The development and validation of an urbanicity scale in a multi-country study

Background : Although urban residence is consistently identified as one of the primary correlates of non-communicable disease in low- and middle-income countries, it is not clear why or how urban settings predispose individuals and populations to non-communicable disease (NCD), or how this relationship could be modified to slow the spread of NCD. The urban–rural dichotomy used in most population health research lacks the nuance and specificity necessary to understand the complex relationship between urbanicity and NCD risk. Previous studies have developed and validated quantitative tools to measure urbanicity continuously along several dimensions but all have been isolated to a single country. The purposes of this study were 1) To assess the feasibility and validity of a multi-country urbanicity scale; 2) To report some of the considerations that arise in applying such a scale in different countries; and, 3) To assess how this scale compares with previously validated scales of urbanicity. Methods : Household and community-level data from the Young Lives longitudinal study of childhood poverty in 59 communities in Ethiopia, India and Peru collected in 2006/2007 were used. Household-level data include parents’ occupations and education level, household possessions and access to resources. Community-level data include population size, availability of health facilities and types of roads. Variables were selected for inclusion in the urbanicity scale based on inspection of the data and a review of literature on urbanicity and health. Seven domains were constructed within the scale: Population Size, Economic Activity, Built Environment, Communication, Education, Diversity and Health Services. Results : The scale ranged from 11 to 61 (mean 35) with significant between country differences in mean urbanicity; Ethiopia (30.7), India (33.2), Peru (39.4). Construct validity was supported by factor analysis and high corrected item-scale correlations suggest good internal consistency. High agreement was observed between this scale and a dichotomized version of the urbanicity scale (Kappa 0.76; Spearman’s rank-correlation coefficient 0.84 (p < 0.0001). Linear regression of socioeconomic indicators on the urbanicity scale supported construct validity in all three countries (p < 0.05). Conclusions : This study demonstrates and validates a robust multidimensional, multi-country urbanicity scale. It is an important step on the path to creating a tool to assess complex processes like urbanization. This scale provides the means to understand which elements of urbanization have the greatest impact on health

Early Nutrition and Cognition in Peru

This paper examines the causal link between early childhood nutrition and cognition, applying instrumental variables to sibling-differences for a sample of pre-school aged Peruvian children. Child-specific shocks in the form of food price changes and household shocks during the critical developmental period of a child are used as instruments. The analysis shows significant and positive returns to early childhood nutritional investments. An increase in the Height-for-Age z-score of one standard deviationkeeping other factors constanttranslates into increases in the Peabody Picture Vocabulary Test (PPVT) score of 17-21 percent of a standard deviation. The period of analysis includes the recent global food price crisis that also affected Peru between 2006 and 2008. This therefore is also a quantification of the nutritional and subsequent cognitive costs of food prices on the sample, which could be magnified in later years

Offering rainfall insurance to informal insurance groups: Evidence from a field experiment in Ethiopia

We show theoretically that the presence of basis risk in index insurance makes it a complement to informal risk sharing, implying that index insurance crowds-in risk sharing and leading to a prediction that demand will be higher among groups of individuals that can share risk. We report results from Ethiopia from a first attempt to market weather insurance to informal risk-sharing groups. The groups were offered training on risk management and insurance. We randomized the content of training provided to group leaders, with some sessions focusing on the benefits of informally sharing idiosyncratic basis risk. Consistent with learning informed by the theoretical results, we found that members of groups whose leaders had received training that emphasized risk-sharing had considerably higher uptake. We find that this effect can be explained either by a more careful selection of training participants by leaders or a direct impact of the treatment on insurance demand

Offering rainfall insurance to informal insurance groups: Evidence from a field experiment in Ethiopia

We show theoretically that the presence of basis risk in index insurance makes it a complement to informal risk sharing, implying that index insurance crowds-in risk sharing and leading to a prediction that demand will be higher among groups of individuals that can share risk. We report results from Ethiopia from a first attempt to market weather insurance to informal risk-sharing groups. The groups were offered training on risk management and insurance. We randomized the content of training provided to group leaders, with some sessions focusing on the benefits of informally sharing idiosyncratic basis risk. Consistent with learning informed by the theoretical results, we found that members of groups whose leaders had received training that emphasized risk-sharing had considerably higher uptake. We find that this effect can be explained either by a more careful selection of training participants by leaders or a direct impact of the treatment on insurance demand

Chronic Poverty in Rural Ethiopia through the Lens of Life Histories

Studying chronic poverty using retrospective qualitative data (life histories) in conjunction with longitudinal panel data is now widely recognised to provide deeper and more reliable insights (Davis and Baulch, 2009). This paper uses three rounds of panel data and life histories collected by Young Lives, a longitudinal study of childhood poverty, to identify factors that contribute to households becoming or remaining poor in rural Ethiopia, with related effects on the children within those households. It combines a case-centred and a variable-centred approach (Ragin, 1987), analysing and comparing the experiences of individual households on the basis of qualitative and quantitative techniques and interrogating these findings by looking at attributes of households (variables) across a larger sample. The substantive findings on poverty ‘drivers’ and ‘maintainers’ (Baulch, 2011) support those of previous studies: rainfall, illness, debt, exclusion from the main form of social protection. But by mixing different types of data and analysis, the paper was able to show that combinations of factors rather than single events drive households into poverty, and that household characteristics can play an important factor. The primary contribution of the paper is methodological as it presents a novel method of using life histories to investigate chronic poverty in rural Ethiopia by generating or testing hypotheses/findings on poverty drivers and maintainers

A mixed-method taxonomy of child poverty - the case of Ethiopia

In this paper, we use mixed methods to develop a taxonomy of poverty and vulnerability to study the situation of children and their households in rural Ethiopia over time. The taxonomy is built using qualitative data from Young Lives, a long-term study of childhood poverty, with the specific purpose of analysing the context of children’s life trajectories using both quantitative and qualitative data. The approach aims to yield insights into changes over time as well as to reflect multiple dimensions and consider issues of current well-being and future ‘well-becoming’. It potentially allows for the identification of underlying mechanisms that influence and determine life trajectories. Until recently, quantitative and qualitative approaches towards the analysis of chronic and transient poverty have developed in isolation with little cross-disciplinary interaction. In this paper, we add to this body of research by using a mixed-method approach to develop a hybrid taxonomy of child poverty and well-being that can be used for a dynamic analysis. The paper also complements existing research and evidence on child poverty and well-being in the context of Ethiopia