420 research outputs found
THE COST STRUCTURE OF MICROFINANCE INSTITUTIONS IN EASTERN EUROPE AND CENTRAL ASIA
Microfinance institutions are important, particularly in developing countries, because they expand the frontier of financial intermediation by providing loans to those traditionally excluded from formal financial markets. This paper presents the first systematic statistical examination of the performance of MFIs operating in Eastern Europe and Central Asia. A cost function is estimated for MFIs in the region from 1999-2004. First, the presence of subsidies is found to be associated with higher MFI costs. When output is measured as the number of loans made, we find that MFIs become more efficient over time and that MFIs involved in the provision of group loans and loans to women have lower costs. However, when output is measured as volume of loans rather than their number, this last finding is reversed. This may be due to the fact that such loans are smaller in size; thus for a given volume more loans must be made.http://deepblue.lib.umich.edu/bitstream/2027.42/40195/3/wp809.pd
âEarly Rupture of Membranesâ during Induced Labor as a Risk Factor for Cesarean Delivery in Term Nulliparas
OBJECTIVE: To determine if "early rupture of membranes" (early ROM) during induction of labor is associated with an increased risk of cesarean section in term nulliparas. STUDY DESIGN: The rate of cesarean section and the timing of ROM during the course of labor were examined in term singleton nulliparas whose labor was induced. Cases were divided into 2 groups according the timing of ROM: 1)"early ROM", defined as ROM at a cervical dilatation<4 cm during labor; and 2) "late ROM", ROM at a cervical dilatationâ„4 cm during labor. Nonparametric techniques were used for statistical analysis. RESULTS: 1) In a total of 500 cases of study population, "early ROM" occurred in 43% and the overall cesarean section rate was 15.8%; 2) patients with "early ROM" had a higher rate of cesarean section and cesarean section due to failure to progress than did those with "late ROM" (overall cesarean section rate: 24%[51/215] vs. 10%[28/285], p<0.01; cesarean section rate due to failure to progress: 18%[38/215] vs. 8%[22/285], p<0.01 for each) and this difference remained significant after adjusting for confounding variables. CONCLUSION: "Early ROM" during the course of induced labor is a risk factor for cesarean section in term singleton nulliparas
Preconception Care in International Settings
Objectives: This literature review briefly describes international programs, policies, and activities related to preconception care and resulting pregnancy outcomes. Methods: Electronic databases were searched and findings supplemented with secondary references cited in the original articles as well as textbook chapters, declarations, reports, and recommendations. Results: Forty-two articles, book chapters, declarations, and other published materials were reviewed. Policies, programs, and recommendations related to preconceptional health promotion exist worldwide and comprise a readily identifiable component of historic and modern initiatives pertaining to women's health, reproductive freedom, and child survival. Conclusions: The integration of preconception care services within a larger maternal and child health continuum of care is well aligned with a prevention-based approach to enhancing global health
Civic Nationalism and Language-in-Education Policies in the United Arab Emirates
A founding principle of the United Arab Emirates is the belief that tolerance promotes peace, while isolation encourages division and conflict. With more than 200 nationalities residing in the UAE, Emiratis constitute only 10% of the population, making them a minority in their own country. Despite the government promoting diversity and tolerance as the norm, such demographic imbalance come with a cost to the Arabic language, the national identity and culture, and the education system. This chapter addresses those concerns through a series of recent government initiatives. The author classifies neo-nationalist movements into different types, arguing that the one in the UAE largely fits within the civic type with its non-hostile, overall welcoming attitude toward foreigners. At the end of the chapter, she discusses the impact of neo-nationalism on education and calls for clearer policies that take into account language(s) as a right and as a resource
Indigenous identity, natural resources, and contentious politics in Bolivia: a disaggregated conflict analysis; 2000-2011
How do natural resources and ethnic identity interact to incite or to mitigate
social conflict? This article argues that high-value natural resources can act as an
important catalyst for the politicization of ethnic, specifically indigenous identity,
and contribute to social conflict as they limit the malleability of identity frames
and raise the stakes of confrontations. We test this argument using unique subnational
data from Bolivian provinces. Drawing on Bolivian newspaper reports,
we code conflict events for all of the 112 provinces from 2000 to 2011. We
join this conflict data with information on local ethnic composition from the
census, the political representation of ethnic groups at the national level, as well
as geo-spatial information on gas deposits. Using time-series cross-sectional
count models, we show a significant conflict-promoting effect of the share of
indigenous people in provinces with gas reserves, but not without
Avoiding the danger that stop smoking services may exacerbate health inequalities: building equity into performance assessment
<p>Abstract</p> <p>Background</p> <p>The UK is the only developed country to have established a nation-wide stop smoking treatment service. Apart from addressing tobacco dependence, which is the leading preventable cause of ill health and premature death, smoking cessation has been identified by the UK department of health as a service priority for reducing gaps in health between disadvantaged groups and the country as a whole. However smoking cessation tends to be more successful among affluent than disadvantaged groups. This means that for stop smoking services there is a trade-off to be had in terms of maximising the number of quitters and reducing socioeconomic inequalities in smoking prevalence. Current performance targets for the national stop smoking services in the UK are set only in terms of numbers of quitters, which does not encourage the adoption of strategies to reduce socioeconomic inequalities in smoking prevalence.</p> <p>Discussion</p> <p>This paper proposes an assessment framework, which allows the two dimensions of overall reduction in smoking prevalence and reductions of inequalities in smoking prevalence to be assessed together. The framework is used to assess the performance over time of a stop smoking service in Derwentside, a former Primary Care Trust in the North East of England, both in terms of meeting targets for the overall number of quitters and in terms of reducing socioeconomic inequalities in smoking prevalence.</p> <p>The example demonstrates how the proposed assessment framework can be applied in practice given existing records kept by stop smoking services in England and the available information on smoking prevalence at small area level. For Derwentside it is shown that although service expansion was successful in increasing the overall number of quitters, the service continued to exacerbate inequality in smoking prevalence between deprived and affluent wards.</p> <p>Summary</p> <p>The Secretary of State for Health in the UK has warned about the dangers of health promotion services and messages being taken up more readily by the better-off, thus exacerbating health inequalities. Because smokers from affluent backgrounds are more successful at quitting than those living in deprived circumstances, it is important to build an equity element into the monitoring of individual stop smoking services. Otherwise the danger highlighted by the Secretary of State for Health will go undetected and unaddressed.</p
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The Rise of the Crime Victim and Punitive Policies? Changes to the Legal Regulation of Intimate Partner Violence in Finland
This article examines intimate partnership violence as a question of criminal justice policy in Finland, and contributes to criminological discussions regarding oft-stated connections between the politicization of the victim, the treatment of offenders, and repressive criminal justice policies. In this discussion, legislation aiming to regulate and prevent violence against women has often been utilized as an example of such punitive policies. Although criminal policies in Nordic countries differ significantly from more punitive Anglophone policies, punitive tendencies have argued to exist in the former too. This article analyses the change in legal regulations and the criminal political status of intimate partner violence in Finland between 1990 and 2004, while examining the juxtaposition of victims and offenders alongside repressive demands
Maternal and perinatal outcomes after bariatric surgery: a spanish multicenter study
The final publication is avaliable at Springer Link[Abstract] Background. Bariatric surgery (BS) has become more frequent among women of child-bearing age. Data regarding the underlying maternal and perinatal risks are scarce. The objective of this nationwide study is to evaluate maternal and perinatal outcomes after BS.
Methods. We performed a retrospective observational study of 168 pregnancies in 112 women who underwent BS in 10 tertiary hospitals in Spain over a 15-year period. Maternal and perinatal outcomes, including gestational diabetes mellitus (GDM), pregnancy-associated hypertensive disorders (PAHD), pre-term birth cesarean deliveries, small and large for gestational age births (SGA, LGA), still births, and neonatal deaths, were evaluated. Results were further compared according to the type of BS performed: restrictive techniques (vertical-banded gastroplasty, sleeve gastrectomy, and gastric banding), Roux-en-Y gastric bypass (RYGB), and biliopancreatic diversion (BPD).
Results. GDM occurred in five (3 %) pregnancies and there were no cases of PAHD. Women whose pregnancies occurred before 1 year after BS had a higher pre-gestational body mass index (BMI) than those who got pregnant 1 year after BS (34.6â±â7.7 vs 30.4â±â5.3 kg/m2, pâ=â0.007). In pregnancies occurring during the first year after BS, a higher rate of stillbirths was observed compared to pregnancies occurring after this period of time (35.5 vs 16.8 %, pâ=â0.03). Women who underwent BPD delivered a higher rate of SGA babies than women with RYGB or restrictive procedures (34.8, 12.7, and 8.3 %, respectively).
Conclusions. Pregnancy should be scheduled at least 1 year after BS. Malabsorptive procedures are associated to a higher rate of SGA births
Impact of financial inclusion in low- and middle-income countries: a systematic review of reviews
Financial inclusion programmes seek to increase access to financial services such as credit, savings, insurance and money transfers and so allow poor and low-income households in low- and middle-income countries to enhance their welfare, grasp opportunities, mitigate shocks, and ultimately escape poverty. This systematic review of reviews assesses the evidence on economic, social, behavioural and gender-related outcomes from financial inclusion. It collects and appraises all of the existing meta-studies - that is systematic reviews and meta-analyses - of the impact of financial inclusion. The authors first analyse the strength of the methods used in those meta-studies, then synthesise the findings from those that are of a sufficient quality, and finally, report the implications for policy, programming, practice and further research arising from the evidence. Eleven studies are included in the analysis
Obstetric risk indicators for labour dystocia in nulliparous women: A multi-centre cohort study
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