral change and measures should be taken. Adequate daily water consumption is required to protect the health of individuals.

ÍNDICE DE VULNERABILIDADE SOCIAL À DESASTRES NATURAIS PARA ÁREAS URBANAS

Apresenta-se uma aplicação do Social Vulnerability Index – SoVI®, com o interesse de contribuir com o estudo geográfico da vulnerabilidade social à desastres naturais em áreas urbanas. Para exemplificação utilizou-se dados do censo demográfico por setores censitários urbanos da cidade de Santos, na Zona Costeira Paulista. Foram detectadas nove componentes que explicam 75,6% da variância da vulnerabilidade em Santos. A primeira componente é a desigualdade social, racial e gênero, e uma vez que, as jovens, alfabetizadas, portadoras da cor parda e residentes em domicílios improvisados sem rendimento, são o grupo populacional mais vulnerável. Valores altos de SoVI® foram observados nos setores norte da cidade, que compreende a zona portuária, o centro e as áreas de aglomerados subnormais. Os menores índices estão distribuídos, no setor sul da cidade, especialmente na orla praiana. Em Santos, a espacialização do SoVI® apresenta-se como um subproduto de eventos históricos e contextos sócioespaciais que explicam como os processos de urbanização (precária e segregada) incorporaram diferentes níveis de vulnerabilidade social com privações de direitos à cidade e à justiça social. Assim, o SoVI® é estratégia interessante para o estudo dos riscos e desastre, desde que os processos metodológicos de elaboração sejam claros e substanciados teoricamente

Factors Related to Oral Healthcare Service Utilization among Korean Adults Aged 25–79 Years

The factors related to oral healthcare service utilization (OHSU) among Korean adults aged 25–79 years were assessed using the Andersen model with the sixth Korean National Health and Nutrition Examination Survey data. The study included 12,937 participants aged 25–79 years who answered questions on the predisposing, enabling, and need factors related to OHSU at dental clinics within the past 1 year. Age, sex, and education level were selected as predisposing factors; household income, residence region, and national and private health insurance status as enabling factors; and self-perceived oral health, dental pain, chewing status, and discomfort while speaking as need factors. These factors were assessed using multivariable complex logistic regression models. OHSU at dental clinics within the past 1 year was lower among less-educated participants, those with low, middle–low, and middle–high household income levels, rural participants, those benefiting from the Medicaid system, and non-insured participants. OHSU was higher among older participants, those who rated their self-perceived oral health status as bad, those with experience of dental pain, and those who experienced discomfort while chewing and speaking. The need factors were the most influential. Thus, interventions to reduce inequalities in OHSU are required to promote oral health for all.

The Determinants of Households Having Savings Accounts in Rwanda

This paper analyses the determinants of Rwandan households having savings accounts using Integrated Household Living Conditions Survey (IHLCS) data of 2010/11. After a background discussion and literature review an empirical analysis is presented with different variables adopted and analysed as determinants of household’s head having savings accounts. Poverty level, age, gender, residential area and level education of household head (literate or not) were considered as independent variables of the study. Findings from the estimations of logit models indicate the likelihood of a household having a savings account is positively and significantly related to each of the following: non-poor status of the household,the household residing in an urban area, the household head being male, and the household head being literate. Having the household head be literate tends to be more important for younger household heads and for non-poor households. The proportion of households having money in a savings account more than doubled over the decade between the IHLCS 2000/2001 survey and the IHLCS 2010/2011 survey. Government policies on savings and poverty reduction may explain the trend of increased cash balances in saving accounts.&#x0D; Key Words: Savings, Bank Accounts, Households, Determinants,

Socioeconomic inequalities in food insecurity and malnutrition among under-five children: within and between-group inequalities in Zimbabwe

BackgroundFood insecurity and malnutrition in children are pervasive public health concerns in Zimbabwe. Previous studies only identified determinants of food insecurity and malnutrition with very little efforts done in assessing related inequalities and decomposing the inequalities across household characteristics in Zimbabwe. This study explored socioeconomic inequalities trend in child health using regression decomposition approach to compare within and between group inequalities.MethodsThe study used Demographic Health Survey (DHS) data sets of 2010\\11 and 2015. Food insecurity in under-five children was determined based on the WHO dietary diversity score. Minimum dietary diversity was defined by a cut- off point of > 4 therefore, children with at least 3 of the 13 food groups were defined as food insecure. Malnutrition was assessed using weight for age (both acute and chronic under-nutrition) Z-scores. Children whose weight-for-age Z-score below minus two standard deviations (− 2 SD) from the median were considered malnourished. Concentration curves and indices were computed to understand if malnutrition was dominant among the poor or rich. The study used the Theil index and decomposed the index by population subgroups (place of residence and socioeconomic status).ResultsOver the study period, malnutrition prevalence increased by 1.03 percentage points, while food insecurity prevalence decreased by 4.35 percentage points. Prevalence of malnutrition and food insecurity increased among poor rural children. Theil indices for nutrition status showed socioeconomic inequality gaps to have widened, while food security status socioeconomic inequality gaps contracted for the period under review.ConclusionThe study concluded that unequal distribution of household wealth and residence status play critical roles in driving socioeconomic inequalities in child food insecurity and malnutrition. Therefore, child food insecurity and malnutrition are greatly influenced by where a child lives (rural/urban) and parental wealth.

Covariates and Spatial Interpolation of HIV Screening in Mozambique: Insight from the 2015 AIDS Indicator Survey.

We examined the factors associated with human immunodeficiency virus (HIV) screening and developed a HIV screening prevalence surface map using spatial interpolation techniques to identify the geographical areas with the highest and lowest rates of HIV screening in Mozambique. We analyzed the cross-sectional 2015 Mozambique AIDS Indicator Surveys with an analytic sample of 12,995 participants. Analyses were conducted on SPSS-21, STATA-14, and R freeware 3.5.3. We adjusted for the sample design and population weights. Results indicated that 52.5% of Mozambicans had undergone HIV screening. Mozambicans with these characteristics have a higher probability of undergoing HIV screening: females, those with a primary education or higher, urban dwellers, residents of wealthy households, having at least one lifetime sexual partner, and dwelling in these provinces—Niassa, Tete, Manica, Sofala, Inhambane, Gaza, Maputo Provincia, and Maputo Cidade. The spatial map revealed that the national and regional estimates mask sub-regional level estimates. Generally, zones with the highest HIV screening prevalence are found in southern provinces while the lowest prevalence was found in the northern provinces. The map further revealed intraregional differences in HIV screening estimates. We recommend that HIV screening be expanded, with equitable screening resource allocations that target more nuanced areas within provinces which have a low HIV screening prevalence.

What Happened to People with Non-Communicable Diseases during COVID-19: Implications of H-EDRM Policies.

People with existing non-communicable diseases (NCDs) are particularly vulnerable to health risks brought upon by emergencies and disasters, yet limited research has been conducted on disease management and the implications of Health-EDRM policies that address health vulnerabilities of people with NCDs during the COVID-19 pandemic. This paper reports the baseline findings of an anonymous, random, population-based, 6-month cohort study that aimed to examine the experiences of people with NCDs and their relevant self-care patterns during the COVID-19 pandemic. A total of 765 telephone interviews were completed from 22nd March to 1st April 2020 in Hong Kong, China. The dataset was representative of the population, with 18.4% of subjects reporting at least one NCD. Results showed that low household income and residence in government-subsidized housing were significant predictors for the subjects who experienced difficulty in managing during first 2 months of the pandemic (11% of the NCD patients). Of those on long-term NCD medication, 10% reported having less than one week’s supply of medication. Targeted services for vulnerable groups during a pandemic should be explored to support NCD self-care.