Can Reproductive Health Voucher Programs Improve Quality of Postnatal Care? A Quasi-Experimental Evaluation of Kenya’s Safe Motherhood Voucher Scheme

This study tests the group-level causal relationship between the expansion of Kenya’s Safe Motherhood voucher program and changes in quality of postnatal care (PNC) provided at voucher-contracted facilities. We compare facilities accredited since program inception in 2006 (phase I) and facilities accredited since 2010-2011 (phase II) relative to comparable non-voucher facilities. PNC quality is assessed using observed clinical content processes, as well as client-reported outcome measures. Two-tailed unpaired t-tests are used to identify differences in mean process quality scores and client-reported outcome measures, comparing changes between intervention and comparison groups at the 2010 and 2012 data collection periods. Difference-in-differences analysis is used to estimate the reproductive health (RH) voucher program’s causal effect on quality of care by exploiting group-level differences between voucher-accredited and non-accredited facilities in 2010 and 2012. Participation in the voucher scheme since 2006 significantly improves overall quality of postnatal care by 39% (p=0.02), where quality is defined as the observable processes or components of service provision that occur during a PNC consultation. Program participation since phase I is estimated to improve the quality of observed maternal postnatal care by 86% (p=0.02), with the largest quality improvements in counselling on family planning methods (IRR 5.0; p=0.01) and return to fertility (IRR 2.6; p=0.01). Despite improvements in maternal aspects of PNC, we find a high proportion of mothers who seek PNC are not being checked by any provider after delivery. Additional strategies will be necessary to standardize provision of packaged postnatal interventions to both mother and new-born. This study addresses an important gap in the existing RH literature by using a strong evaluation design to assess RH voucher program effectiveness on quality improvement

Influences on students’ attainment and progress in Key Stage 3: academic outcomes in English, Maths and Science in Year 9

The Effective Pre-school, Primary and Secondary Education Project (EPPSE) has investigated the academic and social-behavioural development of approximately 3,000 children from the age of 3+ years since 1997. This Research Brief focuses on the relationships between a range of individual student, family, home, pre-, primary and secondary school characteristics and students\u27 academic attainment in English, maths and science in Year 9 at secondary school (age 14). It compares the latest findings with those found for students\u27 attainment at younger ages. It also highlights the influences of secondary school on students\u27 attainment in the core curriculum areas and studies their academic progress across Key Stage 3 between the ages of 11 and 14

The association of cold weather and all-cause and cause-specific mortality in the island of Ireland between 1984 and 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.This article has been made available through the Brunel Open Access Publishing Fund.Background This study aimed to assess the relationship between cold temperature and daily mortality in the Republic of Ireland (ROI) and Northern Ireland (NI), and to explore any differences in the population responses between the two jurisdictions. Methods A time-stratified case-crossover approach was used to examine this relationship in two adult national populations, between 1984 and 2007. Daily mortality risk was examined in association with exposure to daily maximum temperatures on the same day and up to 6 weeks preceding death, during the winter (December-February) and cold period (October-March), using distributed lag models. Model stratification by age and gender assessed for modification of the cold weather-mortality relationship. Results In the ROI, the impact of cold weather in winter persisted up to 35 days, with a cumulative mortality increase for all-causes of 6.4% (95%CI=4.8%-7.9%) in relation to every 1oC drop in daily maximum temperature, similar increases for cardiovascular disease (CVD) and stroke, and twice as much for respiratory causes. In NI, these associations were less pronounced for CVD causes, and overall extended up to 28 days. Effects of cold weather on mortality increased with age in both jurisdictions, and some suggestive gender differences were observed. Conclusions The study findings indicated strong cold weather-mortality associations in the island of Ireland; these effects were less persistent, and for CVD mortality, smaller in NI than in the ROI. Together with suggestive differences in associations by age and gender between the two Irish jurisdictions, the findings suggest potential contribution of underlying societal differences, and require further exploration. The evidence provided here will hope to contribute to the current efforts to modify fuel policy and reduce winter mortality in Ireland

The Unemployed and Job Openings: A Data Primer

New information that adds to the mix of labor market indicators may be useful to Congress. The ratio of unemployed persons per job opening provides information on how many unemployed persons on average there are for every job opening. It adds to the current mix of labor market indicators such as the unemployment rate, which is a measure of the excess supply of workers. In addition, it adds to employment statistics, which measures the demand for workers that have already been met by employers. By dividing the number of unemployed persons with the number of job openings, the ratio gauges the excess supply of workers relative to the demand, where job openings serve as a measure of the unmet need for workers. The resultant statistic compares the number of persons who are actively searching for jobs to the number of available opportunities. Four key findings arise from this analysis: 1. The ratio of unemployed persons per job opening is highly correlated with the unemployment rate between 2001 and 2012. 2. The ratio of unemployed persons per job opening rises during the recessionary periods covered in this data set. In the 2007-2009 recession, the ratio rises to very high levels, especially in the goods-producing industries (construction, manufacturing, mining and logging). 3. Although the ratio is highly correlated with changes in the unemployment rate, the ratio saw modest improvements coming out of the recent recession sooner than the reductions in the unemployment rate. 4. Even though the ratio has reduced, it remains at higher levels than prior to the 2007-2009 recession

Coronatine-insensitive 1 (COI1) mediates transcriptional responses of <i>Arabidopsis thaliana</i> to external potassium supply

The ability to adjust growth and development to the availability of mineral nutrients in the soil is an essential life skill of plants but the underlying signaling pathways are poorly understood. In &lt;i&gt;Arabidopsis thaliana&lt;/i&gt;, shortage of potassium (K) induces a number of genes related to the phytohormone jasmonic acid (JA). Using comparative microarray analysis of wild-type and coi1-16 mutant plants, we classified transcriptional responses to K with respect to their dependence on COI1, a central component of oxylipin signaling. Expression profiles obtained in a short-term experiment clearly distinguished between COI1-dependent and COI1-independent K-responsive genes, and identified both known and novel targets of JA-COI1-signaling. During long-term K-deficiency, coi-16 mutants displayed de novo responses covering similar functions as COI1-targets except for defense. A putative role of JA for enhancing the defense potential of K-deficient plants was further supported by the observation that plants grown on low K were less damaged by thrips than plants grown with sufficient K

Effectiveness of poverty reduction in the EU: A descriptive analysis

The European Union coordinates and encourages Member State actions to combat poverty, and to reform their social protection systems on the basis of policy exchanges and mutual learning (‘best practices’). Some EU countries are more effective in poverty reduction than others. What can explain these variations in effectiveness? This paper analyses the effectiveness of welfare state policies and especially social transfers in EU-countries in alleviating poverty. To indicate whether European economic integration may have had any impact on poverty reduction, we also include several non-EU15 countries as a benchmark into our analysis. We analyze on a cross-country basis the relationship between poverty rates and social effort, as measured by social expenditure ratios. We also correct these expenditure ratios for the impact of the tax system and for private social arrangements, using OECD methodology. Next, we compare poverty rates at the levels of market and disposable incomes, that is before and after transfers, in order to analyze the effect of tax and transfer policies in reducing poverty, i.e. to determine the target efficiency of social transfers. We perform several tests with the most recent data (LIS, OECD SOCX, and Eurostat: ECHP/EU-SILC). Our results are less clear cut than earlier findings. We still find a quite strong negative relationship between the level of social expenditure and poverty among OECD countries. However, for EU-countries this relationship is weaker and there are substantial differences within the EU15. After correcting for the impact of taxes and for private social arrangements, the linkage between social effort and poverty levels becomes even weaker. Also, we do not find a strong relationship between levels of social spending and antipoverty effects of social transfers and taxes. At the program level, family programs and child support alleviate poverty to a large extent

The expenditure experience of older households

This commentary examines detailed trends in expenditure patterns between 1995 and 2007, with a particular focus on the pensioner population. Pensioners are not a homogeneous group, but differ widely in both their levels and patterns of spending, and so we look not just at pensioners as a whole but also at pensioners according to age, income, household composition and so on. Spending may tell us something about household welfare that other, often-used measures like incomes do not. In particular, it may be that spending is informative about long-run well-being whereas income is more about current, short-run living standards. Using data from the Family Expenditure Survey/Expenditure and Food Survey, an annual, cross-sectional study of the spending patterns of 6,000-7,000 households, we look in depth at changes in the level of real expenditures and how spending patterns have changed over time. Then, using data from two waves of the English Longitudinal Study of Ageing, we examine household fuel expenditures in detail. Fuel is clearly of great current policy concern given recent large increases in the price of domestic fuel that may impact particularly severely on poorer and older households

Diversifying the uniform? The participation of minority ethnic personnel in the British armed services

This paper considers the pressures on the British armed services to increase the participation of minority ethnic groups and assesses recent government policy on this issue. Limited progress has been made towards the realisation of current goals, which are framed largely in terms of the concept of ‘equal opportunities’. The authors argue that while the concept of diversity appears to provide a more sociologically well founded basis for future government strategy on this aspect of service personnel policy, there remain significant obstacles to effective implementation of practical measures. These concern in particular the way in which the armed services relate to wider questions of British identity. Successfully increasing the participation of minority ethnic communities in the British armed services, we contend, entails developing a new framework for British identity and citizenship that cannot be accomplished by the armed services alone. Rather it is a responsibility of both government and wider society as a whole