Country Income Level Research Articles

Systematic comparison of household income, consumption, and assets to measure health inequalities in low- and middle-income countries

There has been no systematic comparison of how the three most common measures to quantify household SES—income, consumption, and asset indices—could impact the magnitude of health inequalities. Microdata from 22 Living Standards Measurement Study surveys were compiled and concentration indices, relative indices of inequality, and slope indices of inequality were calculated for underweight, stunting, and child deaths using income, consumption, asset indices, and hybrid predicted income. Meta-analyses of survey year subgroups (pre-1995, 1995–2004, and post-2004), outcomes (child deaths, stunting, and underweight), and World Bank country-income status (low, low-middle, and upper-middle) were then conducted. Asset indices and the related hybrid income proxy result in the largest magnitudes of health inequalities for all 12 overall outcomes, as well as most country-income and survey year subgroupings. There is no clear trend of health inequality magnitudes changing over time, but magnitudes of health inequality may increase as country-income levels increase. There is no significant difference between relative and absolute inequality measures, but the hybrid predicted income measure behaves more similarly to asset indices than the household income it is supposed to model. Health inequality magnitudes may be affected by the choice of household SES measure and should be studied in further detail.

A meta-analytic review of the implementation characteristics in parenting interventions to promote early child development.

This review summarizes the implementation characteristics of parenting interventions to promote early child development (ECD) outcomes from birth to 3 years. We included 134 articles representing 123 parenting trials (PROSPERO record CRD42022285998). Studies were conducted across high-income (62%) and low-and-middle-income (38%) countries. The most frequently used interventions were Reach Up and Learn, Nurse Family Partnership, and Head Start. Half of the interventions were delivered as home visits. The other half used mixed settings and modalities (27%), clinic visits (12%), and community-based group sessions (11%). Due to the lack of data, we were only able to test the moderating role of a few implementation characteristics in intervention impacts on parenting and cognitive outcomes (by country income level) in the meta-analysis. None of the implementation characteristics moderated intervention impacts on cognitive or parenting outcomes in low- and middle-income or high-income countries. There is a significant need in the field of parenting interventions for ECD to consistently collect and report data on key implementation characteristics. These data are needed to advance our understanding of how parenting interventions are implemented and how implementation factors impact outcomes to help inform the scale-up of effective interventions to improve child development.

Determining the drivers of global innovation under COVID-19: An FSQCA approach.

During the COVID-19 epidemic, national innovation faced the challenges of high-risk research and development and intensified trade competition. How to allocate resources reasonably to promote national innovation has become a problem that must be solved. Based on the global innovation index (GII) framework, this study analyzes the influence of national innovation input elements (such as human capital resources, infrastructure, business maturity, etc.) on innovation output from the perspective of configuration, combining with the necessary condition analysis (NCA) and fuzzy set/qualitative comparative analysis (FSQCA). The research results show that:(1) A single innovation input constitutes the necessary condition and serves as a bottleneck for high innovation output;(2) ITT, HCR, IFT, MS and BS are all "multiple concurrent" and form different configurations, namely, two high-innovation and four nonhigh innovation configurations, that drive national innovation governance is characterized by "different roads leading to the same goals." (3) As innovation is limited by the income levels of various countries, there are obvious differences in innovation drive paths between high- and low-income countries. Moreover, the configuration of asymmetric relationships with low-innovation output that occurs in high-income countries has unique characteristics. In this study, the influence of the coupling of national innovation input elements on innovation output is explored.

Evolving trends in prostate cancer: Disparities across income levels and global regions (1990-2019).

25 Background: Prostate Cancer, the third most commonly diagnosed cancer in 2020 and the fifth leading cause of cancer mortality worldwide, has exhibited significant disparities in global prevalence and impact over recent decades. This study assesses the trends in incidence, mortality, and disability-adjusted life years from prostate cancer in the World Bank regions based on country income levels from 1990 to 2019. Methods: The Global Burden of Disease Study database was used to extract Age-standardized incidence rates (ASIR), age-standardized (ASDR), and life years (DALYs) for prostate cancer from different World Bank regions based on income levels from 1990 to 2019. Annual percentage change was also acquired. Mortality-to-incidence ratios (MIR) were then computed. Trends were assessed using Joinpoint regression. Results: Between 1990 and 2019, ASIRs increased across all income levels, with the greatest growth in the upper middle income (+64.7%). While ASDRs decreased in high income, upper middle income, and lower middle income levels, they notably increased in low income levels (+14.3%). DALYs decreased in high income and upper middle income levels, primarily in the high income (-25.7%), and increased in lower middle and low income levels, primarily in the low income (+13.8%). MIRs decreased in all countries, with the largest decrease in high income levels (-50%). In the last 30 years, high income countries have consistently observed the highest ASIR (2019: 77.5/100,000). However, in 1990 high income countries also had the highest ASDRs and DALYs. Interestingly, by 2019 this pattern shifted, with low income surpassing high income countries in both. Conclusions: Over the last 30 years, the incidence of prostate cancer has been rising regardless of income level. Despite the universal decrease of MIRs implying improved outcomes, screening, and therapeutical strategies, the contrasting trends in ASDRs and DALYs across income levels underscore the disparities in health outcomes. Higher income countries experienced highest cancer incidence but also the highest decrease in the mortality rates while lower income countries faced the opposite challenges with lower increase but higher mortality rates. [Table: see text]

Modeling the global impact of reducing out-of-pocket costs for children's surgical care.

Over 1.7 billion children lack access to surgical care, mostly in low- and middle-income countries (LMICs), with substantial risks of catastrophic health expenditures (CHE) and impoverishment. Increasing interest in reducing out-of-pocket (OOP) expenditures as a tool to reduce the rate of poverty is growing. However, the impact of reducing OOP expenditures on CHE remains poorly understood. The purpose of this study was to estimate the global impact of reducing OOP expenditures for pediatric surgical care on the risk of CHE within and between countries. Our goal was to estimate the impact of reducing OOP expenditures for surgical care in children for 149 countries by modeling the risk of CHE under various scale-up scenarios using publicly available World Bank data. Scenarios included reducing OOP expenditures from baseline levels to paying 70%, 50%, 30%, and 10% of OOP expenditures. We also compared the impact of these reductions across income quintiles (poorest, poor, middle, rich, richest) and differences by country income level (low-income, lower-middle-income, upper-middle-income, and high-income countries).Reducing OOP expenditures benefited people from all countries and income quintiles, although the benefits were not equal. The risk of CHE due to a surgical procedure for children was highest in low-income countries. An unexpected observation was that upper-middle income countries were at higher risk for CHE than LMICs. The most vulnerable regions were Africa and Latin America. Across all countries, the poorest quintile had the greatest risk for CHE. Increasing interest in financial protection programs to reduce OOP expenditures is growing in many areas of global health. Reducing OOP expenditures benefited people from all countries and income quintiles, although the benefits were not equal across countries, wealth groups, or even by wealth groups within countries. Understanding these complexities is critical to develop appropriate policies to minimize the risks of poverty.

Global burden of potentially life-threatening maternal conditions: a systematic review and meta-analysis

BackgroundPotentially life-threatening maternal conditions (PLTCs) is an important proxy indicator of maternal mortality and the quality of maternal health services. It is helpful to monitor the rates of severe maternal morbidity to evaluate the quality of maternal care, particularly in low- and lower-middle-income countries. This study aims to systematically identify and synthesize available evidence on PLTCs.MethodsWe searched studies in English from 2009‒2023 in PubMed, the National Library of Medicine (NLM) Gateway, the POPLINE database, and the Science Direct website. The study team independently reviewed the illegibility criteria of the articles. Two reviewers independently appraised the included articles using the Joanna Briggs Instrument for observational studies. Disputes between the reviewers were resolved by consensus with a third reviewer. Meta-analysis was conducted in Stata version 16. The pooled proportion of PLTCs was calculated using the random effects model. The heterogeneity test was performed using the Cochrane Q test, and its level was determined using the I2 statistical result. Using Egger's test, the publication bias was assessed.ResultThirty-two cross-sectional, five case–control, and seven cohort studies published from 2009 to 2023 were included in the meta-analysis. The highest proportion of PLTC was 17.55% (95% CI: 15.51, 19.79) in Ethiopia, and the lowest was 0.83% (95% CI: 0.73, 0.95) in Iraq. The pooled proportion of PLTC was 6.98% (95% CI: 5.98–7.98). In the subgroup analysis, the pooled prevalence varied based on country income level: in low-income 13.44% (95% CI: 11.88–15.00) I2 = 89.90%, low-middle income 7.42% (95% CI: 5.99–8.86) I2 = 99.71%, upper-middle income 6.35% (95% CI: 4.21–8.50) I2 = 99.92%, and high-income 2.67% (95% CI: 2.34–2.99) I2 = 99.57%. Similarly, it varied based on the diagnosis criteria; WHO diagnosis criteria used 7.77% (95% CI: 6.10–9.44) I2 = 99.96% at P = 0.00, while the Centers for Disease Controls (CDC) diagnosis criteria used 2.19% (95% CI: 1.89–2.50) I2 = 99.41% at P = 0.00.ConclusionThe pooled prevalence of PLTC is high globally, predominantly in low-income countries. The large disparity of potentially life-threatening conditions among different areas needs targeted intervention, particularly for women residing in low-income countries. The WHO diagnosis criteria minimize the underreporting of severe maternal morbidity.Trial registrationCRD42023409229.

From Numbers to Insights: Bibliometric Analysis of Obesity and Heart Disease Research Output

Despite significant research advancements, there remain important gaps in the understanding and directions for future investigations regarding obesity and heart disease. Therefore, this study examined the research output on obesity and heart disease across different countries and regions worldwide from 1970 to 2022. Using bibliometric analysis, a comprehensive dataset of 28,315 published articles related to obesity and heart disease was analysed. Specifically, the trends, patterns, recurring and spatial distribution of topics per the income level of countries and indices for measurement in obesity and heart disease research were analysed. A noticeable increase in research activity on obesity and heart disease was established across all regions globally. Notably, North America, Europe, and Central Asia exhibited a higher prevalence of research in these areas, while Sub-Saharan Africa and South Asia showed comparatively lower levels. The research encompassed a diverse range of themes, with a significant proportion of studies focused on obesity indices and comorbidities associated with these conditions. Other results revealed the identification of various anthropometric indices, biomarkers, and comorbidities from the examined studies. Body mass index, waist-to-hip ratio, waist circumference, hip circumference, fasting blood glucose, cholesterol, and lipoprotein levels emerged as recurring indices in the literature. Additionally, prevalent comorbidities associated with obesity and heart disease included diabetes, stroke, and metabolic syndrome. The findings can guide future research endeavours and public health interventions targeted at addressing the complex challenges posed by obesity and heart disease. This study underscores the global significance of obesity and heart disease as areas of scientific inquiry. Thus, this study serves as a clarion call for sustained and collaborative efforts, emphasising the pivotal role of on-going research in forging a healthier and more informed global future.

Global burden of young-onset Alzheimer's disease and other dementias: a secondary analysis of the global burden of disease study, 2019.

To describe the global burden of young-onset Alzheimer's disease and other dementias by world region and income through a secondary analysis of the Global Burden of Disease Study 2019. This is a descriptive cross-sectional ecological study. Data by sex and five-year age groups from 40 to 64 years were extracted from the Global Burden of Disease Study results tool. We performed a descriptive analysis of prevalence, incidence, deaths, disability-adjusted life years, years of life lost, and years lived with disability. In 2019, young-onset Alzheimer's disease and other dementias presented a prevalence of 2.67 cases and an incidence of 0.44 per 1,000 inhabitants globally. It carried a significant burden, resulting in 1.16 disability-adjusted life years per 1,000 inhabitants, primarily due to years of life lost, and to a lesser extent due to years lived with disability. East Asia & the Pacific, Latin America & the Caribbean, and North America are the most affected regions. Burden rates are consistently higher among women; no gradient was observed by country income. Smoking was the most relevant risk factor, presenting a broad difference by country income level. The global burden of young-onset Alzheimer's disease and other dementias may reshape healthcare requirements and the societal impact of dementias, and its understanding is relevant to inform decisions related to service offerings and research agendas.

Mapping the global neurosurgery workforce. Part 2: Trainee density

OBJECTIVE A sustainable neurosurgery workforce depends on robust training pipelines, but the size and distribution of the global neurosurgery trainee workforce has not been described. The objective of this study was to identify the types of training programs that exist in the global neurosurgery workforce, the support that trainees receive, the diversity of trainee experiences, and the accreditation processes that exist to regulate training programs. METHODS This study was a subanalysis of a cross-sectional survey administered online in all 193 countries and 26 territories, independent states, and disputed regions as defined by the World Bank and United Nations. Participants were identified through neurosurgery society leadership, the personal contacts of the coauthors, and bibliometric and search engine searches. Population-weighted statistics were constructed and segregated by country income level and WHO regions. RESULTS Data were obtained for 187 countries (96.9%) and 25 additional territories, states, and disputed regions (96.2%). There were an estimated 1261 training programs and 10,546 trainees within the regions sampled, representing a global pooled density of 0.14 neurosurgery trainees per 100,000 people and a median national density of 0.06 trainees per 100,000 people. There was a higher density in high-income countries (HICs; 0.48 trainees per 100,000 people) compared with upper-middle-income countries (0.09 per 100,000), lower-middle-income countries (0.06 per 100,000), and low-income countries (LICs; 0.07 per 100,000). The WHO European (0.36 per 100,000) and Americas (0.27 per 100,000) regions had the highest trainee densities, while the Southeast Asia (0.04 per 100,000) and African (0.05 per 100,000) regions had the lowest densities. Among countries with training programs, LICs had the poorest availability of subspecialty training and resources such as cadaver laboratories and conference stipends for trainees. Training program accreditation processes were more common in HICs (81.8%) than in low- and middle-income countries (LMICs; 69.2%) with training programs. CONCLUSIONS The authors estimate that there are at least 1261 neurosurgery training programs with 10,546 total trainees worldwide. The density of neurosurgery trainees was disproportionately higher in HICs than LMICs, and the WHO European and Americas regions had the highest trainee densities. The trainee workforce in LICs had the poorest access to subspecialty training and advanced resources.

Use of Guideline-Recommended Heart Failure Drugs in High-, Middle-, and Low-Income Countries: A Systematic Review and Meta-Analysis.

Optimal use of guideline-directed medical therapy (GDMT) can prevent hospitalization and mortality among patients with heart failure (HF). We aimed to assess the prevalence of GDMT use for HF across geographic regions and country-income levels. We systematically reviewed observational studies (published between January 2010 and October 2020) involving patients with HF with reduced ejection fraction. We conducted random-effects meta-analyses to obtain summary estimates. We included 334 studies comprising 1,507,849 patients (31% female). The majority (82%) of studies were from high-income countries, with Europe (45%) and the Americas (33%) being the most represented regions, and Africa (1%) being the least. Overall prevalence of GDMT use was 80% (95% CI 78%-81%) for β-blockers, 82% (80%-83%) for renin-angiotensin-system inhibitors, and 41% (39%-43%) for mineralocorticoid receptor antagonists. We observed an exponential increase in GDMT use over time after adjusting for country-income levels (p < 0.0001), but significant gaps persist in low- and middle-income countries. Multi-level interventions are needed to address health-system, provider, and patient-level barriers to GDMT use.

Factors of Energy Transition of Manufacturing Companies Regarding their Inclusion in Global Value Chains

Environmental problems, the results of structural changes in the world economy and technological progress set forth the task of finding factors that stimulate the transition from the continuous growth of energy consumption to decarbonization and energy transition. The aim of the article is to empirically analyze the factors of companies' energy transition policies in different countries of the world, considering the functioning of global value chains (GVCs). The database is sourced from a survey of representatives of more than 15,000 manufacturing companies conducted by the World Bank Group in 2018-20 in 40 countries. The novelty of the analytical research framework proposed in the paper lies in the integrated presentation of factors which are external and internal to firms that influence decisions on energy transition policies and strategies. Descriptive statistics and econometric modeling revealed the presence of energy efficiency and energy transition policy elements in more than 2/3 of the sampled companies with a focus on energy efficiency, reflecting a desire to reduce related costs. Firms' use of fossil fuels is a driver of energy transition. Two alternative energy transition strategies of firms are found: the first emphasizes energy efficiency plans and actions, while the second involves a shift to carbon neutrality. High country income levels deter firms from energy efficiency decisions but incentivize the implementation of carbon emission reduction strategies. The level of environmental efficiency of countries has a positive impact on the "immersion" of their companies in the energy transition agenda. Companies' participation in the GVCs is generally positively associated with the presence of energy efficiency and energy transition policy elements. Government tax regulation and consumer demand are important factors in companies' commitment to energy efficiency and energy transition policies. Signs of the diffusion of incentives to implement energy transition policies along production chains are also identified. The results can be used in the development of industrial policy.

What is the coverage of retina screening services for people with diabetes? Protocol for a systematic review and meta-analysis

IntroductionDiabetic retinopathy is a leading cause of vision impairment globally. Vision loss from diabetic retinopathy can generally be prevented by early detection and timely treatment. The WHO included a measure...

재정분권이 공공부문 성과에 미치는 영향 분석

This study empirically analyzes the impact of fiscal decentralization on public sector performance, focusing on national competitiveness and government efficiency. It also explores whether the effects of fiscal decentralization on public sector performance differ based on the income level of countries. This study uses a panel dataset of 25 OECD member countries, covering the period from 2001-2020. The results show that fiscal decentralization improves national competitiveness and government efficiency. Moreover, the impact of revenue decentralization on public sector performance is larger than expenditure decentralization. Finally, the impact of fiscal decentralization on national competitiveness and government efficiency varies depending on the national income level. It is also found that the impact of fiscal decentralization on public sector performance is insignificant among 13 countries with a GDP per capita of less than $40,000.

Trade between China and 45 African countries: does the Gravity Model matter?

The population of Africa and that of China put together amounts to a little over one-third of the world's total. The theoretical justification of the gravity model is applied to analyze the factors influencing bilateral trade between China and African countries using the panel data regression technique, covering the period between 2002 and 2021 and with special consideration for the income level of the African countries. Empirical results and estimates reveal that the economic size as well as the population of trade partners positively affect China’s trade with 45 African countries. The positive impact that distance has on trade is inconsistent with previous research. We conclude from the analysis that the factors affecting trade between China and African countries are, namely, the size of the population, the economic size represented by the GDP, and the distance between the countries. The indication of effects on the trade sector is important, and the sensitivity of the potential product to distance and countries varies considerably, giving a revealed comparative advantage. African countries should diversify their exports and improve their trade diplomacy.

The Effects of Employee Recognition, Pay, and Benefits on Job Satisfaction: Cross Country Analysis of Pakistan, China and Saudi Arabia

This paper analyzes the effect of employee recognition, pay, and benefits on job satisfaction. In this cross-sectional study, survey responses from university students in the Pakistan (n = 450), China (n = 340) and Saudi Arabia (n = 399) were analyzed. Employee recognition, pay, and benefits were found to have a significant impact on job satisfaction, regardless of home country income level (high, middle or low income) and culture (collectivist or individualist). However, the effect of benefits on job satisfaction was significantly more important for China. respondents than for respondents from Pakistan and Saudi Arabia. The authors conclude that both financial and nonfinancial rewards have a role in influencing job satisfaction, which ultimately impacts employee performance. Theoretical and practical implications for developing effective recruitment and retention policies for employees are also discussed.

FORMATION OF A NEW PARADIGM OF GLOBAL POLITICAL AND MIGRATION PROCESSES UNDER THE INFLUENCE OF MILITARY ACTIVITIES IN UKRAINE

The events of February 2022, related to the military aggression of the Russian Federation and a full-scale attack on Ukraine, became the greatest catastrophe of the XXI century and the most brutal war on European soil since the World War II, and is gradually being defined as the World War III in terms of its impact on global political and economic relations and the use of military weaponry. Although no final assessment can be made (the war is ongoing), the undeniable consequence of Russia's aggression has been the disruption of the world order built after World War II and the risk of global chaos. One of the most powerful consequences of the war was an unprecedented wave of Ukrainian migration, the lion's share of which took place in Europe. While European countries, faced with an unprecedented influx of refugees, are withstanding the socio-economic burden with dignity, Ukraine is in fact in a demographic catastrophe. The wave of forced migration coincided with long-term demographic problems: a decline in the birth rate, an increase in the number of middle-aged people, and the outflow of population during the war. All these processes will have a steady impact on global migration and political processes. New instruments of state and global regulation of these processes will be required. They will also require the formation of a new paradigm of global economic development. The purpose of the study is to deepen the research on identifying and assessing the preconditions and consequences of migration processes in the world under the influence of military operations in Ukraine. The paper examines the impact of migration processes on globalisation and economic processes in Europe and the world; the dynamics of the share of labour migrants in the total labour force by income level of destination countries in 2013, 2017, 2020; the peculiarities of the migration wave of Ukrainians evacuated due to the military aggression of the Russian Federation in 2022. generalised statistical information on the migration processes of Ukrainians in the period 01.02.2023-21.06.2023; detailed statistical data on the number of Ukrainian citizens abroad (as of 01.02.2023) by migrant countries; political and socio-cultural context of the formation of a new paradigm of migration processes. The full implications for Ukrainian migration will be summarised after the war is over, but the following interim conclusions are relevant today. Results. The analysis of migration processes in the world and Europe in the current context suggests that migration is actively taking place and contributes to the development of international integration, as it reduces the number of barriers and increases opportunities. The war in Ukraine will have a significant impact on the economy in terms of the following effects: disruption of global supply chains, increased inflationary pressures, higher energy and raw material prices; food prices will also rise as supplies of wheat and grain from Russia and Ukraine are disrupted; higher energy and commodity prices will cause further inflation, deterioration of economic prospects, reduced confidence and increased financial market risk associated with greater geopolitical tensions; worsening food security in some developing countries in the Middle East and Africa. On the other hand, migration is currently seen as a tool for long-term growth in the EU. The analysis shows that migration provides significant economic benefits, primarily to host countries. Currently, the EU is facing a growing shortage of skilled labour due to unfavourable demographic trends in Europe. Given the massive emigration of Ukrainian citizens to the EU, migrants are solving the problem of staff shortages. Considering that the emigration of Ukrainians provides for adequate social protection and legal support, which guarantees the right to settlement, work and education. The right to employment is readily exercised by Ukrainian migrants, as they are largely people of working age, primarily women. Conclusion. In general, it can be argued that the prospects for regional migration are currently linked to many factors and very uncertain prospects for a return to the pre-2022 or pre-pandemic EaP models. The war in Ukraine is already turning into a protracted conflict that will threaten both the economic situation of millions of people and the hopes of temporarily displaced Ukrainians to return home for a long time. As a result, displaced Ukrainians, the EU host countries and the Ukrainian government will have to deal with the new circumstances, adapting temporary modalities to longer-term solutions.

Geographic Representation of Authorship in Ophthalmic Research from Low- and Middle-Income Countries

ABSTRACT Purpose Low- and middle-income countries (LMICs) are underrepresented in ophthalmic research, despite carrying the highest burden of visual impairment. To assess the representation of local authors in global ophthalmic research, this cross-sectional, bibliometric analysis measured the proportion of LMIC-affiliated authorship in LMIC-based ophthalmic research. Methods We sampled original, primary research conducted in LMICs and published in 1 of 7 high-impact ophthalmic journals between 2017 and 2021. For each article, we extracted the number and name of country study site(s), country affiliation(s) of first and last author, proportion of LMIC-affiliated authors, funding sources, and study design. Results Of the 1,333 studies exclusively conducted in LMICs, 89.4% of first authors and 80.6% of last authors were exclusively LMIC-affiliated. Representation of LMIC-affiliated first authors were lower in studies based in low-income countries (25.0%) or in sub-Saharan Africa (26.5%), published in journals with higher impact factors (68.0% in Ophthalmology), funded by high-income countries (HICs) (41.4%), or conducted in both LMICs and HICs (27.1%). The United States, United Kingdom, and Australia had the 3rd, 6th, and 8th largest shares of last authors. There were only 12 single-country studies conducted in low-income countries, namely Ethiopia, the Gambia, Guinea, Liberia, the Niger, and Sierra Leone. Of these countries, only three held first authorship and one held last authorship. Conclusions Although LMIC-based ophthalmic research has demonstrated higher local authorship representation compared to other fields, underrepresentation can be exacerbated by country income level, journal “prestige,” and degree of HIC involvement. These discrepancies highlight the need for more equitable data ownership in global ophthalmic research.

Analyzing market power of the agricultural industry in Asia

The study of market power in the primary foods industry is of high interest to policymakers seeking to help develop low-income countries, due to its potential source to create market inefficiencies and hamper economic development. Recent studies have provided ample empirical evidence, that market power has been increasing nearly continuously since the 1980s. Nevertheless, due to the (un)availability of firm-level data, most research is constrained to analyzing firms within industries of a few high-income with a particular focus on manufacturing and service sectors. This paper proposes to remedy this gap in the literature by using aggregate data contained within the Eora Input-Output Tables and a procedure based on Generalized Maximum Entropy to provide estimates of the markup for the primary foods industry (defined as the agriculture, hunting, logging and fishing industries) for 43 countries in Asia. We document a large heterogeneity based on a country's income level classification. Furthermore, measures of globalization are seen to significantly reduce markups. Opening up to trade might therefore be an attractive option to policymakers seeking to stimulate economic efficiency.

Understanding household-level risk factors for zero dose immunization in 82 low- and middle-income countries.

In 2021, an estimated 18 million children did not receive a single dose of routine vaccinations and constitute the population known as zero dose children. There is growing momentum and investment in reaching zero dose children and addressing the gross inequity in the reach of immunization services. To effectively do so, there is an urgent need to characterize more deeply the population of zero dose children and the barriers they face in accessing routine immunization services. We utilized the most recent DHS and MICS data spanning 2011 to 2020 from low, lower-middle, and upper-middle income countries. Zero dose status was defined as children aged 12-23 months who had not received any doses of BCG, DTP-containing, polio, and measles-containing vaccines. We estimated the prevalence of zero-dose children in the entire study sample, by country income level, and by region, and characterized the zero dose population by household-level factors. Multivariate logistic regressions were used to determine the household-level sociodemographic and health care access factors associated with zero dose immunization status. To pool multicountry data, we adjusted the original survey weights according to the country's population of children 12-23 months of age. To contextualize our findings, we utilized United Nations Population Division birth cohort data to estimate the study population as a proportion of the global and country income group populations. We included a total of 82 countries in our univariate analyses and 68 countries in our multivariate model. Overall, 7.5% of the study population were zero dose children. More than half (51.9%) of this population was concentrated in African countries. Zero dose children were predominantly situated in rural areas (75.8%) and in households in the lowest two wealth quintiles (62.7%) and were born to mothers who completed fewer than four antenatal care (ANC) visits (66.5%) and had home births (58.5%). Yet, surprisingly, a considerable proportion of zero dose children's mothers did receive appropriate care during pregnancy (33.5% of zero dose children have mothers who received at least 4 ANC visits). When controlled for other factors, children had three times the odds (OR = 3.00, 95% CI: 2.72, 3.30) of being zero dose if their mother had not received any tetanus injections, 2.46 times the odds (95% CI: 2.21, 2.74) of being zero dose if their mother had not received any ANC visits, and had nearly twice the odds (OR = 1.87, 95% CI: 1.70, 2.05) of being zero dose if their mother had a home delivery, compared to children of mothers who received at least 2 tetanus injections, received at least 4 ANC visits, and had a facility delivery, respectively. A lack of access to maternal health care was a strong risk factor of zero dose status and highlights important opportunities to improve the quality and integration of maternal and child health programs. Additionally, because a substantial proportion of zero dose children and their mothers do receive appropriate care, approaches to reach zero dose children should incorporate mitigating missed opportunities for vaccination.

Food security in the world: Disparities and opportunities by country income levels

Food security in the world: Disparities and opportunities by country income levels