Intergenerational Mobility: Evidence from Pakistan Panel Household Survey

Pakistan over the years, since its independence in 1947, had a rather erratic growth profile but on average GDP growth rate hovered around 5 percent per annum with per capita income growth ranging between 2 to 3 percent. The structure of the economy graduated from being predominantly agriculture in 1950s to being service sector orientated since the turn of the century. The manufacturing sector grew from almost insignificance in 1947 to a reasonable level accounting for around one third of the GDP. The demographic inertia associated with unchecked population growth and emergence of job opportunities in urban areas led to massive rural to urban migration, which resulted in a rather high level of urbanisation. Concomitant changes in both the urban and rural labour markets are visible too. Not only did average years of schooling of the labour force rise but also changes in occupational classification suggest a relative ris

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Remittances, Economic Growth and Poverty: A Case of African OIC Member Countries

This paper investigates the impact of remittance inflows on economic growth and poverty reduction for seven African countries using annual data from 1992-2010. By using the depth of hunger as a proxy for poverty in a Simultaneous Equation Model (SEM), we find that remittances have statistically significant growth enhancing and poverty reducing impact. Drawing on our estimates, we conclude that financial development level significantly increases the remittances inflows and strengthens poverty alleviating impact of remittances. Results of our study further show a signficant interactive imapct of remittances and finacial develpment on economic growth, suggesting the substitutability between remittance inflows and financial development. We further find that 3 percentage point increase in credit provision to the private sector (financial development) can help eliminate the severe depth of hunger in the region. Remittances, serving an alternative source of private credit, can be effective in this regard. Keywords: Remittance Inflow, Poverty Alleviation, Financial Development, Simultaneous Equation Mode

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

On Measuring Inclusiveness of Growth in Pakistan On Measuring Inclusiveness of Growth in Pakistan

Abstract: Using social opportunity function approach, this work assesses, firstly, the change in and access to education and employment opportunities available to the population and secondly, how equitably these opportunities are distributed. Opportunity Index (OI) and Equity Index of Opportunities (EIO) are calculated to measure and quantify the extent of progress made in these two most important socio-economic components of development. Based on data, extracted from Pakistan Social and Living Standards Measurement (PSLM) Surveys of 1998/99 and 2007/08, the present work finds that growth process has resulted in increased inequalities both in education and employment opportunities over the study period. Average opportunities available to population increased for education while a decline in average employment opportunities is documented in 2007/08 as compared to 1998/99. OI registered an increase for primary and secondary levels of education. EIO improved at primary level, remained stagnant for secondary level and decreased for literacy rate over the time. Moreover, EIO for employment opportunities, suggesting equitable distribution for employment and paid employment, registered a decrease and opportunities distribution turn inequitable when calculated based on average monthly income earned. Findings of the paper suggest that policies should be focused to actively engage the marginalized groups of the society in growth process through improvement in higher education and more equitable distribution of opportunities

On Measuring Inclusiveness of Growth in Pakistan.

Using social opportunity function approach, this work assesses, firstly, the change in and access to education and employment opportunities available to the population and secondly, how equitably these opportunities are distributed. Opportunity Index (OI) and Equity Index of Opportunities (EIO) are calculated to measure and quantify the extent of progress made in these two most important socio-economic components of development. Based on data, extracted from Pakistan Social and Living Standards Measurement (PSLM) Surveys of 1998-99 and 2007-08, the present work finds that growth process has resulted in increased inequalities both in education and employment opportunities over the study period. Average opportunities available to population increased for education while a decline in average employment opportunities is documented in 2007-08 as compared to 1998-99. OI registered an increase for primary and secondary levels of education. EIO improved at primary level, remained stagnant for secondary level and decreased for literacy rate over the time. Moreover, EIO for employment opportunities, suggesting equitable distribution for employment and paid employment, registered a decrease and opportunities distribution turn inequitable when calculated based on average monthly income earned. Findings of the paper suggest that policies should be focused to actively engage the marginalised groups of the society in growth process through improvement in higher education and more equitable distribution of opportunities. JEL classification: C46, D63, E24, I24, O12 Keywords: Inclusive Growth, Inequality, Opportunity Curve, Opportunity Index, Equity Index of Opportunities, Pakista