Why a universal Child Grant makes sense in Nepal: a four-step analysis

Whether cash transfers should be poverty targeted or universal within certain social categories remains a hotly debated topic. Recent plans to expand Nepal’s Child Grant programme brought this question sharply into focus. Using available secondary data, this article presents a four-step analysis that examines the costs and benefits of different approaches. Given the country’s poverty profile, the theoretical results of different targeting models, government capacity and overall costs, a universal (age-cohort targeted) approach achieves the best outcomes for childre

Dynamics of social protection in fragile contexts: Nepal and Myanmar

This article explores some of the shared dimensions of fragility experienced by Myanmar and Nepal to illuminate the challenging contexts in which social protection policies and programmes have taken shape. Both countries have adopted a universalist, rights-based vision in their approaches to social protection, with social pensions and child benefits at the forefront of social protection programming. At the same time, both countries are employing incremental strategies to overcome political, social, and administrative obstacles, while demonstrating that fiscal space is available. The politics of social protection policy making are obvious, and consistent engagement by progressive social policy advocates in these countries will be necessary to seize opportunities, and to ensure continued investment in building inclusive, effective, and accountable social protection systems

The evolution of Nepal’s child grant: from humble beginnings to a real driver of change for children?

Nepal’s Child Grant was introduced in 2009, and the government made a commitment to enhance and expand the programme in 2016. This contribution argues that good evidence, local popularity, and a combination of political legitimacy and opportunity were all necessary to bring about the reforms. Despite initial underinvestment and various design and implementation challenges, the reforms provide a solid platform to help the programme realise its full potentia

Poverty, cash transfers and adolescents’ lives: exploring the unintended consequences of Nepal’s social pension: a mixed-methods study

This thesis contributes new evidence and analyses on the effects of cash transfers on adolescent school attendance, work participation and marital status. The mixed-methods study investigates the effects of Nepal’s Old Age Allowance (OAA), an unconditional cash transfer, on adolescents who co-reside with older persons using primary data from a household survey (n=2018) and in-depth interviews (IDI) (n=55) conducted in Rautahat district in the Terai region. The quantitative analysis exploits the age criteria for OAA eligibility to isolate its effects on co-resident adolescents. Using a hybrid thematic approach, IDIs are used to elucidate whether and how the OAA was factored into household decision-making and its relation to other factors that influence decisions about adolescents’ lives. The findings show that the OAA supports households to fulfil existing preferences for adolescents, which depend on the socioeconomic status, decision-making dynamics and religion of the household, the type and quality of local schools, the nature of local credit markets, and gendered social norms and expectations attached to transitions to adulthood. For many adolescents, this means increased access to school, whether public, private, or religious. However, some households support adolescents to access private school by taking loans in anticipation of OAA eligibility but fail to sustain the costs in the face of delays in registration and receipt of the first payments. Some out-of-school adolescents are prevented from engaging in paid work. However, other households use the OAA to accelerate transitions to adulthood, supporting economic migration of older boys and expediting the formalisation of marriage of older girls. This study makes five main contributions to the literature. First, studies on income effects on access to education tend to consider school as a homogenous entity, but the findings show that a UCT can expand school choice with different effects for different types of school. Second, the findings on adolescent marriage are novel for a dowry context and should prompt the research and policy literature to recognise the possibility that UCTs can increase the risk of early marriage. Third, this study provides unique evidence on the role of cash transfers in leveraging loans for human capital investment and marriage. Fourth, the study examines the dynamics of household decision-making in relation to causal processes and shows that variation in outcomes according to the gender of the cash transfer recipient may stem from differences in bargaining power and economic opportunity as much as from differences in preferences. Finally, most studies on cash transfers often fail to account for the complexity in people’s lives which may lead to blunt or erroneous conclusions. This study shows that adopting the tenets of a critical realist perspective and placing decision-making about the outcomes of interest at the centre of the analysis focuses attention on the diverse contextual factors that shape the effects of cash transfers on individual household members, and provides for richer and more nuanced findings

The northern sector of the last British ice sheet : maximum extent and demise

Strongly divided opinion has led to competing, apparently contradictory, views on the timing, extent, flow configuration and decay mechanism of the last British Ice Sheet. We review the existing literature and reconcile some of these differences using remarkable new sea-bed imagery. This bathymetric data provides unprecedented empirical evidence of confluence and subsequent separation of the last British and Fennoscandian Ice Sheets. Critically, it also allows a viable pattern of ice-sheet disintegration to be proposed for the first time. Covering the continental shelf around the northern United Kingdom, extensive echosounder data reveals striking geomorphic evidence – in the form of tunnel valleys and moraines – relating to the former British and Fennoscandian Ice Sheets. The pattern of tunnel valleys in the northern North Sea Basin and the presence of large moraines on the West Shetland Shelf, coupled with stratigraphic evidence from the Witch Ground Basin, all suggest that at its maximum extent a grounded ice sheet flowed from SE to NW across the northern North Sea Basin, terminating at the continental-shelf edge. The zone of confluence between the British and much larger Fennoscandian Ice Sheets was probably across the northern Orkney Islands, with fast-flowing ice in the Fair Isle Channel focusing sediment delivery to the Rona and Foula Wedges. This period of maximum confluent glaciation (c. 30–25 ka BP) was followed by a remarkable period of large-scale ice-sheet re-organisation. We present evidence suggesting that as sea level rose, a large marine embayment opened in the northern North Sea Basin, as far south as the Witch Ground Basin, forcing the two ice sheets to decouple rapidly along a north–south axis east of Shetland. As a result, both ice sheets rapidly adjusted to new quasi-stable margin positions forming a second distinct set of moraines (c. 24–18 ka BP). The lobate overprinted morphology of these moraines on the mid-shelf west of Orkney and Shetland indicates that the re-organisation of the British Ice Sheet was extremely dynamic — probably dominated by a series of internally forced readvances. Critically, much of the ice in the low-lying North Sea Basin may have disintegrated catastrophically as decoupling progressed in response to rising sea levels. Final-stage deglaciation was marked by near-shore ice streaming and increasing topographic control on ice-flow direction. Punctuated retreat of the British Ice Sheet continued until c. 16 ka BP when, following the North Atlantic iceberg-discharge event (Heinrich-1), ice was situated at the present-day coastline in NW Scotlan

Outcomes important to patients with non-infectious posterior segment-involving uveitis:a qualitative study

Objective: Uveitis, a group of disorders characterised by intraocular inflammation, causes 10–15% of total blindness in the developed world. The most sight-threatening forms of non-infectious uveitis are those affecting the posterior segment of the eye, collectively known as posterior-segment involving uveitis (PSIU). Numerous different clinical outcomes have been used in trials evaluating treatments for PSIU but these may not represent patients’ and carers’ concerns. Therefore, the aims of this study were to understand the impact of PSIU on adult patients’ and carers’ lives, and to explore what outcomes of treatment are important to them.Methods: Four focus group discussions were undertaken to understand the perspectives of adult patients (n=18) and carers (n=10) with PSIU. Participants were grouped according to whether or not their uveitis was complicated by the sight-threatening condition uveitic macular oedema (UMO). Discussions were audio recorded, transcribed and analysed using the framework analytical approach. Outcomes were identified and grouped into outcome domains. Results: Eleven core domains were identified as important to patients and carers undergoing treatment for PSIU comprising: (1) visual function, (2) symptoms, (3) functional ability, (4) impact on relationships, (5) financial impact, (6) psychological morbidity and emotional well-being (7) psychosocial adjustment to uveitis, (8) doctor/patient/interprofessional relationships and access to health care, (9) treatment burden, (10) treatment side effects, (11) disease control.Conclusion: The domains identified represent patients and carers experience and perspectives and can be used to reflect on outcomes assessed in PSIU. They will directly inform the development of a core outcome set for PSIU clinical trials.Ethical approval: Ethical approval was obtained from the United Kingdom National Research Ethics Service (Reference 17-WM-0111).<br/

Life Lost Due to Premature Deaths in New South Wales, Australia

This study attempts to measure premature mortality, in addition to overall death rates, in order to provide more information that can be used to develop and monitor health programmes that are aimed at reducing premature (often preventable) mortality in New South Wales (NSW), Australia. Premature years of potential life lost (PYPLL) and valued years of potential life lost methods are applied for mortality data in NSW from 1990 to 2002. Variations in these measures for 2001 are studied further in terms of age, sex, urban/rural residence, and socio-economic status. PYPLL rates for all leading causes of death have declined. It is shown that the average male to female ratio of PYPLLs is highest for accidents, injury and poisoning (3.4:1) followed by mental disorders (2.7:1) and cardiovascular diseases (2.6:1). Although fewer women than men die of cardiovascular diseases, there is a greater proportionate importance of cerebrovascular mortality among women. In order to further reduce premature deaths, programs are required to improve the health of people living in lower socio-economic status areas, especially in rural NSW. Targeted regional or community level programs are required to reduce avoidable deaths due to accidents, injury and poisoning occasioned by motor vehicle accidents, poisoning and suicide among young adults

A Standardized Strategy for Simultaneous Quantification of Urine Metabolites to Validate Development of a Biomarker Panel Allowing Comprehensive Assessment of Dietary Exposure

SCOPE: Metabolites derived from individual foods found in human biofluids after consumption could provide objective measures of dietary intake. For comprehensive dietary assessment, quantification methods would need to manage the structurally diverse mixture of target metabolites present at a wide concentration range. METHODS & RESULTS: We developed a strategy for selection of candidate dietary exposure biomarkers, providing comprehensive coverage. An analytical method for 62 food biomarkers was validated by extensive analysis of chromatographic and ionization behaviour characteristics using triple quadrupole mass spectrometry. We used urine samples from two food intervention studies: one controlled, inpatient study (n = 19) and the other a free-living study where individuals (n = 15) were provided with food as a series of menu plans. As proof-of-principle, we demonstrated that the biomarker panel could discriminate between menu plans by detecting distinctive changes in the concentration in urine of targeted metabolites. We showed quantitative relationships between four biomarker concentrations in urine and dietary intake. CONCLUSIONS: We have demonstrated design concepts for an analytical strategy allowing simultaneous quantification of a comprehensive panel of chemically-diverse biomarkers of a wide range of commonly-consumed foods. We propose that integration of self-reported dietary recording tools with biomarker approaches will provide more robust assessment of dietary exposure. This article is protected by copyright. All rights reserved