Poverty moderates the association between gender and school dropout in South African adolescents

This study examined prospective associations between poverty, gender, and school dropout in a large community sample of South African adolescents (baseline: n = 3515, follow-up: n = 3401, 57% female, age range at baseline: 10–17 years, mean age at baseline = 13.45). School dropout was defined as being enrolled in school at baseline assessment but no longer enrolled in school at follow-up assessment. Poverty was measured at baseline assessment using an index of access to the eight highest socially perceived necessities for South African children and adolescents. Demographic characteristics including child gender and age, province, and urban versus rural location were recorded at baseline assessment and controlled for in the analysis. As predicted, higher poverty scores (AOR = 2.01, p < .001) were associated with increased odds of school dropout 1 year later. Gender was not a significant predictor of school dropout (AOR = 1.56, p = .07) but did interact with poverty (AOR = 0.66, p = .04) in predicting school dropout. However, our initial hypothesis that the impact of poverty on school dropout would be stronger for girls than boys was not supported. Instead, results indicated that while girls were at elevated risk of school dropout at low and mean levels of poverty, at high levels of poverty this gender difference was no longer evident. Findings suggest that vulnerable boys should not be neglected in policies to improve retention in education in contexts of extreme poverty

A decade of inequality in maternity care: antenatal care, professional attendance at delivery, and caesarean section in Bangladesh (1991–2004)

<p>Abstract</p> <p>Background</p> <p>Bangladesh is committed to the fifth Millennium Development Goal (MDG-5) target of reducing its maternal mortality ratio by three-quarters between 1990 and 2015. Since the early 1990s, Bangladesh has followed a strategy of improving access to facilities equipped and staffed to provide emergency obstetric care (EmOC).</p> <p>Methods</p> <p>We used data from four Demographic and Health Surveys conducted between 1993 and 2004 to examine trends in the proportions of live births preceded by antenatal consultation, attended by a health professional, and delivered by caesarean section, according to key socio-demographic characteristics.</p> <p>Results</p> <p>Utilization of antenatal care increased substantially, from 24% in 1991 to 60% in 2004. Despite a relatively greater increase in rural than urban areas, utilization remained much lower among the poorest rural women without formal education (18%) compared with the richest urban women with secondary or higher education (99%). Professional attendance at delivery increased by 50% (from 9% to 14%, more rapidly in rural than urban areas), and caesarean sections trebled (from 2% to 6%), but these indicators remained low even by developing country standards. Within these trends there were huge inequalities; 86% of live births among the richest urban women with secondary or higher education were attended by a health professional, and 35% were delivered by caesarean section, compared with 2% and 0.1% respectively of live births among the poorest rural women without formal education. The trend in professional attendance was entirely confounded by socioeconomic and demographic changes, but education of the woman and her husband remained important determinants of utilization of obstetric services.</p> <p>Conclusion</p> <p>Despite commendable progress in improving uptake of antenatal care, and in equipping health facilities to provide emergency obstetric care, the very low utilization of these facilities, especially by poor women, is a major impediment to meeting MDG-5 in Bangladesh.</p