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Adhvaryu A, Bharadwaj P, Fenske J, Nyshadham A, Stanley R. Dust and Death: Evidence from the West African Harmattan. ECONOMIC JOURNAL (LONDON, ENGLAND) 2024; 134:885-912. [PMID: 38505244 PMCID: PMC10945368 DOI: 10.1093/ej/uead088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 10/20/2023] [Indexed: 03/21/2024]
Abstract
Using two decades of data from 12 low-income countries in West Africa, we show that dust carried by harmattan trade winds increases infant and child mortality. Health investments respond to dust exposure, consistent with compensating behaviours. Despite these efforts, surviving children still exhibit negative health impacts. Our data allow us to investigate differential impacts over time and across countries. We find declining impacts over time, suggesting adaptation. Using national-level measures of macroeconomic conditions and health resources, we find suggestive evidence that both economic development and public health improvements have contributed to this adaptation, with health improvements playing a larger role.
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Meierrieks D, Schaub M. Terrorism and child mortality. HEALTH ECONOMICS 2024; 33:21-40. [PMID: 37717244 DOI: 10.1002/hec.4757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 09/19/2023]
Abstract
How does terrorism affect child mortality? We use geo-coded data on terrorism and spatially disaggregated data on child mortality to study the relationship between both variables for 52 African countries between 2000 and 2017 at the 0.5 × 0.5° grid level. Our estimates suggest that moderate increases in terrorism are linked to several thousand additional annual deaths of children under the age of five. A panel event-study points to economic effects that are larger and compound over time. Interrogating our data, we show that the direct impact of terrorism tends to be very small. Instead, we theorize that terrorism causes child mortality primarily by triggering adverse behavioral responses by parents, medical workers, and policymakers. We provide tentative evidence in support of this argument.
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Affiliation(s)
| | - Max Schaub
- WZB Berlin Social Science Center, Berlin, Germany
- University of Hamburg, Hamburg, Germany
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Tsadik M, Gebretnsae H, Ayalew A, Asgedom AA, Gebreyesus A, Hagos T, Abrha M, Weldegerima K, Abrha B, Gebre G, Hagos M, Esayas R, Gebregeorgis M, Gesesew HA, Mulugeta A. Child health services and armed conflict in Tigray, North Ethiopia: a community-based study. Confl Health 2023; 17:47. [PMID: 37798759 PMCID: PMC10557173 DOI: 10.1186/s13031-023-00545-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 09/26/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Access to basic health services, notably child health services, is severely hampered by the armed conflict in Tigray, North Ethiopia. Little is known regarding the impacts of the armed conflict during the war in Tigray on access to child health services. The current study investigates the impact of the armed conflict on the utilization of child health services in Tigray. METHODS 4,381 caregivers from randomly recruited households (HHs) with at least one child younger than 1 year old participated in a community-based cross-sectional survey. We collected data on childhood immunizations and illness-related treatment seeking from August 4 to 20, 2021. We describe data using frequency and percentage and carry out an internal comparison among the study participants using chi-square tests. RESULTS 4,381 children under the age of one included in the study. In total, 39% of infants received no basic vaccines, 61.3% of the children under the age of one received at least one vaccine, and 20% received all the vaccinations recommended for their age. About 61% of children were affected by at least one childhood ailments where majority of them were from rural areas. Mothers who did not seek postnatal care (PNC) were responsible for more than 75% of reported childhood illnesses. CONCLUSIONS A sizable portion of children were unvaccinated and had at least one childhood sickness while the war was in progress. Particularly, people who live in rural areas reported a higher percentage of children's illnesses but a lower use of child health services. To lower childhood morbidity and mortality in the besieged area, such as Tigray, local to global actors need to get coordinated and warrying parties should stop weaponization of vaccination healthcare services.
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Affiliation(s)
- Mache Tsadik
- School of Public Health, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | | | - Asefa Ayalew
- School of Public Health, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Akeza Awealom Asgedom
- School of Public Health, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Aregawi Gebreyesus
- School of Public Health, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Tigist Hagos
- School of Public Health, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Marta Abrha
- School of Medicine, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Kiros Weldegerima
- School of Medicine, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Birikti Abrha
- School of Midwifery, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Gelawdiwos Gebre
- School of Midwifery, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Mulubrhan Hagos
- School of Midwifery, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
| | - Rie Esayas
- Tigray Regional Health Bureau, Tigray, 07, Ethiopia
| | | | - Hailay Abrha Gesesew
- School of Public Health, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia.
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, SA, 5000, Australia.
| | - Afework Mulugeta
- School of Public Health, College of Health Sciences, Mekelle University, Tigray, 231, Ethiopia
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Conte B, Piemontese L, Tapsoba A. The power of markets: Impact of desert locust invasions on child health. JOURNAL OF HEALTH ECONOMICS 2023; 87:102712. [PMID: 36528913 DOI: 10.1016/j.jhealeco.2022.102712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 11/19/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
This paper investigates the consequences of the 2004 locust plague in Mali. We argue that in agricultural economies with a single harvest per year, this type of shock can affect households through two channels: first, a speculative/anticipatory effect that kicks in during the growing season, followed by a local crop failure effect after harvest. We document a substantial impact of the plague on crop price inflation before the harvest. Regarding health setbacks, children subject only to the speculative/anticipatory effect suffered as much as those exposed to the actual crop failure effect. The latter is more severe for children born in isolated areas.
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Affiliation(s)
- Bruno Conte
- Università di Bologna, P. Scaravilli 2, 40126, BO, Italy.
| | | | - Augustin Tapsoba
- Toulouse School of Economics, University of Toulouse-Capitole, 1 Esplanade de l'Université, 31080, Toulouse, Cedex 06, France.
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Tavares W, Morais J, Martins JF, Scalsky RJ, Stabler TC, Medeiros MM, Fortes FJ, Arez AP, Silva JC. Malaria in Angola: recent progress, challenges and future opportunities using parasite demography studies. Malar J 2022; 21:396. [PMID: 36577996 PMCID: PMC9795141 DOI: 10.1186/s12936-022-04424-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022] Open
Abstract
Over the past two decades, a considerable expansion of malaria interventions has occurred at the national level in Angola, together with cross-border initiatives and regional efforts in southern Africa. Currently, Angola aims to consolidate malaria control and to accelerate the transition from control to pre-elimination, along with other country members of the Elimination 8 initiative. However, the tremendous heterogeneity in malaria prevalence among Angolan provinces, as well as internal population movements and migration across borders, represent major challenges for the Angolan National Malaria Control Programme. This review aims to contribute to the understanding of factors underlying the complex malaria situation in Angola and to encourage future research studies on transmission dynamics and population structure of Plasmodium falciparum, important areas to complement host epidemiological information and to help reenergize the goal of malaria elimination in the country.
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Affiliation(s)
- Wilson Tavares
- grid.10772.330000000121511713Global Health and Tropical Medicine, GHTM, Instituto de Higiene E Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal
| | - Joana Morais
- Instituto Nacional de Investigação Em Saúde, INIS, Luanda, Angola
| | - José F. Martins
- Programa Nacional de Controlo da Malária, PNCM, Luanda, Angola
| | - Ryan J. Scalsky
- grid.411024.20000 0001 2175 4264Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, USA
| | - Thomas C. Stabler
- grid.416786.a0000 0004 0587 0574Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, Basel, Switzerland
| | - Márcia M. Medeiros
- grid.10772.330000000121511713Global Health and Tropical Medicine, GHTM, Instituto de Higiene E Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal
| | - Filomeno J. Fortes
- grid.10772.330000000121511713Global Health and Tropical Medicine, GHTM, Instituto de Higiene E Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal
| | - Ana Paula Arez
- grid.10772.330000000121511713Global Health and Tropical Medicine, GHTM, Instituto de Higiene E Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal
| | - Joana C. Silva
- grid.411024.20000 0001 2175 4264Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, USA ,grid.411024.20000 0001 2175 4264Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, USA
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Ritter PI, Sanchez RA. The effects of an epidemic on prenatal investments, childhood mortality and health of surviving children. JOURNAL OF POPULATION ECONOMICS 2022; 36:505-544. [PMID: 35378850 PMCID: PMC8968331 DOI: 10.1007/s00148-022-00886-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/17/2021] [Indexed: 06/14/2023]
Abstract
The potential death toll from an epidemic is larger than the number of deaths directly associated with the infection. In this study, we find that prenatal exposure to a cholera epidemic in Peru increased childhood mortality and that surviving children were more likely to be underweight and to suffer from diarrhea. We further find that a significant part of this mortality happened during the first day of life, and that prenatal exposure to cholera decreased prenatal care and institutional deliveries, suggesting that the mortality and possibly other longer-term effects were partially driven by a reduction in prenatal investments.
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Bwirire D, Crutzen R, Ntabe Namegabe E, Letschert R, de Vries N. Health inequalities in post-conflict settings: A systematic review. PLoS One 2022; 17:e0265038. [PMID: 35286351 PMCID: PMC8920275 DOI: 10.1371/journal.pone.0265038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 02/23/2022] [Indexed: 11/18/2022] Open
Abstract
Conflict can be a primary driver of health inequalities, but its impact on the distribution of social determinants of health is not very well documented. Also, there is limited evidence on the most suitable approaches aiming at addressing health inequalities in post-conflict settings. Thus, we undertook a systematic review of the literature concerning the current knowledge and knowledge gaps about structural determinants of health inequalities and assessed the effects of approaches aimed at addressing health inequalities in post-conflict settings. We performed a systematic search in bibliographic databases such as Web of Science, PubMed, and PsycINFO for relevant publications, as well as institutional websites that are relevant to this topic. The search was initiated in March 2018 and ultimately updated in December 2020. No time or geographical restrictions were applied. The quality of each study included in this review was independently assessed using criteria developed by CASP to assess all study types. Sixty-two articles were deemed eligible for analysis. The key findings were captured by the most vulnerable population groups, including the civilian population, women, children, internally displaced persons (IDPs), and people with symptoms of mental illness. A considerable range of approaches has been used to address health inequalities in post-conflict settings. These approaches include those used to address structural determinants of health inequalities which are accountable for the association between poverty, education, and health inequalities, the association between human rights and health inequalities, and the association between health inequalities and healthcare utilization patterns. However, these approaches may not be the most applicable in this environment. Given the multifactorial characteristics of health inequalities, it is important to work with the beneficiaries in developing a multi-sector approach and a strategy targeting long-term impacts by decision-makers at various levels. When addressing health inequalities in post-conflict settings, it may be best to combine approaches at different stages of the recovery process.
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Affiliation(s)
- Dieudonne Bwirire
- Faculty of Health, Medicine and Life Science, Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Rik Crutzen
- Faculty of Health, Medicine and Life Science, Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Edmond Ntabe Namegabe
- Faculté de Santé et Développement Communautaires, Université Libre des Pays des Grands Lacs (ULPGL), Goma, Democratic Republic of the Congo
| | | | - Nanne de Vries
- Faculty of Health, Medicine and Life Science, Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
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Rodríguez L. Violence and newborn health: Estimates for Colombia. HEALTH ECONOMICS 2022; 31:112-136. [PMID: 34655149 DOI: 10.1002/hec.4445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 08/03/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
This paper examines the relationship between maternal exposure to violence during pregnancy and newborn birthweight. The identification strategy exploits variation in the timing of exposure and in the geographic location of expectant mothers across Colombian municipalities. Exposure to violence in early pregnancy had a large negative impact on birthweight, primarily for boys, and the effect was mitigated by their mothers' education. Girls' birthweight was affected mainly by shocks in later stages of gestation. Furthermore, their mothers were more likely to engage in potentially harmful behaviors during the pregnancy. This evidence exposes the importance of parental responses in shaping the effect of exposure to violence on newborn health.
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Affiliation(s)
- Laura Rodríguez
- World Bank Poverty and Equity Global Practice, Washington, District of Columbia, USA
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