Adolescence and young adulthood offer opportunities for health gains both through prevention and early clinical intervention. Yet development of health information systems to support this work has ...been weak and so far lagged behind those for early childhood and adulthood. With falls in the number of deaths in earlier childhood in many countries and a shifting emphasis to non-communicable disease risks, injuries, and mental health, there are good reasons to assess the present sources of health information for young people. We derive indicators from the conceptual framework for the Series on adolescent health and assess the available data to describe them. We selected indicators for their public health importance and their coverage of major health outcomes in young people, health risk behaviours and states, risk and protective factors, social role transitions relevant to health, and health service inputs. We then specify definitions that maximise international comparability. Even with this optimisation of data usage, only seven of the 25 indicators, covered at least 50% of the world's adolescents. The worst adolescent health profiles are in sub-Saharan Africa, with persisting high mortality from maternal and infectious causes. Risks for non-communicable diseases are spreading rapidly, with the highest rates of tobacco use and overweight, and lowest rates of physical activity, predominantly in adolescents living in low-income and middle-income countries. Even for present global health agendas, such as HIV infection and maternal mortality, data sources are incomplete for adolescents. We propose a series of steps that include better coordination and use of data collected across countries, greater harmonisation of school-based surveys, further development of strategies for socially marginalised youth, targeted research into the validity and use of these health indicators, advocating for adolescent-health information within new global health initiatives, and a recommendation that every country produce a regular report on the health of its adolescents.
While the living conditions of children and young people in the European Union have gained increasing recognition across the EU, the well-being of children is not monitored on the European level. ...Based on a rights-based, multi-dimensional understanding of child well-being we analyse data already available for the EU 25, using series data as well as comparative surveys of children and young people. We compare the performance of EU Member States on eight clusters with 23 domains and 51 indicators and give a picture of children's overall well-being in the European Union. The clusters are children's material situation, housing, health, subjective well-being, education, children's relationships, civic participation and risk and safety.
Background
More than half of the global population is not effectively covered by any type of social protection benefit and women's coverage lags behind. Most girls and boys living in low‐resource ...settings have no effective social protection coverage. Interest in these essential programmes in low and middle‐income settings is rising and in the context of the COVID‐19 pandemic the value of social protection for all has been undoubtedly confirmed. However, evidence on whether the impact of different social protection programmes (social assistance, social insurance and social care services and labour market programmes) differs by gender has not been consistently analysed. Evidence is needed on the structural and contextual factors that determine differential impacts. Questions remain as to whether programme outcomes vary according to intervention implementation and design.
Objectives
This systematic review aims to collect, appraise, and synthesise the evidence from available systematic reviews on the differential gender impacts of social protection programmes in low and middle‐income countries. It answers the following questions:
1.
What is known from systematic reviews on the gender‐differentiated impacts of social protection programmes in low and middle‐income countries?
2.
What is known from systematic reviews about the factors that determine these gender‐differentiated impacts?
3.
What is known from existing systematic reviews about design and implementation features of social protection programmes and their association with gender outcomes?
Search Methods
We searched for published and grey literature from 19 bibliographic databases and libraries. The search techniques used were subject searching, reference list checking, citation searching and expert consultations. All searches were conducted between 10 February and 1 March 2021 to retrieve systematic reviews published within the last 10 years with no language restrictions.
Selection Criteria
We included systematic reviews that synthesised evidence from qualitative, quantitative or mixed‐methods studies and analysed the outcomes of social protection programmes on women, men, girls, and boys with no age restrictions. The reviews included investigated one or more types of social protection programmes in low and middle‐income countries. We included systematic reviews that investigated the effects of social protection interventions on any outcomes within any of the following six core outcome areas of gender equality: economic security and empowerment, health, education, mental health and psychosocial wellbeing, safety and protection and voice and agency.
Data Collection and Analysis
A total of 6265 records were identified. After removing duplicates, 5250 records were screened independently and simultaneously by two reviewers based on title and and 298 full texts were assessed for eligibility. Another 48 records, identified through the initial scoping exercise, consultations with experts and citation searching, were also screened. The review includes 70 high to moderate quality systematic reviews, representing a total of 3289 studies from 121 countries. We extracted data on the following areas of interest: population, intervention, methodology, quality appraisal, and findings for each research question. We also extracted the pooled effect sizes of gender equality outcomes of meta‐analyses. The methodological quality of the included systematic reviews was assessed, and framework synthesis was used as the synthesis method. To estimate the degree of overlap, we created citation matrices and calculated the corrected covered area.
Main Results
Most reviews examined more than one type of social protection programme. The majority investigated social assistance programmes (77%, N = 54), 40% (N = 28) examined labour market programmes, 11% (N = 8) focused on social insurance interventions and 9% (N = 6) analysed social care interventions. Health was the most researched (e.g., maternal health; 70%, N = 49) outcome area, followed by economic security and empowerment (e.g., savings; 39%, N = 27) and education (e.g., school enrolment and attendance; 24%, N = 17). Five key findings were consistent across intervention and outcomes areas: (1) Although pre‐existing gender differences should be considered, social protection programmes tend to report higher impacts on women and girls in comparison to men and boys; (2) Women are more likely to save, invest and share the benefits of social protection but lack of family support is a key barrier to their participation and retention in programmes; (3) Social protection programmes with explicit objectives tend to demonstrate higher effects in comparison to social protection programmes without broad objectives; (4) While no reviews point to negative impacts of social protection programmes on women or men, adverse and unintended outcomes have been attributed to design and implementation features. However, there are no one‐size‐fits‐all approaches to design and implementation of social protection programmes and these features need to be gender‐responsive and adapted; and (5) Direct investment in individuals and families' needs to be accompanied by efforts to strengthen health, education, and child protection systems. Social assistance programmes may increase labour participation, savings, investments, the utilisation of health care services and contraception use among women, school enrolment among boys and girls and school attendance among girls. They reduce unintended pregnancies among young women, risky sexual behaviour, and symptoms of sexually transmitted infections among women. Social insurance programmes increase the utilisation of sexual, reproductive, and maternal health services, and knowledge of reproductive health; improve changes in attitudes towards family planning; increase rates of inclusive and early initiation of breastfeeding and decrease poor physical wellbeing among mothers. Labour market programmes increase labour participation among women receiving benefits, savings, ownership of assets, and earning capacity among young women. They improve knowledge and attitudes towards sexually transmitted infections, increase self‐reported condom use among boys and girls, increase child nutrition and overall household dietary intake, improve subjective wellbeing among women. Evidence on the impact of social care programmes on gender equality outcomes is needed.
Authors' Conclusions
Although effectiveness gaps remain, current programmatic interests are not matched by a rigorous evidence base demonstrating how to appropriately design and implement social protection interventions. Advancing current knowledge of gender‐responsive social protection entails moving beyond effectiveness studies to test packages or combinations of design and implementation features that determine the impact of these interventions on gender equality. Systematic reviews investigating the impact of social care programmes, old age pensions and parental leave on gender equality outcomes in low and middle‐income settings are needed. Voice and agency and mental health and psychosocial wellbeing remain under‐researched gender equality outcome areas.
This is the protocol for a Campbell review. The review aims to systematically collect, appraise, map and synthesise the evidence from systematic reviews on the differential gender impacts of social ...protection programmes in Low‐ and Middle‐Income Countries (LMICs). Therefore, it will answer the following questions: (1) What is known from systematic reviews on the gender‐differentiated impacts of social protection programmes in LMICs? (2) What is known from systematic reviews about the factors that determine these gender‐differentiated impacts? (3) What is known from existing systematic reviews about design and implementation features of social protection programmes and their association with gender outcomes?
Index of Child Well-Being in Europe Bradshaw, Jonathan; Richardson, Dominic
Child indicators research,
09/2009, Volume:
2, Issue:
3
Journal Article
Peer reviewed
This is a comparison of child well-being in the 27 countries of the European Union and Norway and Iceland. It is based on 43 indicators forming 19 components derived from administrative and survey ...data around 2006. It covers seven domains: health, subjective well-being, personal relationships, material resources, education, behaviour and risks, housing and the environment. Comparisons are made of countries performance on each of the domains and components. Overall child well-being is highest in the Netherlands which is also the only country to perform in the top third of countries across all domains. Child well-being is worst in the former Eastern bloc countries with the exception of Slovenia. Lithuania performs in the bottom third on all domains. The United Kingdom does notably badly given its level of national wealth. The index is subjected to sensitivity analysis and analysis is undertaken to explain variations in child well-being. We find that there are positive associations between child well-being and spending on family benefits and services and GDP per capita, a negative association with inequality and no association with the prevalence of 'broken' families.
At the beginning of 2008, a number of the world’s major economies began to experience the effects of the biggest economic financial crisis in history. By the end of that year, the financial crisis ...was a global recession, and governments responded with changes to a suite of social and economic policies. Two broad stages of government response are identifiable: a period of stimulus followed by a move towards austerity. This study views the crisis period from the perspective of children and family policies and assesses the justification for the changes in the economic context and in the context of the recommendations for spending on children outlined in Doing Better for Children (OECD, 2009) of early investment with a focus on at‐risk children. Across Europe, with few exceptions, child and family policies have more often than not avoided direct cuts; cash benefits are most often amended (and subject to temporary reduction in coverage or amounts); and (so far) during the crisis child and family policies continue to be advanced in many European countries.
Adolescence and young adulthood off er opportunities for health gains both through prevention and early clinical intervention. Yet development of health information systems to support this work has ...been weak and so far lagged behind those for early childhood and adulthood. With falls in the number of deaths in earlier childhood in many countries and a shifting emphasis to non-communicable disease risks, injuries, and mental health, there are good reasons to assess the present sources of health information for young people. We derive indicators from the conceptual framework for the Series on adolescent health and assess the available data to describe them. We selected indicators for their public health importance and their coverage of major health outcomes in young people, health risk behaviours and states, risk and protective factors, social role transitions relevant to health, and health service inputs. We then specify defi nitions that maximise international comparability. Even with this optimisation of data usage, only seven of the 25 indicators, covered at least 50% of the world's adolescents. The worst adolescent health profi les are in sub- Saharan Africa, with persisting high mortality from maternal and infectious causes. Risks for non-communicable diseases are spreading rapidly, with the highest rates of tobacco use and overweight, and lowest rates of physical activity, predominantly in adolescents living in low-income and middle-income countries. Even for present global health agendas, such as HIV infection and maternal mortality, data sources are incomplete for adolescents. We propose a series of steps that include better coordination and use of data collected across countries, greater harmonisation of school-based surveys, further development of strategies for socially marginalised youth, targeted research into the validity and use of these health indicators, advocating for adolescent-health information within new global health initiatives, and a recommendation that every country produce a regular report on the health of its adolescents. PUBLICATION ABSTRCT
Research Statement : With an increase in competition within the South African property sector, real estate agencies need to ensure that their channels are as effective as possible. Using the Internet ...and mobile technologies represents a new means to reach customers and achieve lower operating costs. This study seeks to ascertain which factors potential buyers consider important when perusing residential property in an online environment. Hence, the dimensions of e-service quality, which constitute their online experience, will be explored. In addition, this research explores buyer typologies and probes whether other forms of technology, such as a mobile interface, may be of commercial value to the realtor. Methodology : The empirical analysis was conducted by means of a quantitative survey. A questionnaire was designed to test the application of the e-service quality construct in the South African real-estate sector. Data was obtained from 300 respondents, across the age spectrum, who filled the criteria of being prospective buyers. Convenience sampling was primarily used to collect responses as the researchers were unable to obtain access to a specific database of listed property buyers. Results & Conclusion : As mirrored in other studies of this nature, it was found that trust is paramount when initiating property sales online. All other variables in the construct (site features, information, accessibility, communication, reliability, responsiveness and personalisation) also proved significant. A cluster analysis revealed that older respondents preferred a higher level of support - across all attributes of e-service quality - when interacting with online property services. Lastly, the mobile interface appears to appeal to 'students' as well as 'mature workers'. It is surmised that these individuals have access to smart phones capable of being used for accessing property portals. However, the 'young workers' appear less enthusiastic about the mobile interface, seemingly preferring to either access such portals via the Internet or visiting agents personally.
Acute kidney injury (AKI) is a common manifestation among patients critically ill with SARS-CoV-2 infection (Coronavirus 2019) and is associated with significant morbidity and mortality. The ...pathophysiology of renal failure in this context is not fully understood, but likely to be multifactorial. The intensive care unit outcomes of patients following COVID-19 acute critical illness with associated AKI have not been fully explored. We conducted a cohort study to investigate the risk factors for acute kidney injury in patients admitted to and intensive care unit with COVID-19, its incidence and associated outcomes.
We reviewed the medical records of all patients admitted to our adult intensive care unit suffering from SARS-CoV-2 infection from 14th March 2020 until 12th May 2020. Acute kidney injury was defined using the Kidney Disease Improving Global Outcome (KDIGO) criteria. The outcome analysis was assessed up to date as 3rd of September 2020.
A total of 81 patients admitted during this period. All patients had acute hypoxic respiratory failure and needed either noninvasive or invasive mechanical ventilatory support. Thirty-six patients (44%) had evidence of AKI (Stage I-33%, Stage II-22%, Renal Replacement Therapy (RRT)-44%). All patients with AKI stage III had RRT. Age, diabetes mellitus, immunosuppression, lymphopenia, high D-Dimer levels, increased APACHE II and SOFA scores, invasive mechanical ventilation and use of inotropic or vasopressor support were significantly associated with AKI. The peak AKI was at day 4 and mean duration of RRT was 12.5 days. The mortality was 25% for the AKI group compared to 6.7% in those without AKI. Among those received RRT and survived their illness, the renal function recovery is complete and back to baseline in all patients.
Acute kidney injury and renal replacement therapy is common in critically ill patients presenting with COVID-19. It is associated with increased severity of illness on admission to ICU, increased mortality and prolonged ICU and hospital length of stay. Recovery of renal function was complete in all survived patients.
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