Social science & medicine
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Social science & medicine · Nov 2013
Randomized Controlled TrialEffectiveness of a parenting program in Bangladesh to address early childhood health, growth and development.
A stratified cluster design was used to evaluate a 10-month parenting program delivered to mothers of children in rural Bangladesh. Intervention mothers through a combination of group meetings and home visits received messages along with an illustrative card concerning hygiene, responsive feeding, play, communication, gentle discipline, and nutritious foods. Control mothers received the standard government care. ⋯ Age effects were found only for dietary diversity in that younger children in the program benefited more than older ones. However, all children became more stunted. Findings are discussed in terms of theories of behaviour change and parenting, critical ages for parenting programs, and implications for program delivery.
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Social science & medicine · Nov 2013
Randomized Controlled TrialThe seven Cs of the high acceptability of home-based VCT: results from a mixed methods approach in Zambia.
HIV testing and counselling is a critical gateway to prevention and treatment. Yet, coverage remains insufficient, few couples are tested together and gender differences in access exist. We used an embedded mixed methods approach to investigate possible explanations for the high acceptance of home-based voluntary HIV counselling and testing (HB-VCT) in a pair-matched cluster-randomized trial in Zambia. ⋯ The high level of couple counselling within HB-VCT may contribute to closing the gender gap in HIV testing, and has benefits for both genders and potentially for prevention of HIV transmission. The study demonstrates the feasibility of achieving high test coverage with an opt-in consent approach. The embedded qualitative component confirmed the high satisfaction with HB-VCT reported in the quantitative survey and was crucial to fully understand the intervention and its consequences.
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Social science & medicine · Nov 2013
Subsidized childcare and child development in Colombia: effects of Hogares Comunitarios de Bienestar as a function of timing and length of exposure.
Rigorous evidence regarding the impact of early care and education on children's development comes primarily from high-income nations. A few studies from Latin America and the Caribbean have identified benefits of conditional cash transfer and home visiting programs on children's development. However, there is still controversy around the impact and cost-effectiveness of childcare approaches. ⋯ No significant gains were found for nutritional status. The estimated benefit-cost ratio ranged from 1.0 to 2.7, depending upon varying discount rates. Findings lend support for a potentially effective strategy to promote the development of low-income children in Colombia and other developing nations.
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Social science & medicine · Nov 2013
Meta AnalysisEffectiveness and equity impacts of town-wide cycling initiatives in England: a longitudinal, controlled natural experimental study.
Cycling confers health and environmental benefits, but few robust studies have evaluated large-scale programmes to promote cycling. In England, recent years have seen substantial, town-wide cycling initiatives in six Cycling Demonstration Towns (funded 2005-2011) and 12 Cycling Cities and Towns (funded 2008-2011). The initiatives involved mixtures of capital investment (e.g. cycle lanes) and revenue investment (e.g. cycle training), tailored to each town. ⋯ We conclude that to date, cycling to work has increased (and driving to work decreased) in the intervention towns, in a relatively equitable manner. The variation in effects between towns indicates uncertainty regarding the likely impact of comparable investment in future towns. Nevertheless these results support the case for implementing and evaluating further town-wide cycling initiatives.
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Social science & medicine · Nov 2013
Willingness to pay for voluntary community-based health insurance: findings from an exploratory study in the state of Penang, Malaysia.
Health care in Malaysia is funded primarily through taxation and is no longer sustainable. One funding option is voluntary community-based health insurance (VCHI), which provides insurance coverage for those who are unable to benefit immediately from either a social or private health insurance plan. This study is performed to assess the willingness of Malaysians to participate in a VCHI plan. ⋯ The results indicated that more than 63.1% of the respondents were willing to join and contribute an average of Int$114.38 per month per household towards VCHI. This amount was influenced by ethnicity, educational level, household monthly income, the presence of chronic disease and the presence of private insurance coverage (p < 0.05). In conclusion, our study findings suggest that most Malaysians are willing to join the proposed VCHI and to pay an average of Int$114.38 per month per household for the plan.