Monthly Household Expenditure Research Articles

ANALYSIS OF GROUNDWATER USE EFFICIENCY AND PRODUCTIVITY OF CROPS IN PAKISTAN: EVIDENCE FROM BALOCHISTAN PROVINCE

Balochistan is the largest province of Pakistan in terms of area, and most of its population depends on agriculture. It has an arid/semi-arid climate with frequent drought and dry spells. Almost half of the cultivated area is irrigated, and the primary source of irrigation is groundwater. Indus water available in Balochistan remains underutilized. Drought and tube well subsidy and other factors have resulted in over-exploited groundwater and unsustainable groundwater table. This situation affects agriculture, hence the livelihood of the residents. The study focused on analyzing the impact of using groundwater for irrigation on agricultural productivity and farmer’s livelihood in the Balochistan province of Pakistan. For this purpose, five villages were randomly selected from the district Quetta, where groundwater was the only source for irrigation. In each village, 20 farmers were interviewed through well-structured and pre-tested questionnaires. For each significant crop cultivated in the area, ‘Water Productivity’ was measured as Yield ⁄ Volume of water required in cubic meter/acre, ‘Crop Profitability’ was analyzed using ‘Benefit-Cost Ratio’ and ‘Impact of Groundwater Use on Gross Value Product’s was estimated using double log model. Results revealed that the net revenue generated from cropping was Rs. 32168 per month, whereas the monthly household expenditure of the farmers was Rs.33960, on average. Cropping alone cannot sustain the households’ livelihoods. With net income from livestock and non-farm income, farmers can meet their monthly household expenditure. Results of BCR show that all the crops are profitable, but this profitability is at the expense of over-fetching scarce groundwater. Wheat is the only crop with more than 1.19 kg/meter water productivity. Crops’ water productivity may decline if the water table keeps reducing. GVP of wheat and maize is negatively affected by the cost of groundwater. Cost sensitivity can be decreased if cost-efficient methods of irrigation are available. The government should regularize groundwater use through proper legislation and provide infrastructure/incentives for using other sources of water for irrigation as well. Availability of good quality seed to farmers should be ensured to enhance crop yield.

Factors affecting ability of TB patients to follow treatment guidelines – applying a capability approach

BackgroundNegotiating anti-Tuberculosis treatment is a complicated process comprising daily consumption of multiple medications at stipulated times and dosages, as well as periodic follow-ups and investigations, may not be uniform for all Tuberculosis (TB) patients and some may perform better than others. In this context, we conducted a study in Thiruvananthapuram district, Kerala to ascertain the ability of those suffering from TB to follow treatment guidelines.MethodsThis study used an embedded mixed methods design. We collected cross-sectional data from 135 drug sensitive pulmonary TB patients aged 18 years or above in Thiruvananthapuram, Kerala using a structured questionnaire to get the proportion of patients following all treatment guidelines. We also did eight in-depth interviews (four men and four women) from within the survey sample. The in-depth interviews were inductively analysed for getting deeper insights about reasons for the choices people made regarding the treatment guidelines. Written informed consent was taken from all participants and the study was implemented after the necessary programmatic and ethical clearances.ResultsOf the 105 men and 30 women studied, uninterrupted daily drug consumption was reported by 80 persons (59.3%, 95% Confidence Intervals (CI) 50.8-67.2%). Overall, 38 (28.2%, 95% CI 21.3%-36.3%) persons were able to follow all seven aspects of advised guidelines. Living in an extended/ joint family (Adjusted Odds ratio (AOR) 2.6, 95% CI 1.1-6.0), approximate monthly household expenditure of over rupees 13,500 (AOR 2.9, 95% CI 1.3–6.7) and no perceived delay in seeking initial care (AOR 3.2, 95% CI 1.2–8.7) were significantly associated with following all aspects of treatment guidelines. In-depth interviews revealed reflective treatment related behaviours were influenced by bodily experiences, moral perceptions, social construct of TB, programmatic factors and substance use. Sometimes behaviours were non-reflective also. Programmatic stress was on individual agency for changing behaviour but capability and opportunity for these were influenced social aspects like stigma, gender roles and poverty.ConclusionTB patients live amidst a syndemic of biomedical and social problems. These problems influence the capabilities and opportunities of such TB patients to follow treatment guidelines. Interventions should balance focus on individual agency and social abd economic factors.

Storage conditions, microbial quality, and transport costs of drinking water from alternative sources in a South African municipality.

Makana Local Municipality is located in the Eastern Cape Province of South Africa. The area is water-scarce and has been undergoing aridification in recent years, ie, there has been a 7-year long drought. At the same time, there has been a breakdown in provision of municipal services, such as drinking water, to the population since at least 2008. Mi-crobial water quality has been a result of this, and monitoring has been a challenge. Given the drought and the prob-lems with drinking water delivery, it was necessary to conduct this study to investigate the microbial quality of alterna-tive water resources that the Makana population can use during the municipal water outage. The microbial water quality of alternative sources of drinking water in the Makana Local Municipality was examined using the H2S test kit and enumeration of the fecal coliforms. Storage of the collected water was examined for potential factors influencing the microbial water quality of the alternative sources of drinking water. The costs of the water provision from the most suitable alternative sources of potable water were calculated. There was a general correlation between the H2S test kit results and the fecal coliform concentrations, with the latter values ranging from <0 to 23 ± 7 colony-forming units/100 mL. The bottled water from two retail outlets was provided the best alternative source of potable/drinking water, which is microbially safe, for the Makana population. If the consumption of the drinking water from an alternative source takes place within 24 hours of collection, then the Fairview spring could also be used as a source of drinking water for Maka-na residents. The total cost per 1 L of drinking water from alternative sources was estimated to be from 1.51 to 5.81 ZAR. Therefore, the maximum cost of daily provision of drinking water from alternative sources would account for a maximum of 0.88 percent of the monthly household expenditure in the middle-to-high-income household. However, the daily costs of such provision of drinking water would account for a maximum of 8.11 percent of the monthly household expenditure in the low-income household. Provision of the drinking water from the alternative sources would have a minor impact of the monthly ex-penditure in the middle-to-high-income households. However, it is likely that the low-income households would not be able to sustain their water supply from alternative sources for longer than 24 hours, during a municipal outage in the drinking water supply.

The crowding-out effect of sugar-sweetened beverages (SSBs) on household expenditure patterns in Bangladesh

BackgroundConsumption of sugar-sweetened beverages (SSBs) or sugary drinks may reduce or even eliminate the household income allocation for other essential commodities. Reducing expenditure for consumption of other household commodities is known as the crowding-out effect of SSB. We aimed to determine the crowding-out effect of SSB expenditure on other household commodities. In addition, we also identified the factors influencing the household's decision to purchase of SSBs.MethodsWe used the logistic regression (logit and multinomial logit models) and the Seemingly Unrelated Regression (SUR) models. In order to find the probability of a given change in the socio-demographic variables, we also estimated the average marginal effects from the logistic regression. In addition, we regressed the SUR model by gender differences. We used Household Income and Expenditure Survey (HIES) 2016 data to estimate our chosen econometric models. HIES is nationally representative data on the household level across the country and is conducted using a multistage random sampling method by covering 46,075 households.ResultsThe findings from the logit model describe that the greater proportion of male members, larger household size, household heads with higher education, profession, having a refrigerator, members living outside of the house, and households with higher income positively affect the decision of purchasing SSB. However, the determinants vary with the various types of SSB. The unadjusted crowding out effect shows that expenditure on SSB or sugar-added drinks crowds out the household expenditure on food, clothing, housing, and energy items. On the other hand, the adjusted crowding out effect crowds out the spending on housing, education, transportation, and social and state responsibilities.ConclusionAlthough the household expenditure on beverages and sugar-added drinks is still moderate (around 2% of monthly household expenditure), the increased spending on beverages and sugar-added drinks is a concern due to the displacement of household expenditure for basic commodities such as food, clothing, housing, education, and energy. Therefore, evidence-based policies to regulate the sale and consumption of SSB are required for a healthy nation.

Catastrophic Health Expenditure (CHE) among Cancer Population in a Middle Income Country with Universal Healthcare Financing.

The study investigated healthcare expenditure from the perspective of cancer patients, to determine the level of Catastrophic Health Expenditure (CHE) and its associated factors. This cross-sectional study was conducted in three Malaysian public hospitals namely Hospital Kuala Lumpur, Hospital Canselor Tuanku Muhriz and the National Cancer Institute using a multi-level sampling technique to recruit 630 respondents from February 2020 to February 2021. CHE was defined as incurring a monthly health expenditure of more than 10% of the total monthly household expenditure. A validated questionnaire was used to collect the relevant data. The CHE level was 54.4%. CHE was higher among patients of Indian ethnicity (P = 0.015), lower level education (P = 0.001), those unemployed (P < 0.001), lower income (P < 0.001), those in poverty (P < 0.001), those staying far from the hospital (P < 0.001), living in rural areas (P = 0.003), small household size (P = 0.029), moderate cancer duration (P = 0.030), received radiotherapy treatment (P < 0.001), had very frequent treatment (P < 0.001), and without a Guarantee Letter (GL) (P < 0.001). The regression analysis identified significant predictors of CHE as lower income aOR 18.63 (CI 5.71-60.78), middle income aOR 4.67 (CI 1.52-14.41), poverty income aOR 4.66 (CI 2.60-8.33), staying far from hospital aOR 2.62 (CI 1.58-4.34), chemotherapy aOR 3.70 (CI 2.01-6.82), radiotherapy aOR 2.99 (CI 1.37-6.57), combination chemo-radiotherapy aOR 4.99 (CI 1.48-16.87), health insurance aOR 3.99 (CI 2.31-6.90), without GL aOR 3.38 (CI 2.06-5.40), and without health financial aids aOR 2.94 (CI 1.24-6.96). CHE is related to various sociodemographic, economic, disease, treatment and presence of health insurance, GL and health financial aids variables in Malaysia.

Socioeconomic Conditions of Migrants and Non-Migrants in Haryana

Purpose : Internal migration is considered an essential factor that significantly affects the origin and destination areas in varying degrees depending upon the employment situation in the destination region and the characteristics of migrants themselves. Haryana has the highest per-capita income among the major states in India and witnessed increased mobility over the years due to its advanced agricultural base, highly developed industrial sector, and proximity to the National Capital Region. Therefore, the present study examined the socioeconomic conditions of migrants and non-migrants in Haryana. Methodology : The study is based on secondary as well as primary data. The survey was conducted in four districts randomly selected in the state. A total of 509 households were surveyed from June 2021–February 2022. A detailed questionnaire was used to collect information about the socioeconomic conditions of the migrants and non-migrants. The collected data were analyzed using appropriate statistical techniques. Findings : The results suggested that most migrants were male heads of households who moved for work/employment to provide better living conditions. There were wide variations among inter-state and intra-state migrants. The level of education was significantly lower among inter-state migrants compared to non-migrants and intra-state migrants. Most inter-state migrants’ heads of households were illiterate or literate up to the middle, employed as daily wage casual laborers working in the informal sector, and living in precarious conditions. Such workers generally suffered from low earnings, lack of stability, and durability of employment. The average monthly household income and expenditure of the inter-state migrant household were lower than that of the non-migrants. The reason for low per capita household consumption among inter-state migrant families was that some portion of their relatively low income was also repatriated to the point of origin. Practical Implications : The findings highlighted that inter-state migration plays an important role in developing the state’s economy by providing cheap and flexible labor ready to take up any work. Originality : This is the only study that attempted to examine the socioeconomic conditions of migrants in various districts of Haryana and their comparison with non-migrants.

Catastrophic pharmaceutical expenditure in patients with type 2 diabetes in Iran

ObjectivesThis study aimed to assess the financial burden of out-of-pocket (OOP) payments to purchase antidiabetic medicines for type 2 patients in Iran.MethodThe “budget share” and “capacity to pay” approaches were employed to assess the catastrophic pharmaceutical expenditures of antidiabetic medication therapies. The catastrophic thresholds were adjusted for pharmaceutical sectors. The data was 2019 monthly household expenditures in rural and urban areas, insurance coverages of antidiabetic medicines and patients' out-of-pocket (OOP) payments in 30-day treatment schedules.ResultsThe results show that expenditure on diabetes medication therapies in the form of mono-dual therapy and some cases triple oral therapies were not catastrophic even for rural households. Insulin puts patients at risk of catastrophic pharmaceutical expenditures when added to the treatment schedules, and lack of financial protection intensifies it. In general, the poorer households and those resistant to first-line treatments were at increased risk of catastrophic pharmaceutical expenditures. The number of treatments that put patients at risk of catastrophic pharmaceutical expenditure in "budget share" was higher than the "capacity to pay" approach.ConclusionsAssessing medication treatment affordability instead of a single medicine assessment is needed. Assessment could be done by utilizing a macro-level data approach and applying adjusted pharmaceutical sector threshold values. Considering the variation between treatment schedules that put patients at risk of catastrophic pharmaceutical expenditures, targeted pharmaceutical policies and reimbursement decisions are recommended to promote Universal Health Coverage (UHC) and to protect vulnerable populations from hardship.

Estimating the economic burden of typhoid in children and adults in Blantyre, Malawi: A costing cohort study.

Typhoid causes preventable death and disease. The World Health Organization recommends Typhoid Conjugate Vaccine for endemic countries, but introduction decisions depend on cost-effectiveness. We estimated household and healthcare economic burdens of typhoid in Blantyre, Malawi. In a prospective cohort of culture-confirmed typhoid cases at two primary- and a referral-level health facility, we collected direct medical, non-medical costs (2020 U.S. dollars) to healthcare provider, plus indirect costs to households. From July 2019-March 2020, of 109 cases, 63 (58%) were <15 years old, 44 (40%) were inpatients. Mean hospitalization length was 7.7 days (SD 4.1). For inpatients, mean total household and provider costs were $93.85 (95%CI: 68.87-118.84) and $296.52 (95%CI: 225.79-367.25), respectively. For outpatients, these costs were $19.05 (95%CI: 4.38-33.71) and $39.65 (95%CI: 33.93-45.39), respectively. Household costs were due mainly to direct non-medical and indirect costs, medical care was free. Catastrophic illness cost, defined as cost >40% of non-food monthly household expenditure, occurred in 48 (44%) households. Typhoid can be economically catastrophic for families, despite accessible free medical care. Typhoid is costly for government healthcare provision. These data make an economic case for TCV introduction in Malawi and the region and will be used to derive vaccine cost-effectiveness.

Host Identity and Consumption Behavior: Evidence from Rural–Urban Migrants in China

Rural–urban migrants significantly contribute to developing economy, whereas they face high housing prices, rare work opportunities and insufficient consumption. By stimulating the consumption of migrants, their happiness and life satisfaction can increase, regional consumption structural transformation can be stimulated, and economic growth can be boosted. By exploiting the data from the “China Migrants’ Dynamic Survey” (CMDS) conducted by the National Health and Family Planning Commission of China, this study explores the effect of rural–urban migrants’ host identity on their consumption. We measure host city identity by migrants’ sense of belonging in the city. Propensity score matching (PSM), instrumental variable methods (IV), and structural equation modeling (SEM) are adopted to tackle down the potential selection bias and endogeneity concerns. As indicated by the empirical results, host identity significantly impacts rural–urban migrants’ consumption, while regional cultural differences hinder migrants from forming host identity. Compared with those without a host identity, migrants with a host identity, the monthly household consumption increased by 4%, and savings decreased significantly by 1.7%. As revealed by the heterogeneity analysis, the host identity effects are significantly larger for migrants aged over 30 years or for those staying in big cities. The results of SEM show that a one-unit increase in the latent variable of identity will increase the consumption by 5.2%, and education, social insurance, and household registration have a significant effect not only on consumption but also on host identity. The findings of this paper contribute to a comprehensive understanding of the psychological and economic integration of migrants in cities and provide valuable suggestions for city managers and policymakers.

Response of China's electricity consumption to climate change using monthly household data.

Intensifying climate change significantly impacts residential electricity consumption, especially in developing countries, such as China, that are experiencing rapid income growth. By combining meteorological and monthly household consumption survey data, this study explores the response function of residential electricity consumption to temperature in China from a micro perspective. Future residential electricity demands and related CO2 emissions are then forecast under different climate scenarios. Overall, the response function is U-shaped, and one additional day above 34 °C will increase monthly residential electricity consumption by 2.11%. Global warming will more likely increase the electricity burden on low-income groups. There will be notable seasonal changes in electricity demand in the future, and the largest increase will occur in August. The total demand for residential electricity caused by temperature change will show a fluctuating growth trend, from 0.8% and 1% in 2025 to 2% and 2.9% in 2060 under the RCP4.5 scenario and RCP8.5 scenario, respectively; meanwhile, this demand will be accompanied by a cumulative increase in carbon dioxide emissions.

Risk factors related to psychological distress among elderly patients with cardiovascular disease.

Psychological distress is associated with poor prognosis in patients with cardiovascular disease (CVD). However, factors related to psychological distress in elderly patients with CVD are less understood. We aim to investigate the rate of psychological distress in elderly patients with CVD in comparison with that of patients without CVD and to examine the clinical, socio-economic, and lifestyle factors associated with this condition. Data from a nationwide population-based study in Japan of patients aged ≥60 years were extracted, and 1:1 propensity score matching was conducted of patients with and without CVD. Psychological distress was assessed using the K6 scale, on which a score ≥6 was defined as psychological distress. Of the 24 388 matched patients, the rate of psychological distress was significantly higher among patients with CVD compared with those without CVD (29.8 vs. 20.5%, P < 0.0001). The multivariate analysis revealed that female sex, comorbidities, except for hypertension, current smoking status, daily sleep duration of <6 vs. ≥8 h, home renter vs. owner, retired status, having a walking disability, and lower monthly household expenditure were independently associated with psychological distress. Walking disability was observed to be in greatest association with psychological distress (odds ratio 2.69, 95% confidence interval 2.46-2.93). Elderly patients with CVD were more likely to have psychological distress compared with those without CVD. Multiple factors, including clinical, socio-economic, and lifestyle variables, were associated with psychological distress. These analyses may help healthcare providers to identify high-risk patients with psychological distress in a population of older adults with CVD.

Financial Burden and Catastrophic Health Expenditure Associated with COVID-19 Hospitalizations in Kerala, South India.

IntroductionCatastrophic health expenditure during COVID-19 hospitalization has altered the economic picture of households, especially in low resource settings with high rates of COVID-19 infection. This study aimed to estimate the out of pocket (OOP) expenditure and the proportion of households that incurred catastrophic health expenditure due to COVID-19 hospitalization in Kerala, South India.Materials and MethodsA cross-sectional study was conducted among a representative sample of 155 COVID-19 hospitalized patients in Kottayam district over four months, using a pretested interview schedule. The direct medical and non-medical costs incurred by the study participants during hospitalization and the total monthly household expenditure were obtained from the respective COVID-19 affected households. Catastrophic health expenditure was defined as direct medical expenditure exceeding 40% of the household’s capacity to pay.ResultsFrom the study, median and mean OOP expenditure was obtained as USD 93.57 and USD 502.60 respectively. The study revealed that 49.7% of households had catastrophic health expenditure, with 32.9% having incurred distress financing. Multivariate analysis revealed being below poverty line, hospitalization in private healthcare facility, and presence of co-morbid conditions as significant determinants of catastrophic health expenditure.ConclusionHigh levels of catastrophic health expenditure and distress financing revealed by the study have unveiled major unaddressed challenges in the road to universal health coverage.

Malaysian household expenditure on tobacco: evidence from pooled cross-sectional quantile estimations

PurposeThis study aims to examine the factors associated with household expenditure share on tobacco at different ranges of the expenditure share among Malaysian households.Design/methodology/approachThe analyses were based on pooled cross-sectional data of the Malaysian Household Expenditure Survey. A quantile regression was used to estimate the differentials in the share of monthly household expenditure on tobacco across different socio-economic, demographic and household groups at the 0.1, 0.25, 0.5, 0.75 and 0.9 quantiles of the tobacco expenditure share.FindingsCharacteristics of household heads (age, gender, ethnicity, marital status, education level, employment status) and household location were significant factors. Households headed by individuals aged 29 years or less spent a bigger share of their expenditure on tobacco than those headed by individuals older than 59 years. Households with heads who were employed and had primary-level education devoted a greater share of their expenditure for tobacco than households with heads who were unemployed and had tertiary-level education. The corresponding differentials were between 0.2% and 2.3%.Practical implicationsThe results identify the target groups based on not only the socio-economic and demographic factors but also the distributional effects of tobacco expenditure share for the design of public policy to reduce the prevalence of smoking-induced illnesses.Originality/valueThis study represents new attempts to use pooled cross-sectional data and a quantile regression to take into account the heterogeneous tobacco expenditure behaviour according to different levels of tobacco spending among Malaysian households.

The Association Between Informal Caregiving and Poor Self-rated Health Among Ever-married Women in Japan: A Nationally Representative Survey.

BackgroundThe number of people providing informal caregiving, including dual care, which is the combination of child and nursing care, is increasing. Due to the burden of multiple responsibility, dual care could negatively affect the health of informal caregivers. Previous research has not studied the effects of combining different types of informal caregiving. Therefore, we examined, among Japanese women, 1) the association between types of informal caregiving and self-rated health (SRH), and 2) difference in this association according to caregivers’ socio-economic conditions.MethodsWe analyzed the nationally representative 2013 Comprehensive Survey of Living Conditions data of 104,171 women aged 20–59 years. The odds ratios (ORs) for poor SRH by type of informal caregiving (no care, childcare, nursing care, and dual care) were estimated using logistic regression. We also conducted sub-group analyses by socio-economic conditions (equivalent monthly household expenditure and educational attainment).ResultsCompared to the no care group, the adjusted ORs for poor SRH of the childcare, nursing-care, and dual care groups were 0.92 (95% confidence interval [CI], 0.88–0.97), 1.33 (95% CI, 1.21–1.47), and 1.42 (95% CI, 1.23–1.64), respectively. There was no extra risk arisen from combining childcare and nursing care. The sub-group analyses indicated that neither household expenditure nor educational attainment affected the association between caregiving type and poor SRH.ConclusionOur study found that informal nursing care and dual care impose a health burden on female caregivers, regardless of their socio-economic conditions. This highlights the importance of addressing the effects of informal caregiving on the health of women.

The paradox of food production, consumption, poverty and malnutrition in Tanzania: an ecological study design

Background: There have been claims amongst nutrition stakeholders in Tanzania that the food basket regions, are the regions most affected by stunting among children. However, this study could not find evidence that combines food production and stunting levels, to substantiate this claim. Therefore, this study aims to compare data on stunting, food production and consumption within administrative regions of the Tanzania mainland. Methods: The study used an ecological study design to show the relationship between stunting, poverty, food production and consumption across administrative regions in Tanzania. The study used data from three national wide surveys: 2017/2018 Household Budget Survey (HBS), Tanzania National Nutrition Survey (TNNS) 2018 and Agriculture Statistics for Food Security report 2018/2019. Results: The study showed that there is a positive relationship between the prevalence of stunting and food production (r=0.43, p=0.03), while there is a negative relationship between stunting and the level of both the average monthly household consumption expenditure (r = -0.48, p = 0.01) and average monthly household food consumption expenditure (r = -0.509, p = 0.01). It was further found that some regions which have higher levels of stunting such as Njombe, have the lowest level of basic need poverty. Conclusion: The study found a positive relationship between food production and the prevalence of stunting using data across regions in mainland Tanzania. This is an indication that regional food security may not entail nutrition security, hence a call for more advocacy on nutrition-sensitive agriculture.

Socioeconomic and Demographic Factors of household Expenditures: A Case Study of Southern Punjab (Pakistan)

Household expenditures are the main source of society's well-being and welfare. The examination of socioeconomic and demographic determinants of Household Expenditure in Southern Punjab is the major objective of the study. The primary data of 785 households is collected in Southern Punjab. The estimation analysis is based on the Ordinary Least Square (OLS) methodology. The age of household head, years of schooling, household size, Remittances, the value of assets, number of earners, distance of health center from household residence, the distance of the school from household residence have a positive effect on household monthly expenditures in Multan division, D.G Khan division, Bahawalpur division, and Southern Punjab. The households which belong to the informal sector have a negative relationship with monthly household expenditures in all three divisions and Southern Punjab. The association between the area of residence and monthly household expenditures is positive in all three divisions and Southern Punjab. The result shows that households living in urban areas of Southern Punjab have more expenditure as compared to rural areas. The presence of disease and household expenditures are negatively related to each other in Southern Punjab. Therefore, this study suggests that health facilities should provide at a large scale in various divisions of southern Punjab.

Exclusive Breastfeeding Protects Young Children from Stunting in a Low-Income Population: A Study from Eastern Indonesia.

The prevalence of stunting in young Indonesian children is the highest among countries belonging to the Association of Southeast Asian Nations (ASEAN). Breastfed children are reported to grow better than non-breastfed. The present study examined the protective effect of exclusive breastfeeding against stunting in children under two years old (CU2) and its interaction with monthly household expenditure. Secondary analyses were conducted based on a 2012 cross-sectional study including 408 children aged 6–24 months and their caregivers from 14 villages in rural Eastern Indonesia. Data on breastfeeding history, childcare, and household expenditures were collected using structured questionnaires. Focus Group Discussions (FGDs) were conducted in each village (n = 14). Nearly two-thirds (61%) of caregivers who identified as the biological mother exclusively breastfed their child at 6 months. Exclusively-breastfed CU2 from poorer households were 20% less likely to be stunted than their non-exclusively-breastfed peers. Further, exclusively-breastfed CU2 from wealthier households were 50% less likely to be stunted than non-exclusively-breastfed CU2 from poorer households. FGDs revealed that some mothers were unaware of the importance of recommended breastfeeding practices. Exclusive breastfeeding may protect low-income children against stunting. Health promotion to improve caregiver motivation to exclusively breastfeed is critical in the present setting and beyond.

How to Assess the Child Poverty and Distributional Impact of COVID-19 Using Household Budget Surveys: An Application Using Turkish Data

This study presents a methodology to predict the child poverty impact of COVID-19 that can be readily applied in other country contexts where similar household data are available—and illustrates this case using data from Turkey. Using Household Budget Survey 2018, the microsimulation model estimates the impact of labour income loss on household expenditures, considering that some types of jobs/sectors may be more vulnerable than others to the COVID-19 shock. Labour income loss is estimated to lead to reductions in monthly household expenditure using an income elasticity model, and expenditure-based child poverty is found to increase in Turkey by 4.9–9.3 percentage points (depending on shock severity) from a base level of 15.4%. Among the hypothetical cash transfer scenarios considered, the universal child grant for 0–17 years old children was found to have the highest child poverty reduction impact overall, while schemes targeting the bottom 20–30% of households are more cost-effective in terms of poverty reduction. The microsimulation model set out in this paper can be readily replicated in countries where similar Household Budget Surveys are available.

Socio-economic Factors Affecting Monthly Household Expenditure on Tuition for Advanced Level Students in Embilipitiya Educational Zone in Sri Lanka

School education as well as university education (up to undergraduate level) is mostly government-owned and free in Sri Lanka. However, the General Certificate of Education Advanced Level (G.C.E A/L) Examination has become a huge challenge for students as this is the only eligibility criterion for university entrance which is extremely competitive. Consequently, parents increasingly spend on getting private tuition for their children. This study investigates the socio-economic factors affecting monthly household expenditure on A/L students’ tuition. A stratified random sample of 200 out of 1160 students who sat for the A/L examination in 2019 in each subject stream: Arts, Biological Science, Commerce, Physical Science, and Technology in Embilipitiya educational zone of Rathnapura district in Sri Lanka was selected for the study. Based on the current literature and the Sri Lankan context related to the area of research, 11 factors were identified as the potential determinants of monthly tuition expenditure of Advanced Level students. Data were collected using a structured questionnaire. The multiple linear regression analysis performed in the study revealed that household income, total tuition hours, type of class, and subject stream are the major factors determining the monthly expenditure on private tuition classes. The finalized regression model including the above factors explains more than 71% of the variation in monthly tuition expenditure. Furthermore, the highest and the lowest median monthly tuition expenditures were observed for the students from Physical Science and Arts streams respectively. The findings of this research provide important insights to educators and policymakers while extending the limited current knowledge on private tuition in Sri Lanka.

Analysis of Poverty Status of Ebonyi State Farming Households

Poverty is a major menace in Nigeria. Therefore, the research centered on the analysis of poverty status of farming households in Ebonyi State. Multi stage and simple random sampling techniques were used to select 450 respondents for the study. Primary data were collected using electronic data capturing instrument containing the questionnaire and analyzed using descriptive statistics, Foster, Greer and Thorbeecke (FGT), and Logit regression model. The result from the study shows that 54% of the farming households in Ebonyi state were poor while 46% of them were not poor. The result further reveals that household size, dependency ratio, sex, monthly household expenditure, and farm size were the significant factors that influenced poverty status of Ebonyi state farming households. Therefore, government at the federal, state and local levels should consider socioeconomic characteristics of the farming households in the design and implementation of any poverty driven projects in order to improve their standard of living. Also, government at the various level, should consider embarking on programs to address the youth unemployment and aged members of the Nigerian society for these will reduce the dependency burden which have continued to increase the poverty level in farming households in Ebonyi state.