Pathways to Family Success Final Evaluation Report

This report presents findings from the second year of the evaluation of the Pathways to Family Success Programs (PFS) funded by the Department of Elementary and Secondary Education (ESE) and conducted by the Center for Social Policy (CSP) for the period September 2010 through June 2011. The 2010-2011 evaluation aimed to determine the extent to which PFS activities and interventions were effective in supporting learning outcomes and goal attainment for participating families and their children, and to identify strengths and areas of growth for the PFS Programs and partners. There were four Program sites implementing the PFS indepth project during the second year evaluation period. These leading agencies for the PFS sites included the following: Cambridge Community Learning Center Greater Lawrence Community ActionCouncil, Inc. Holyoke Public Schools Berkshire Children and Families, Inc. The evaluation design involved gathering information on three different outcome levels: the first level includes outcomes for adults, children and families; the second includes outcomes at the program level, and the third focuses on outcomes for the community partnership as a whole. The evaluation utilized a mixed-method approach including both qualitative and quantitative methods and a range of data sources to answer the research questions related to the PFS indepth projects and community partnerships. The evaluation team also conducted case studies of a sample of Pathways Families by interviewing two families from each Pathways site at two points in time

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Microfinance: A tool for financial access, poverty alleviation or gender empowerment? – Empirical findings from Pakistan

In just 30 years microfinance has transformed from a credit-based rural development scheme that has claimed to reduce poverty and empower poor women, to a $70 billion financial industry. In the process, the traditional NGO-led model has given way to commercialized institutions, resulting in an increased emphasis on profitmaking. This has also led to confusion in the sector around its mission: is it to alleviate poverty and empower poor women or simply to provide the "unbanked" with access to formal sources of finance? This research considers the main debates in microfinance with regard to its mission and presents empirical evidence on the effectiveness of microfinance. The study is based on the Pakistani microfinance sector, which provides an ideal opportunity for a comparative analysis of two distinct models of microfinance – the nonprofit microfinance institutions (MFI) and the microfinance banks (MFB). The research compares the depth of outreach, mission, practice, and borrower experiences of MFIs and MFBs, employing a political economy framework. The data includes 140 interviews with policymakers, donors, senior, mid and low-level microfinance officers, and their clients; as well as observations of practitioner-client interactions, including the process of disbursement and collection, group meetings, and field visits with loan officers in urban Pakistan. It also comprises two district-level surveys: the microfinance outreach survey from the Pakistan Microfinance Network (PMN) and the Government of Pakistan's Social and Living Standards Survey (PSLM). The surveys are analyzed econometrically to test whether district-level socioeconomic differences affect patterns of outreach. This study broadens our understanding of the extent to which the local political economy shapes the outcomes of a market-based intervention, such as microfinance. It also provides an insight into the evolution of microfinance, specifically as framed by the global development discourse and subsequent public policy choices. Finally, the study provides an authoritative account of how institutional structure affects microfinance's effectiveness as a tool for poverty alleviation, empowerment and financial access

Massachusetts\u27 System Redesign to End Homelessness: An Overview and Assessment

The Clayton-Mathews and Wilson 2003 analysis of Massachusetts’ expenditures of state and federal dollars to address family homelessness documented a serious system misalignment of public resources: that is, 80% of state and federal resources were tied up in shelter provision, while only 20%, including rental assistance, were designated for homelessness prevention (Clayton-Matthews and Wilson, 2003). Their analysis demonstrated what many had long suspected: if homelessness is to be ended in Massachusetts, fundamental changes would be needed to shift the state system from shelter-oriented toward prevention-oriented. Both the Romney and the Patrick administrations have clearly prioritized this objective with broad-based support and involvement from public, philanthropic, business and nonprofit stakeholders. This essay begins with an overview of the system redesign components being implemented by the state administration, as well as those proposed by the Governor which require legislative approval. Following this overview are the research team’s perspectives on these changes, grounded in what is known about effective homelessness prevention strategies and what has been learned through the project team’s other analytical work. The essay ends with the research team’s recommendations

Massachusetts\u27 System Redesign to End Homelessness: An Overview and Assessment

The Clayton-Mathews and Wilson 2003 analysis of Massachusetts’ expenditures of state and federal dollars to address family homelessness documented a serious system misalignment of public resources: that is, 80% of state and federal resources were tied up in shelter provision, while only 20%, including rental assistance, were designated for homelessness prevention (Clayton-Matthews and Wilson, 2003). Their analysis demonstrated what many had long suspected: if homelessness is to be ended in Massachusetts, fundamental changes would be needed to shift the state system from shelter-oriented toward prevention-oriented. Both the Romney and the Patrick administrations have clearly prioritized this objective with broad-based support and involvement from public, philanthropic, business and nonprofit stakeholders. This essay begins with an overview of the system redesign components being implemented by the state administration, as well as those proposed by the Governor which require legislative approval. Following this overview are the research team’s perspectives on these changes, grounded in what is known about effective homelessness prevention strategies and what has been learned through the project team’s other analytical work. The essay ends with the research team’s recommendations

A Comparison Between Online and on-campus Classes: Taking University Students’ Perspective

During the current pandemic Covid-19, the universities had to start their online classes instead of traditional on-campus classes. The students are a pivotal point as well as a significant stakeholder of education, so they must be given the opportunity for expressing their perspectives in this regard. So, this study aimed to investigate university students' perceptions regarding online and on-campus classes. The students’ perspectives were further compared regarding the abovementioned to get insight into what they prefer to be taught with. The survey was conducted for this study. The sample consisted of 440 university students enrolled in the BS Program at three public whereas three private universities at Lahore. The sample includes students of both genders (male=221, female=219). The instrument for data collection was developed by the researcher which was consisted of five point Likert’s rating scale with 40 items. Based on findings, it is concluded that overall university students prefer to learn through on-campus classes as compared to online classes. Moreover, males students are more inclined towards learning through online classes, whereas female students were in favor of on-campus classes