Women’s use of family planning services: An experiment on the husband’s involvement

Despite the increased availability of family planning services (FPS) in low-income countries, their use remains low, especially in rural sub-Saharan Africa. To investigate to what extent this is explained by the husband’s involvement in the decision process, we use an experiment in rural Tanzania in which couples choose between two payments, one being conditional on attending a family planning meeting at a health center. Experimentally varying the husband’s involvement, we find that FPS are more likely chosen in treatments that involve the husband. Exploring potential mechanisms, we show that this is driven by couples where the wife (incorrectly) believes that the husband disapproves of contraceptives. We also find that involving the husband increases the wife’s expectation that the family planning meeting will be attended. Both findings suggest that initiating communication between spouses could reduce demand constraints

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Household Bargaining and Spending on Children: Experimental Evidence from Tanzania

This paper studies whether an increase in women’s intrahousehold bargaining power causes couples to allocate more resources to their child’s education, and, if so, what the underlying mechanisms for this might be. We conduct a between-subject lab experiment with couples and vary the relative bargaining power between spouses. The paper provides two main insights. First, increasing the wife’s bargaining power improves gender equality in allocation to children’s education. However, it does not increase the amount invested in the child’s education. Second, we show that the difference in time preferences between spouses matters for how much the household invests in the child’s education. It benefits the child that the most patient spouse has more relative bargaining power. This implies that increasing the wife’s bargaining power may reduce the allocation to the child’s education if she is the less patient spouse. The results provide new insights into the current debate on female empowerment, and highlight the importance of incorporating a broader set of preferences in the analysis of intrahousehold decision-makingpublishedVersio

Household bargaining and spending on children: Experimental evidence from Tanzania.

It is frequently assumed that money in the hands of women leads to better out-comes for their children than money in the hands of men. However, empirical and theoretical evidence are mixed. We conduct a novel between-subject lab-in-the-field experiment to study whether increasing the wife's control over resources causes a couple to allocate more to their child. The paper provides two main insights. First, increasing the wife's bargaining power does not increase the share allocated to the child, but leads to more gender-equal allocations to children. Second, time preferences are important in explaining household decision-making; it is better for the child that the most patient spouse has more relative bargaining power. Our results highlight the importance of taking a broader set of preferences into account when studying household decision-making, and suggest that policy aimed to increase spending on children should target the spouse with preferences most aligned with such spending

Small hands should play, not work: A theoretical analysis of interventions in child labor

Tolv timer i døgnet, året rundt, arbeider 150 millioner barn under 15 år med å produsere klærne vi går i, teppene vi går på og mobilene vi har i lommen. De fleste av barna har ikke noen valgmuligheter, alternativene er så mye verre. I denne masteroppgaven ser jeg på hvordan inngrep rettet mot barnearbeid kan påvirket omfanget av fenomenet. Ved hjelp av økonomiske modeller analyserer jeg hvordan tiltak som utdannelsestilbud, lovverk, internasjonale konvensjoner og produktmerking påvirker dagens situasjon. Jeg finner at alle tiltak sannsynligvis vil redusere barnearbeid nasjonalt, lokalt eller i en spesifikk industri. Samtidig har enkelte tiltak (som forbud mot barnearbeid) en større sannsynlighet for å redusere velferden til barna enn andre (som utdannelsestilbud). Det kan se ut som om dersom husholdningene ikke selv velger å ta barna ut fra arbeidsmarkedet eller er kompensert for den tapte inntekten, vil velferden til husholdningen og dermed også barna bli redusert. Med dette som bakteppe har jeg sett nærmere på ett tiltak i teppesektoren i Nepal - Nepal GoodWeave Foundation. Denne organisasjonen arbeider med produktmerking av tepper som eksporteres til blant annet Tyskland og USA. Jeg finner at organisasjonen lykkes i målet om å redusere barnearbeid hos fabrikkene som bærer deres etikett. Samtidig, bidrar de til å beholde barnas velferd gjennom utdannelsesprogram, samt forhindre barnearbeid ved å tilby barn av teppearbeidere tilgang til barnehager og skoler. Likevel er dessverre omfanget av programmet for lite til å eliminere barnearbeid i hele Nepals teppesektor

Women’s use of family planning services: An experiment on the husband’s involvement

Despite the increased availability of family planning services (FPS) in low-income countries, their use remains low, especially in rural sub-Saharan Africa. To investigate to what extent this is explained by the husband’s involvement in the decision process, we use an experiment in rural Tanzania in which couples choose between two payments, one being conditional on attending a family planning meeting at a health center. Experimentally varying the husband’s involvement, we find that FPS are more likely chosen in treatments that involve the husband. Exploring potential mechanisms, we show that this is driven by couples where the wife (incorrectly) believes that the husband disapproves of contraceptives. We also find that involving the husband increases the wife’s expectation that the family planning meeting will be attended. Both findings suggest that initiating communication between spouses could reduce demand constraints

Household Bargaining and Spending on Children: Experimental Evidence from Tanzania

This paper studies whether an increase in women’s intrahousehold bargaining power causes couples to allocate more resources to their child’s education, and, if so, what the underlying mechanisms for this might be. We conduct a between-subject lab experiment with couples and vary the relative bargaining power between spouses. The paper provides two main insights. First, increasing the wife’s bargaining power improves gender equality in allocation to children’s education. However, it does not increase the amount invested in the child’s education. Second, we show that the difference in time preferences between spouses matters for how much the household invests in the child’s education. It benefits the child that the most patient spouse has more relative bargaining power. This implies that increasing the wife’s bargaining power may reduce the allocation to the child’s education if she is the less patient spouse. The results provide new insights into the current debate on female empowerment, and highlight the importance of incorporating a broader set of preferences in the analysis of intrahousehold decision-makin

Understanding Inequality Within Households

To describe and understand the economic inequality in a given society, it is necessary to understand intra-household inequality. This chapter gives an overview of within-household distributions in different settings, both between the adults and also between adults and children. It documents that there are substantial inequalities within households in some contexts and that these often, but not always, disfavor women and children. The chapter also discusses the importance of intra-household allocations for poverty and inequality measurement. Methods that assign each household member a per-adult share of household consumption lead to underestimation of inequalities and misclassification of poverty. In comparison, structural models seem to do better in predicting individual poverty when disaggregated data on allocation within households are not available. Main determinants of power in household decision-making are also discussed, and relatedly, so are two important policy questions: Are targeted transfers to women good for female empowerment? And, are targeted transfers to mothers good for child outcomes? The empirical evidence is clearly pointing to targeting being beneficial for female empowerment, but the evidence is less clear when it comes to child outcomes