Teacher absence as a factor in gender inequalities in access to primary schooling in rural Pakistan

This paper examines the case of Pakistan, where primary school enrollment among girls in rural areas is substantially lower than among children in urban areas and boys in rural areas, owing to lack of access to government girls’ schools. The focus is on teacher absence as a further barrier to schooling for girls. Using data from a panel study of primary schooling in rural Punjab and NWFP in 1997 and 2004, the report examines trends in teacher absence, examine the factors correlated with teacher absence in the government and private sector, and assesses the implications of these absence levels for access to schooling among enrolled boys and girls

Early childhood development through an integrated program : evidence from the Philippines

More attention and resources have been devoted in recent years to early childhood development (ECD) in low- and middle-income countries. Rigorous studies on the effectiveness of ECD-related programs for improving children's development in various dimensions in the developing world are scant. The authors evaluate an important ECD initiative of the Philippine government using longitudinal data collected over three years on a cohort of 6,693 children age 0-4 years at baseline in two"treatment"regions and a"control"region that did not receive the intervention. The initiative includes a wide range of health, nutrition, early education, and social services programs. The authors estimate its impact by using"intent-to-treat"difference-in-difference propensity score matching estimators to control for a variety of observed characteristics measured at the municipality, barangay, household, and child level and unobserved fixed characteristics, with differential impacts by age of children and duration of exposure to the program. There has been a significant improvement in the cognitive, social, motor, and language development, and in short-term nutritional status of children who reside in ECD program areas compared to those in non-program areas, particularly for those under age four at the end of the evaluation period. The proportions of children below age four with worms and diarrhea also have been lowered significantly in program compared to non-program areas, but there are effects in the opposite direction for older children so the overall impact on these two indicators is mixed.Health Monitoring&Evaluation,Early Childhood Development,Youth and Governance,Primary Education,Educational Sciences

Evaluation of non-response bias in a cohort study of World Trade Center terrorist attack survivors

Background: Few longitudinal studies of disaster cohorts have assessed both non-response bias in prevalence estimates of health outcomes and in the estimates of associations between health outcomes and disaster exposures. We examined the factors associated with non-response and the possible non-response bias in prevalence estimates and association estimates in a longitudinal study of World Trade Center (WTC) terrorist attack survivors. Methods: In 2003-04, 71,434 enrollees completed the WTC Health Registry wave 1 health survey. This study is limited to 67,670 adults who were eligible for both wave 2 and wave 3 surveys in 2006-07 and 2011-12. We first compared the characteristics between wave 3 participants (wave 3 drop-ins and three-wave participants) and non-participants (wave 3 drop-outs and wave 1 only participants). We then examined potential non-response bias in prevalence estimates and in exposure-outcome association estimates by comparing one-time non-participants (wave 3 drop-ins and drop-outs) at the two follow-up surveys with three-wave participants. Results: Compared to wave 3 participants, non-participants were younger, more likely to be male, non-White, non-self enrolled, non-rescue or recovery worker, have lower household income, and less than post-graduate education. Enrollees' wave 1 health status had little association with their wave 3 participation. None of the disaster exposure measures measured at wave 1 was associated with wave 3 non-participation. Wave 3 drop-outs and drop-ins (those who participated in only one of the two follow-up surveys) reported somewhat poorer health outcomes than the three-wave participants. For example, compared to three-wave participants, wave 3 drop-outs had a 1.4 times higher odds of reporting poor or fair health at wave 2 (95% CI 1.3-1.4). However, the associations between disaster exposures and health outcomes were not different significantly among wave 3 drop-outs/drop-ins as compared to three-wave participants. Conclusion: Our results show that, despite a downward bias in prevalence estimates of health outcomes, attrition from the WTC Health Registry follow-up studies does not lead to serious bias in associations between 9/11 disaster exposures and key health outcomes. These findings provide insight into the impact of non-response on associations between disaster exposures and health outcomes reported in longitudinal studies

Family Background, Service Providers, and Early Childhood Development in the Philippines: Proxies and Interactions

We examine the importance of family background for early childhood development (ECD) using data collected in 2001 from 3,556 children ages 0–36 months in three regions of the Philippines. We focus on four main research questions: (1) Are associations of family background with ECD in part proxying for health and ECD‐related programs? (2) Are associations of family background with ECD biased due to omission of unobserved community characteristics that may be related to placement of health and ECD‐related services? (3) Are there important interactions between family background and health and ECD‐related programs in their effect on ECD? (4) Are there important interactions among the components of family background? Physical assets and human assets have a number of important positive associations with ECD. These include the positive relations between physical assets and the anthropometrics and hemoglobin levels of children, as well as lower occurrence of worms. Each parent’s schooling and height also have notable positive effects on these outcomes and the motor and language skills of children. The failure to account for community characteristics is related to often substantial bias in the estimated effect of family background on ECD. We do not find strong evidence that interactions are important

Attitudes About Sex and Marital Sexual Behavior in Hai Duong Province, Vietnam

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74926/1/j.1728-4465.2005.00047.x.pd

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The relationship between women\u27s autonomy and infant and child survival: Evidence from five Asian countries

I evaluate the hypothesis that higher autonomy of mothers is related to lower infant and child mortality in 47 communities across five south and southeast Asian countries: India, Pakistan, Malaysia, Philippines and Thailand. I also consider the idea that the lower autonomy of Muslim compared to non-Muslim women is related to experience of higher infant and child death for the former group. The main method is a proportional hazards model that includes a correction for clustering of mortality risks within families. I find that women\u27s autonomy is not a consistent or strong correlate of infant and child survival and any observed association between autonomy and mortality is often heavily contingent on country and communities within country. In Malaysia and Philippines, the mother\u27s discretion over family income is related to lower post neonatal and child death. But in Pakistan, north India, and Thailand several dimensions of women\u27s autonomy such as freedom of movement, discretion over material resources, and decision making over children\u27s illness have weak associations with child survival once the socioeconomic status of the mother and her family or region of residence are considered. In India, these features of women\u27s position are positively related to child survival only in the more gender egalitarian southern area of Tamil Nadu. In all five countries measures of women\u27s autonomy are relatively useless for understanding variation in neonatal mortality. Examination of Muslim and non-Muslim differences in mortality and women\u27s autonomy shows that Muslims usually have higher death rates in the southeast Asian settings of Philippines, Malaysia and Thailand. But they do not have consistently lower autonomy compared to non-Muslims. At the community and individual level, the relation between Muslim and non-Muslim differences in mortality and autonomy is weak. Socioeconomic status usually fails in explaining the religious differences in mortality, in part due to the indeterminate relation between religion and household wealth in these settings

The relationship between women\u27s autonomy and infant and child survival: Evidence from five Asian countries

I evaluate the hypothesis that higher autonomy of mothers is related to lower infant and child mortality in 47 communities across five south and southeast Asian countries: India, Pakistan, Malaysia, Philippines and Thailand. I also consider the idea that the lower autonomy of Muslim compared to non-Muslim women is related to experience of higher infant and child death for the former group. The main method is a proportional hazards model that includes a correction for clustering of mortality risks within families. I find that women\u27s autonomy is not a consistent or strong correlate of infant and child survival and any observed association between autonomy and mortality is often heavily contingent on country and communities within country. In Malaysia and Philippines, the mother\u27s discretion over family income is related to lower post neonatal and child death. But in Pakistan, north India, and Thailand several dimensions of women\u27s autonomy such as freedom of movement, discretion over material resources, and decision making over children\u27s illness have weak associations with child survival once the socioeconomic status of the mother and her family or region of residence are considered. In India, these features of women\u27s position are positively related to child survival only in the more gender egalitarian southern area of Tamil Nadu. In all five countries measures of women\u27s autonomy are relatively useless for understanding variation in neonatal mortality. Examination of Muslim and non-Muslim differences in mortality and women\u27s autonomy shows that Muslims usually have higher death rates in the southeast Asian settings of Philippines, Malaysia and Thailand. But they do not have consistently lower autonomy compared to non-Muslims. At the community and individual level, the relation between Muslim and non-Muslim differences in mortality and autonomy is weak. Socioeconomic status usually fails in explaining the religious differences in mortality, in part due to the indeterminate relation between religion and household wealth in these settings

Teacher absence as a factor in gender inequalities in access to primary schooling in rural Pakistan

The presence of a teacher in the classroom is central to the provision of schooling, with accumulating evidence showing that teacher absence compromises student learning (e.g., Duflo and Hanna 2005; Das et al. 2006; Das et al. 2007). Teacher absence is common in schools in low‐ and middle‐income countries. In six low‐ and middle‐income countries, 11–27 percent of primary school teachers were absent on the day of the school visit (Chaudhury et al. 2006). Only 3 percent of teachers were absent due to “sanctioned” causes such as illness or participation in election or public health campaigns. In four states in India, one‐third of head teachers were absent at the time of the primary school visit, and teaching‐related activity (supervising written work, writing on the blackboard, teaching by rote, or teaching via any other method) was found in only about one‐half of schools (PROBE Team 1999). Teachers were instead found to be minding the class, outside the classroom, talking to their peers, or engaged in other nonteaching activities. With much of the developing world making rapid progress in achieving universal primary school enrollment and gender equality in enrollment, Pakistan lags substantially behind other nations at its income level on both measures (Easterly 2003). This is due to a large extent to the exclusion of girls from education, particularly in rural areas. In Pakistan, government schools for boys and girls are separate; in addition, only women are employed as teachers in government girls’ schools and only men teach in government boys’ schools. The lack of a nearby government school for girls in rural communities is a significant barrier to girls’ access to schooling, with a third of rural communities lacking a government girls’ primary school (Lloyd et al. 2005; World Bank 2005). “Access” to schooling depends not only on the physical availability of schools by type (i.e., government girls’, government boys’, or private schools) but also on other supply‐side barriers to use, such as the presence of the teacher and whether or not the teacher is actually teaching. As we confirm in our study, teacher absence is high in government schools and particularly among women who teach in girls’ schools. Little empirical attention has been paid to the factors correlated with teacher absence among female compared to male teachers in government schools or how the higher absence rate among female teachers differentially affects opportunities to learn among girls as compared to boys attending public primary schools. Specifically, in a government school system where schools for boys and girls are separate and where only women teach girls and men teach boys, the higher absence rate among female teachers may limit access to schooling for girls more so than for boys, further exacerbating existing gender inequalities in primary school access. In this article we focus on teacher absence among female teachers in government girls’ schools, male teachers in government boys’ schools, and, by way of comparison, among teachers in private coeducational schools in rural Pakistan. First, we analyze the school and teacher‐level characteristics that are correlated with absence in teachers in each of these three types of schools. Second, we examine how teacher absence differentially affects access to schooling among girls enrolled in government girls’ schools as compared to pupils enrolled in boys’ school or in coeducational private schools. We conducted our analysis using data collected on teachers and pupils in 1997 and 2004 from primary schools serving 12 villages in rural Punjab and Northwest Frontier Province (NWFP)