Neighbourhood mothers' education and its differential impact on stunting: Evidence from 30 Sub-Saharan African countries.

The study used data from Demographic and Health Surveys for 30 Sub-Saharan African countries to investigate differences in the residential effects of mothers' education on stunting. Multilevel logistic regressions were employed to examine the neighbourhood effects of mothers' education on stunting. The study found that although a higher proportion of mothers with secondary education in a neighbourhood, irrespective of the residence type (rural or urban), reduces a child's probability of being stunted, this effect is stronger for children residing in rural areas than those in the urban. Achieving a target of at least 75 per cent of mothers obtaining secondary education and higher will bridge the rural-urban gap in stunting in Sub-Saharan Africa.

Comparative study of the effect of National Health Insurance Scheme on use of delivery and antenatal care services between rural and urban women in Ghana.

BACKGROUND: Despite the focus of the National Health Insurance Scheme (NHIS) to bridge healthcare utilisation gap among women in Ghana, recent evidence indicates that most maternal deaths still occur from rural Ghana. The objective of this study was to examine the rural-urban differences in the effects of NHIS enrolment on delivery care utilisation (place of delivery and assistance at delivery) and antenatal care services among Ghanaian women. METHODS: A nationally representative sample of 4169 women from the 2014 Ghana Demographic and Health Survey was used. Out of this sample, 2880 women are enrolled in the NHIS with 1229 and 1651 being urban and rural dwellers, respectively. Multivariate logistic and negative binomial models were fitted as the main estimation techniques. In addition, the Propensity Score Matching technique was used to verify rural-urban differences. RESULTS: At the national level, enrolment in NHIS was observed to increase delivery care utilisation and the number of ANC visits in Ghana. However, rural-urban differences in effects were pronounced: whereas rural women who are enrolled in the NHIS were more likely to utilise delivery care [delivery in a health facility (OR = 1.870; CI = 1.533-2.281) and assisted delivery by a medical professional (OR = 1.994; CI = 1.631-2.438)], and have a higher number of ANC visits (IRR = 1.158; CI = 1.110-1.208) than their counterparts who are not enrolled, urban women who are enrolled in the NHIS on the other hand, recorded statistically insignificant results compared to their counterparts not enrolled. The PSM results corroborated the rural-urban differences in effects. CONCLUSION: The rural-urban differences in delivery and antenatal care utilisation are in favour of rural women enrolled in the NHIS. Given that poverty is endemic in rural Ghana, this positions the NHIS as a potential social equaliser in maternal health care utilisation especially in the context of developing countries by increasing access to delivery care services and the number of ANC visits.

Effects of Parental Attitudes Toward Spousal Violence on Early Childhood Development and Learning Support Among Ghanaian Children.

The prevalence of condoning attitudes toward spousal violence (SV) is high in Ghana, yet much is not known about how the development of children is compromised in households where attitudes toward SV are tolerated. This study is premised on two objectives: (a) examination of the effect of parents condoning attitudes toward SV on early childhood development; and (b) investigation of the effect of parents condoning attitudes toward SV on the amount of learning support children receive from household members. Data on 2,740 children aged between 36 and 59 months were drawn from the 2011 Ghana Multiple Indicator Cluster Survey for the first objective and 1,595 households with children aged between 4 and 15 years were sourced from the 2014 Ghana Demographic and Health Survey for the second. Analytical methods employed are descriptive statistics, instrumental variable (IV), and ordinary least squares (OLS) micro-econometric estimation techniques. The findings suggest that parents who condone attitudes toward SV reduce early childhood development by 3.269 units. Compared with the physical and socioemotional domains, parents tolerating attitudes toward SV have the highest adverse effect on the literacy, numeracy, and learning development domain of early childhood development (2.916 units). In addition, households that accept attitudes toward SV reduce the amount of learning support offered to children by 0.261 units, and every additional attitude toward SV acceptance reduces child learning support by 0.079 units. Attitudes of parents toward condoning SV retard the early development of children, impair children's cognitive development, and compromise the amount of learning support children receive from household members. This study reinforces the evidence that parental attitudes are related to child outcomes in Ghana. The evidence calls for strengthening healthy family environments and child protection systems through behavioral change communication interventions and awareness creation among parents.

Policy Stringency, Handwashing and COVID-19 cases: Evidence from Global dataset.

Objective: : Since the COVID-19 pandemic, many governments globally have introduced policy measures to contain the spread of the virus. Popular COVID-19 containment measures include lockdowns of various forms (aggregated into government response stringency index [GRSI]) and handwashing (HWF). The effectiveness of these policy measures remains unclear in the academic literature. This study, therefore, examines the effect of government policy stringency and handwashing on total daily reported COVID-19 cases. Method: : We use a comprehensive dataset of 176 countries to investigate the effect of government policy stringency and handwashing on daily reported COVID-19 cases. In this study, we apply the Lewbel (2012) two-stage least squares technique to control endogeneity. Results: : Our results indicated that GRSI significantly contributes to the increase in the total and new confirmed cases of COVI-19. Sensitivity analyses revealed that the 1st, 4th, and 5th quintiles of GRIS significantly reduce total confirmed cases of COVID-19. Also, the result indicated that while the 1st quintile of GRIS contributes significantly to reducing the new confirmed cases of COVID-19, the 3rd, 4th, and 5th quintiles of GRSI contribute significantly to increasing the new confirmed cases of COVID-19. The results indicated that HWF reduces total and new confirmed cases of COVID-19; however, such effect is not robust to income and regional effects. Nonlinear analysis revealed that while GRSI has an inverted U-shaped relationship with total and new confirmed cases of COVID-19, HWF has a U-shaped relationship. Conclusion: : We suggest that policymakers should focus on raising awareness and full engagement of all members of society in implementing public health policies rather than using stringent lockdown measures.