Dataset Information

Impact of Maternal Death on Household Economy in Rural China: A Prospective Path Analysis.

ABSTRACT:

Objectives

The present study aimed to explore the inter-relationships among maternal death, household economic status after the event, and potential influencing factors.

Methods

We conducted a prospective cohort study of households that had experienced maternal death (n = 195) and those that experienced childbirth without maternal death (n = 384) in rural China. All the households were interviewed after the event occurred and were followed up 12 months later. Structural equation modeling was used to test the relationship model, utilizing income and expenditure per capita in the following year after the event as the main outcome variables, maternal death as the predictor, and direct costs, the amount of money offset by positive and negative coping strategies, whether the husband remarried, and whether the newborn was alive as the mediators.

Results

In the following year after the event, the path analysis revealed a direct effect from maternal death to lower income per capita (standardized coefficient = -0.43, p = 0.041) and to lower expenditure per capita (standardized coefficient = -0.51, p<0.001). A significant indirect effect was found from maternal death to lower income and expenditure per capita mediated by the influencing factors of higher direct costs, less money from positive coping methods, more money from negative coping, and the survival of the newborn.

Conclusion

This study analyzed the direct and indirect effects of maternal death on a household economy. The results provided evidence for better understanding the mechanism of how this event affects a household economy and provided a reference for social welfare policies to target the most vulnerable households that have suffered from maternal deaths.

SUBMITTER: Ye F

PROVIDER: S-EPMC4527779 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Publications

Impact of Maternal Death on Household Economy in Rural China: A Prospective Path Analysis.

Ye Fang F Ao Deng D Feng Yao Y Wang Lin L Chen Jie J Huntington Dale D Wang Haijun H Wang Yan Y

PloS one 20150806 8

<h4>Objectives</h4>The present study aimed to explore the inter-relationships among maternal death, household economic status after the event, and potential influencing factors.<h4>Methods</h4>We conducted a prospective cohort study of households that had experienced maternal death (n = 195) and those that experienced childbirth without maternal death (n = 384) in rural China. All the households were interviewed after the event occurred and were followed up 12 months later. Structural equation m ...[more]

PMID: 26247210

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Project description:ObjectiveTo assess the economic impact of maternal death on rural Chinese households during the year after maternal death.MethodsA prospective cohort study matched 183 households who had suffered a maternal death to 346 households that experienced childbirth without maternal death in rural areas of three provinces in China. Surveys were conducted at baseline (1-3 months after maternal death or childbirth) and one year after baseline using the quantitative questionnaire. We investigated household income, expenditure, accumulated debts, and self-reported household economic status. Difference-in-Difference (DID), linear regression, and logistic regression analyses were used to compare the economic status between households with and without maternal death.FindingsThe households with maternal death had a higher risk of self-reported "household economy became worse" during the follow-up period (adjusted OR = 6.04, p<0.001). During the follow-up period, at the household level, DID estimator of income and expenditure showed that households with maternal death had a significant relative reduction of US$ 869 and US$ 650, compared to those households that experienced childbirth with no adverse event (p<0.001). Converted to proportions of change, an average of 32.0% reduction of annual income and 24.9% reduction of annual expenditure were observed in households with a maternal death. The mean increase of accumulated debts in households with a maternal death was 3.2 times as high as that in households without maternal death (p = 0.024). Expenditure pattern of households with maternal death changed, with lower consumption on food (p = 0.037), clothes and commodity (p = 0.003), traffic and communication (p = 0.022) and higher consumption on cigarette or alcohol (p = 0.014).ConclusionCompared with childbirth, maternal death had adverse impact on household economy, including higher risk of self-reported "household economy became worse", decreased income and expenditure, increased debts and changed expenditure pattern.

Project description:BackgroundDigital technology and economy have profound impact on rural revitalization and become important initiatives to promote rural development. This study analyzes the spatial effect of digital economy on rural revitalization in Guangdong, China.MethodThe entropy weight method is used to evaluate the level of rural revitalization and digital economy in 20 prefecture level cities of Guangdong province during 2011-2021. Spatial panel model is used to analyze the spatial spillover effect of digital economy on rural revitalization. Threshold model is employed to analyze the marginal effects of the digital economy on rural revitalization. Heterogeneous analysis is made by grouping the prefecture-level cities into four regions: the Pearl River Delta (PRD), the East Wing, the West Wing and the Mountainous region.ResultsBoth the level of rural revitalization and digital economy development in every prefecture-level city experienced an increase during 2011-2021 and the PRD region take the lead in both the rural revitalization and digital economy. There is significant spatial spillover effect of digital economy on the rural revitalization as a whole (the coefficient is about 0.3537). However, in the regions with a low level of digital economic development, there is a negative impact (-0.1847) of the digital economy on rural revitalization; while in regions with medium or high level of digital economy, it has a significant positive effect (0.3835) on rural revitalization. The impact of digital economy on rural revitalization development is significantly greater in the PRD (0.3141), the East Wing (0.7215), the West Wing (0.5467) than in the mountainous region (0.2238).ConclusionsThere is significant spatial differentiation in the digital economy and rural revitalization. The digital economy has significant spatial spillover effect on the rural revitalization. And this effect is found out to have heterogeneous and non-linear characteristics. In order to promote rural revitalization, it is necessary to make full use of the digital economy and technology in rural areas. Besides, it is important to improve the digital skills and literary of the rural population so that the digital economy could play a greater role in rural revitalization.

Project description:Abstract The household energy mix has significant impacts on human health and climate, as it contributes greatly to many health- and climate-relevant air pollutants. Compared to the well-established urban energy statistical system, the rural household energy statistical system is incomplete and is often associated with high biases. Via a nationwide investigation, this study revealed high contributions to energy supply from coal and biomass fuels in the rural household energy sector, while electricity comprised ∼20%. Stacking (the use of multiple sources of energy) is significant, and the average number of energy types was 2.8 per household. Compared to 2012, the consumption of biomass and coals in 2017 decreased by 45% and 12%, respectively, while the gas consumption amount increased by 204%. Increased gas and decreased coal consumptions were mainly in cooking, while decreased biomass was in both cooking (41%) and heating (59%). The time-sharing fraction of electricity and gases (E&G) for daily cooking grew, reaching 69% in 2017, but for space heating, traditional solid fuels were still dominant, with the national average shared fraction of E&G being only 20%. The non-uniform spatial distribution and the non-linear increase in the fraction of E&G indicated challenges to achieving universal access to modern cooking energy by 2030, particularly in less-developed rural and mountainous areas. In some non-typical heating zones, the increased share of E&G for heating was significant and largely driven by income growth, but in typical heating zones, the time-sharing fraction was <5% and was not significantly increased, except in areas with policy intervention. The intervention policy not only led to dramatic increases in the clean energy fraction for heating but also accelerated the clean cooking transition. Higher income, higher education, younger age, less energy/stove stacking and smaller family size positively impacted the clean energy transition. In rural China, affordable modern energy was increasingly adopted for cooking, and clean energy carriers were also used more for space heating.

Project description:ObjectivesThis study aims to describe how household economies and health service utilisation of pregnant and postpartum women were affected during the pandemic.DesignA cross-sectional study.SettingThis study was conducted in the Anuradhapura district, Sri Lanka.ParticipantsThe study participants were 1460 pregnant and postpartum women recruited for the Rajarata Pregnancy Cohort during the initial stage of the COVID-19 pandemic.Primary and secondary outcome measuresHousehold economic (income, poverty, nutritional and health expenditures) and health service utilisation details during the COVID-19 pandemic were gathered through telephone interviews. Sociodemographic and economic data were obtained from the cohort baseline and analysed with descriptive and non-parametric analysis.ResultsOut of the 1460 women in the sample, 55.3% (n=807) were pregnant and 44.7% (n=653) were postpartum women. Of the total sample, 1172 (80.3%) women participated in the economic component. The monthly household income (median (IQR)=212.39 (159.29-265.49)) reduced (median (IQR)=159.29 (106.20-212.39)) in 50.5% (n=592) families during the pandemic (Z=-8.555, p<0.001). Only 10.3% (n=61) of affected families had received financial assistance from the government, which was only 46.4% of the affected income. The nutritional expenditure of pregnant women was reduced (Z=-2.023, p=0.043) by 6.7%. During the pandemic, 103 (8.8%) families with pregnant or postpartum women were pushed into poverty, and families who were pushed into poverty did not receive any financial assistance. The majority of women (n=1096, 83.3%) were satisfied with the free public health services provided by the public health midwife during the pandemic.ConclusionDuring the early stages of the pandemic, healthcare utilisation of pregnant women was minimally affected. Even before the country's current economic crisis, the household economies of pregnant women in rural Sri Lanka were severely affected, pushing families into poverty due to the pandemic. The impact of COVID-19 and the aftermath on pregnant women will have many consequences if the policies and strategies are not revised to address this issue.

Project description:ObjectivesTo identify factors associated with kinesiophobia (fear of movement) after cardiac hospitalisation and to assess the impact of kinesiophobia on cardiac rehabilitation (CR) initiation.DesignProspective cohort study.SettingAcademic Medical Centre, Department of Cardiology.ParticipantsWe performed a prospective cohort study in cardiac patients recruited at hospital discharge. In total, 149 patients (78.5% male) with a median age of 65 years were included, of which 82 (59%) were referred for CR.Primary and secondary outcome measuresWe assessed kinesiophobia with the Tampa Scale for Kinesiophobia (TSK). For this study, the total score was used (range 13-52). We assessed baseline factors (demographics, cardiac disease history, questionnaire data on anxiety, biopsychosocial complexity and self-efficacy) associated with kinesiophobia using linear regression with backward elimination. For linear regression, the standardised beta (β) was reported. Prospectively, the impact of kinesiophobia on probability of CR initiation, in the first 3 months after hospital discharge (subsample referred for CR), was assessed with logistic regression. For logistic regression, the OR was reported.ResultsModerate and severe levels of kinesiophobia were found in 22.8%. In the total sample, kinesiophobia was associated with cardiac anxiety (β=0.33, 95% CI: 0.19 to 0.48), social complexity (β=0.23, 95% CI: 0.06 to 0.39) and higher education (β=-0.18, 95% CI: -0.34 to -0.02). In those referred for CR, kinesiophobia was negatively associated with self-efficacy (β=-0.29, 95% CI: -0.47 to -0.12) and positively with cardiac anxiety (β=0.43, 95% CI: 0.24 to 0.62). Kinesiophobia decreased the probability of CR initiation (OR Range13-52 points =0.92, 95% CI: 0.85 to 0.99).ConclusionIn patients hospitalised for cardiovascular disease, kinesiophobia is associated with cardiac anxiety, social complexity, educational level and self-efficacy. Kinesiophobia decreased the likelihood of CR initiation with 8% per point on the TSK.

Project description:BACKGROUND:In recent years, attempts have been made to use mobile phone text messaging (short message service, SMS) to achieve positive results for a range of health issues. Reports on the impact of maternal education programs based on this widely available, inexpensive, and instant communication tool are sparse. OBJECTIVE:This study aimed to explore the impact of a maternal education program through text messaging. METHODS:We conducted a cluster randomized trial in a remote region in the Chinese province of Hunan between October 1, 2011, and December 31, 2012. We used county as the unit of randomization (a total of 10 counties), with half of the counties randomly allocated to the intervention arm (with maternal education material adapted from the World Health Organization being delivered by text messaging to village health workers and pregnant women alike) and the other half to the control arm (normal care without text messaging). Data on maternal and infant health outcomes and health behaviors were collected and compared between the 2 arms, with maternal and perinatal mortality as the primary outcomes. RESULTS:A total of 13,937 pregnant women completed the follow-up and were included in the final analysis. Among them, 6771 were allocated to the intervention arm and 6966 were allocated to the control arm. At the county level, the mean (SD) of maternal mortality and perinatal mortality rate were 0.0% (0.1) and 1.3% (0.6), respectively, in the intervention arm and 0.1% (0.2) and 1.5% (0.4), respectively, in the control arm. However, these differences were not statistically significant. At the individual level, there were 3 maternal deaths (0.04%) and 84 perinatal deaths (1.24%) in the intervention arm and 6 maternal deaths (0.09%) and 101 perinatal deaths (1.45%) in the control arm. However, the differences were again not statistically significant. CONCLUSIONS:Adequate resources should be secured to launch large-scale cluster randomized trials with smaller cluster units and more intensive implementation to confirm the benefits of the text messaging-based maternal education program suggested by this trial. TRIAL REGISTRATION:ClinicalTrials.gov NCT01775150; https://clinicaltrials.gov/ct2/show/NCT01775150 (Archived by WebCite at http://www.webcitation.org/74cHmUexo).

Dataset Information

Impact of Maternal Death on Household Economy in Rural China: A Prospective Path Analysis.

Objectives

Methods

Results

Conclusion

Publications

Impact of Maternal Death on Household Economy in Rural China: A Prospective Path Analysis.

Similar Datasets

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