RESUMO
BACKGROUND: Globally, child mortality rate has remained high over the years, but the figure can be reduced through proper implementation of spatially-targeted public health policies. Due to its alarming rate in comparison to North American standards, child mortality is particularly a health concern in Mexico. Despite this fact, there remains a dearth of studies that address its spatio-temporal identification in the country. The aims of this study are i) to model the evolution of child mortality risk at the municipality level in Greater Mexico City, (ii) to identify municipalities with high, medium, and low risk over time, and (iii) using municipality trends, to ascertain potential high-risk municipalities. METHODS: In order to control for the space-time patterns of data, the study performs a Bayesian spatio-temporal analysis. This methodology permits the modelling of the geographical variation of child mortality risk across municipalities, within the studied time span. RESULTS: The analysis shows that most of the high-risk municipalities were in the east, along with a few in the north and west areas of Greater Mexico City. In some of them, it is possible to distinguish an increasing trend in child mortality risk. The outcomes highlight municipalities currently presenting a medium risk but liable to become high risk, given their trend, after the studied period. Finally, the likelihood of child mortality risk illustrates an overall decreasing tendency throughout the 7-year studied period. CONCLUSIONS: The identification of high-risk municipalities and risk trends may provide a useful input for policymakers seeking to reduce the incidence of child mortality. The results provide evidence that supports the use of geographical targeting in policy interventions.
Assuntos
Mortalidade da Criança , Teorema de Bayes , Criança , Cidades , Humanos , México/epidemiologia , Análise Espaço-TemporalRESUMO
Solid waste management in many cities of developing countries is not environmentally sustainable. People traditionally dispose of their solid waste in unsuitable urban areas like sidewalks and satellite dumpsites. This situation nowadays has become a serious public health problem in big Latin American conurbations. Among these densely-populated urban spaces, the Colombia's capital and main city stands out as a special case. In this study, we aim to identify the factors that shape the attitudes towards source-separated recycling among households in Bogotá. Using data from the Colombian Department of Statistics and Bogotá's multi-purpose survey, we estimated a multivariate Probit model. In general, our results show that the higher the household's socioeconomic class, the greater its effort for separating solid wastes. Likewise, our findings also allowed us to characterize household profiles regarding solid waste separation and considering each socioeconomic class. Among these profiles, we found that at lower socioeconomic classes, the attitudes towards solid waste separation are influenced by the use of Internet, the membership to an environmentalist organization, the level of education of the head of household and the homeownership. Hence, increasing the education levels within the poorest segment of the population, promoting affordable housing policies and facilitating Internet access for the vulnerable population could reinforce households' attitudes towards a greater source-separated recycling effort.
Assuntos
Opinião Pública , Reciclagem , Eliminação de Resíduos , Atitude , Cidades , Colômbia , Fatores SocioeconômicosRESUMO
Abstract This article aims to assess the impact of the Child Growth, Development and Care Program in the Caribbean region of Colombia by analyzing variables such as maternal childcare practices and indicators of the nutritional status and health of children under the age of five. To this end, the authors used the quasi-experimental technique Propensity Score Matching. Positive impacts included a decrease in acute diarrheal disease, and an increase in immunization and seeking treatment for acute respiratory infection or fever symptoms. However, the program had little influence on chronic and acute malnutrition in the region.
Resumen Este artículo tiene como objetivo evaluar el impacto del Programa de Crecimiento y Desarrollo y el Cuidado del Niño en la región Caribe de Colombia. La evaluación se efectúa sobre variables como el estado nutricional, indicadores antropométricos y salud de los niños menores de cinco años de edad y las prácticas maternales de cuidado infantil. Para este propósito se emplean técnicas cuasi-experimentales de emparejamiento tipo Propensity Score Matching. Entre los resultados de la evaluación se encuentran una disminución de la enfermedad diarreica aguda, una inmunización más alta y la búsqueda de tratamiento para atender síntomas de infección respiratoria aguda o fiebre. Sin embargo, el programa tuvo poca influencia sobre la desnutrición crónica y desnutrición aguda en la región.
Resumo Este artigo tem como objetivo a avaliação do impacto do Programa de Crescimento, Desenvolvimento e Cuidado Infantil na região do Caribe colombiano. A avaliação é realizada em variáveis como status nutricional, indicadores antropométricos, saúde das crianças menores de cinco anos de idade e as práticas de cuidados infantis maternos. Para isso, são utilizadas técnicas quase experimentais do tipo Propensity Score Matching. Entre os resultados da avaliação, verificou-se uma diminuição da doença diarreica aguda, uma imunização mais alta e a busca pelo tratamento de sintomas de infecção respiratória aguda ou febre. Porém, o programa teve pouca influência sobre a desnutrição crônica e a desnutrição aguda na região.
Assuntos
Pré-Escolar , Humanos , Lactente , Recém-Nascido , Desenvolvimento Infantil/fisiologia , Avaliação de Programas e Projetos de Saúde , Pesos e Medidas Corporais , Região do Caribe , Fenômenos Fisiológicos da Nutrição Infantil , Colômbia , Estado NutricionalRESUMO
This article aims to assess the impact of the Child Growth, Development and Care Program in the Caribbean region of Colombia by analyzing variables such as maternal childcare practices and indicators of the nutritional status and health of children under the age of five. To this end, the authors used the quasi-experimental technique Propensity Score Matching. Positive impacts included a decrease in acute diarrheal disease, and an increase in immunization and seeking treatment for acute respiratory infection or fever symptoms. However, the program had little influence on chronic and acute malnutrition in the region.
Assuntos
Desenvolvimento Infantil/fisiologia , Avaliação de Programas e Projetos de Saúde , Pesos e Medidas Corporais , Região do Caribe , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Colômbia , Humanos , Lactente , Recém-Nascido , Estado NutricionalRESUMO
The Growth and Development Monitoring Programme is a longstanding early childhood social intervention in Colombia. The programme's goal is the prevention and early identification of problems affecting children's health and nutrition. To achieve this aim, the programme's basic strategy is to educate parents about the overall health care of infants. The objective of this study is to measure the impact of this programme on children's nutrition and health status and maternal child-care practices. To address potential selection bias, we employ quasi-experimental techniques. This article uses data from the Demographic Health Survey of 2010. The evidence suggests that the programme improved immunization status and the likelihood of health care for acute respiratory infection or fever. As expected, the programme has a greater impact on children from among the poorest people in the country. In the most advanced regions and for the beneficiaries of private health care, the effects of the programme have tended to be negligible. In this sense, our central policy recommendation is to optimize the programme for the poorest households in the country.
Assuntos
Serviços de Saúde da Criança , Saúde da Criança , Diagnóstico Precoce , Política de Saúde , Transtornos da Nutrição Infantil/prevenção & controle , Pré-Escolar , Colômbia , Humanos , LactenteRESUMO
The determinants of maternal and child health have been the recurrent topics of study in developing countries. Using the Demographic and Health Survey (2010) of Colombia, this study aimed to identify the determinants for professional antenatal care and institutional delivery, taking into account the interdependence of these two decisions, which we consider using a bivariate probit model. This study found that when certain factors affecting both the decision to seek prenatal care and giving birth in a hospital are neglected, the results of the estimates are inefficient. Estimates show that the effects of education, parity, regional location and economic status on institutional delivery tend to be underestimated in a univariate probit model. The results indicate that economic status, level of education, parity and medical-insurance affiliation influenced the joint likelihood of accessing professional antenatal care and delivering in a health facility. An important finding is that mothers with a higher level of education are 9 percentage points more likely to access these two health services compared with mothers who are illiterate. Another observed finding is the regional disparities. The evidence indicates that mothers in the Pacific Region, the poorest region of Colombia, are 6 percentage points less likely to access such services. Thus, the results indicate that the Colombian health policy should emphasize increasing the level of schooling of mothers and establish health facilities in the poorest regions of the country to ensure that women in need are provided with social health insurance.